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Note: Measure 2 of the Core - Percent of Transitions for which Summary of Care Provided report can be used in 2015 to attest for Objective 5: Health Information Exchange. |
Core Measure 15 of 17 for Meaningful Use Stage 2 (2014)
Report Name: Core - Percent of Transitions for which Summary of Care Provided
This report measures the percentage of transitions of care and referrals where a summary of care record was provided. It can be used to satisfy the following Meaningful Use objective and associated measures for reporting periods until 12/31/2014:
• Objective: The eligible professional who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide a summary care record for each transition of care or referral.
• Measure 1: The eligible professional who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals.
• Measure 2: The eligible professional who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 10 percent of such transitions and referrals either (a) electronically transmitted using CEHRT to a recipient or (b) where the recipient receives the summary of care record via exchange facilitated by an organization that is a NwHIN Exchange participant or in a manner that is consistent with the governance mechanism.
1 Determine the total number of transitions of care and referrals during the measurement period for an eligible professional. A transition of care or referral is counted when the following conditions are met:
• A transition of care or referral is provided through the faxing, messaging (clinical and Direct), CCD export, or printing functions of Care360 EHR.
• The reason for disclosure is set to either Referral or Transfer/Transition of Care Report.
• The eligible provider is either set as the Referring Provider or the eligible provider is logged into Care360 EHR and completes the transition of care or referral through faxing, messaging, CCD export, or printing.
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Note: If the recipient of the transition of care or referral belongs to the same organization as the referring provider, then it is excluded from the count. |
2 Determine the total number of transitions of care and referrals for which a summary of care was provided. Of the transitions of care and referrals determined in step 1, identify those transitions of care and referrals which include a summary of care record that contains, at minimum, the following information:
• Most recent smoking status
• Referring provider’s contact information
• All active problems and allergies
• All medications and immunizations
• Lab tests, results, and values for the last two years
• Procedures for the last two years
• Encounters with dates of service within the last 2 years
• Vital signs
• Cognitive and functional status
• Care plan; including goals and instructions
• Care team
• Patient demographics
• Reason for referral
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Notes: • If the problems, medications, and allergies lists contain non-compliant MU data or do not contain any data, then the transition of care or referral is not included in the count. • If substantial harm may come from disclosing information to the patient, selecting the Information withheld due to potential harm to the patient check box will allow you to hide information in the summary of care record and have the transition of care or referral included in the count. |
3 Divide the value in step 2 above by the value in step 1 above. The result is then multiplied by 100 to achieve the percentage.
The system uses the following steps to calculate the percentage:
1 Determine the total number of transitions of care and referrals during the measurement period for an eligible professional. A transition of care or referral is counted when the following conditions are met:
• A transition of care or referral is provided through the faxing, messaging (Labs & Meds and Direct), CCD export, or printing functions of Labs & Meds.
• The reason for disclosure is set to either Referral or Transfer/Transition of Care Report.
• The eligible provider is either set as the Referring Provider or the eligible provider is logged into Labs & Meds and completes the transition of care or referral through faxing, messaging, CCD export, or printing.
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Note: If the recipient of the transition of care or referral belongs to the same organization as the referring provider, then it is excluded from the count. |
2 Determine the total number of transitions of care and referrals that were received (by another entity) as a Direct message and for which a summary of care was provided. Of the transitions of care and referrals determined in step 1, identify those transitions of care and referrals which were sent as a Direct message, have been identified as received, and include a summary of care record that contains, at minimum, the following information:
• Most recent smoking status
• Referring provider’s contact information
• All active problems and allergies
• All medications and immunizations
• Lab tests, results, and values for the last two years
• Procedures for the last two years
• Encounters with dates of service within the last 2 years
• Vital signs
• Cognitive and functional status
• Care plan; including goals and instructions
• Care team
• Patient demographics
• Reason for referral
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Notes: • If the problems, medications, and allergies lists contain non-compliant MU data or do not contain any data, then the transition of care or referral is not included in the count. • If substantial harm may come from disclosing information to the patient, selecting the Information withheld due to potential harm to the patient check box will allow you to hide information in the summary of care record and have the transition of care or referral included in the count. |
3 Divide the value in step 2 above by the value in step 1 above. The result is then multiplied by 100 to achieve the percentage.