Continuity Of Care Document and Meaningful Use Stage 2

Exchanging patient clinical summaries during all transitions of care not only leads to improved patient outcomes, but it is also a federally mandated objective. The continuity of care document implements a standard for the data exchange to ensure the information is accepted and usable by all participating systems.

First thing to note down is that CCR and CCD (the C32 version) are no longer included in the Stage 2 ruling. Consolidated CDA is the new document standard for Stage 2 Meaningful Use. The selected standard, known as the Consolidated Clinical Document Architecture (C-CDA) was developed by Health Level 7 and includes nine document types, one of which is an updated version of the CCD.

These documents must be capable of including data elements known as the “Common MU Data Set” that include: Patient name, sex, date of birth, race, ethnicity, preferred language, smoking status, problems, medications, medication allergies, laboratory tests, laboratory values/results, vital signs, care plan fields including goals and instructions, procedures and care team members. In addition encounter diagnoses, immunizations, referral reason and discharge instructions may be required base on context.

For stage 2 the EMR/EHR system need to be compliant and be able to

  • Receive Summary Care Record Using Direct
  • Display Summary of Care Record
  • Create Transition of Care/Referral Summary
  • Transmit Health Information to a Third Party Using Direct

The Direct Project was launched by the ONC within Health and Human Services (HHS) on March 1, 2010. It was initially called NHIN Direct. The object of the Direct Project is to replace the use of faxes, phones, and paper transactions with a simple and secure point-to-point communication over the Internet. Pls refer

From certification point of view one would need to use Direct Certificate Discovery Testing Tool. This tool was created to support automated testing of systems that plan to enact the Certificate Discovery and Provider Directory Implementation Guide. Pls refer

There are third party platforms which provides certified Direct messaging platform which can be used easily by healthcare providers. So now need is there, specification is there, mandation is there, tools are there and infrastructure is there. I hope this would be smooth transition to achieve interoperabilty and exchange health information between various stake holders.

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