Stage 2 Requirements for Health Information Exchange (HIE) . . . The Challenges and Possible Solutions

In the past three years, physicians’ adoption rate of electronic health record systems (EHRs) has been growing steadily. This is largely due to their efforts to meet Stage 1 meaningful use requirements in order to receive financial incentives from the U.S. government.

The likelihood that you’re among the 72 percent of office-based physicians who’ve adopted an EHR system is high. And chances are you’re taking a closer look at the Stage 2 objectives and considering ways you can improve functionality and expand usage, including interoperability and the exchange of health information between physicians.

As a part of Stage 2, physicians are tasked with providing care summaries when they refer or transition patients to other healthcare providers. And this health information exchange includes three measures that physicians must meet:

1. Provide a summary of care record for more than 50 percent of referrals and transitions of care.2. Deliver summary of care records electronically for more than 10 percent of those cases.3. Conduct at least one successful electronic exchange of a summary of care record with a recipient that uses a different EHR technology.

Establishing better communication between healthcare providers sounds like a great way to enhance patient care, reduce costs, and improve public health. But many practices have run into issues while trying to make interoperability possible. The main challenge is that various practices, hospitals, and healthcare providers use different EHR systems—and those systems have difficulty communicating directly with one another.

So what can you do to overcome this challenge and still meet the Stage 2 requirements?

EHR vendors and the U.S. government are currently working to address the interoperability concerns and provide tools to meet meaningful use requirements. But in the meantime, many groups—integrated healthcare networks, hospital systems, and state and regional groups—are building their own exchange networks and setting common standards for sending health information electronically.

Depending on where your practice is located, you may have the opportunity to join one of these exchange networks in order to fulfill the meaningful use measures. You can find more information on healthcare information technology initiatives, including statewide and regional exchange networks, on the Healthcare Information and Management Systems Society (HIMSS) website.

Beyond exchange networks, other possible solutions may become available in 2014. One such option comes out of the Direct Project, which aims to provide a simple and secure way to send encrypted health information with a key focus on establishing technical standards. And for practices located in areas where many physicians are using the same EHR system, the Centers for Medicare and Medicaid Services (CMS) is building an EHR test site where physicians can exchange information with a provider who uses a different EHR system and fulfill that particular Stage 2 requirement.

If you’re struggling to find a way to meet Stage 2 requirements due to interoperability challenges, look into exchange networks in your area and get informed as to the standards and protocols they have in place. And as we approach 2014, stay in the loop regarding other groups’ developments, such as the Direct Project and CMS. The very nature of health information exchange requires physicians to work together, so remember that you’re not alone in the search for technology solutions.


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