Summary of Care

The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral.

EPs must satisfy both of the following measures in order to meet the objective:

Measure 1:
• The EP 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 EP 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 ONC establishes for the NwHIN.

Measure 3:
An EP must satisfy one of the following criteria:
• Conducts one or more successful electronic exchanges of a summary of care document, as part of which is counted in "measure 2" (for EPs the measure at §495.6(j)(14)(ii)(B) with a recipient who has EHR technology that was developed designed by a different EHR technology developer than the sender's EHR technology certified to 45 CFR 170.314(b)(2).
• Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting period.

Exclusions - Any EP who transfers a patient to another setting or refers a patient to another provider less than 100 times during the EHR reporting period is excluded from all three measures. 

 

Measure Numerator

MEASURE 1:
The number of transitions of care and referrals in the denominator where a summary of care record was provided.

THRESHOLD:
The percentage must be more than 50 percent in order for an EP to meet this measure.

MEASURE 2:
The number of transitions of care and referrals in the denominator where a summary of care record was 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 ONC establishes for the nationwide health information network. The organization can be a third-party or the sender's own organization.

THRESHOLD:
The percentage must be more than 10 percent in order for an EP to meet this measure.

MEASURE 3:
The EP attests YES to one of the two criteria:
1. Conducts one or more successful electronic exchanges of a summary of care document, as part of which is counted in "measure 2" (for EPs the measure at §495.6(j)(14)(ii)(B) with a recipient who has EHR technology that was developed designed by a different EHR technology developer than the sender's EHR technology certified to 45 CFR 170.314(b)(2).
OR
2. Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting period.

 

Measure Denominator

MEASURE 1:
Number of transitions of care and referrals during the EHR reporting period for which the EP was the transferring or referring provider.

MEASURE 2:
Number of transitions of care and referrals during the EHR reporting period for which the EP was the transferring or referring provider.