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EHR: Summary of Care

This information is old and has been replaced by the Modifed Stage 2 requirements per the Final Rule, 10/7/2015. For new requirements, see EHR Objective 5 Health Information Exchange.

EHR Stage 1: Menu Measure 7
EHR Stage 2: Core Measure 15

Overview

This measure requires that you provide a Summary of Care record when a patient is referred to another provider. Summary of care records are intended to ensure coordination and continuity of health care.

Stage 1: Provide summaries of care for outgoing referrals to another provider. They can be sent electronically, exported, or printed.

Stage 2: There are three parts to the measure:

    1. Provide summaries of care for outgoing referrals to another provider (same as Stage 1).
    2. A certain percentage of summaries of care must be sent electronically. 
    3. Electronically exchange at least one summary of care with a provider who uses a different EHR certied technology, or with a CMS designated test EHR.

Exclusions Available? Yes

Resources:

Calculations

Stage 1: Summaryof Care:

  • Denominator:  Number of outgoing Referrals TO another provider (must be a doctor) during the reporting period.
  • Numerator: Number of referrals in the denominator to whom a summary of care was provided (printed, by Email, or exported).  Creating a Referral automatically provides a summary of care to the patient portal and affects the numerator.

Stage 2: There are two calculations. There is also one yes/no measure.

  1. SummaryofCare:  Calculated the same as in Stage 1 (see above).
  2. SummaryofCareElectronic: 
    • Denominator:  Number of outgoing Referrals TO another provider (must be a doctor) during the reporting period. 
    • Numerator: Referrals in the denominator to whom a summary of care was sent electronically (by Email or exported),
  3. Electronically exchange one or more summaries of care with a recipient who uses a different EHR certified software, or with a CMS designated test EHR. 
    This is a yes/no measure and not based on a percentage calculation. Retain supporting documentation that the exchange was successful. 

Currently there are only two CMS designated test EHRs and they both require that a provider is Direct Trust (DT) accredited (which most Open Dental users will not be). 

  • If you are not DT accredited AND in common practice do not exchange summaries of care with recipients who use different EHR certified software, CMS has said you can retain documentation on your circumstances and attest Yes to meeting measure #3, as long as you are using a certified EHR software which meets the standards required to send a CCDA (Open Dental is).  See CMS FAQ: https://questions.cms.gov/faq.php?id=5005&faqId=11666
  • If you are DT accredited, you can use the NIST EHR Randomizer Application (https://ehr-randomizer.nist.gov/ehr-randomizer-app/#/home).

Setup

EHR General Setup

Electronic Exchange Requirements: Parts 2 and 3 of Stage 2 require setting up Direct Messaging. You have two options:

  1. Email summaries of care directly from Open Dental. You must obtain and install Email Security Certificates, then host the public certificates in DNS.  See Public Certificate Hosting.
  2. Contract with a Health Information Service Provider (HISP) to perform authentication, encryption, and trust verification on your behalf. You can then export summaries of care and use the HISP to send securely.

Instructions

Generate a Summary of Care
Send an Email
Email Inbox

 

Open Dental Software 1-503-363-5432