Posted on behalf of Jeff Ford, Senior Director of Client Services

Promoting Interoperability, formerly known as Meaningful Use, was established by the 2009 American Recovery and Reinvestment Act. Its focus was on three components:

  • Using certified EHR in a meaningful manner
  • Exchanging health information electronically in a way that improves the quality of care, and
  • Using certified EHR to submit clinical quality and other measures

You’ve worked hard to reach your Promoting Interoperability standards. As part of this, you have set up direct messaging from your HCIS to a chosen HISP.

The HISP sends the Message Disposition Notification (MDN) back to your engine and that’s where the communication stops. The MDNs are your certainty of receipt of your HIE messages. Integration engines are a fine suppository for these, but what if your HCIS is better? Your HCIS probably has much better reporting tools than your engine. Your users are more familiar with your HCIS, so looking there for your MDNs would be more intuitive. Plus, there is a far less likely chance that someone would mistakenly delete these receipts if they lived in your HCIS instead of in your engine. It makes sense to do your attestation out of your HCIS, if possible.

The problem, as always, is in the details. MDNs are very specific and differ slightly from HISP to HISP. Your HCIS has very specific expectations for these and is not willing to customize. And MDNs are not as simple as just a standard HL7 translation. In my experience, most HCIS are expecting a multipart message while most HISPS are sending a single, plaintext message.

So how can you get over this hurdle? A strong integration engine is the key to solving a lot of your problems. Your engine can interrogate the plain text, extract the required fields, and generate an acceptable multipart message. In this case, the ability of your engine to translate plaintext to whatever format your HCIS wants gives you the ability to complete your attestation completely within your HCIS.   When it comes to passing audits, the simpler the better!

If you currently have the Summit Exchange integration engine, and would like to attest out of your HCIS instead, this can be accomplished entirely within the engine.  If you have the expertise in-house this can be completed with the mapper.  If you do not have a Summit Exchange expert, please reach out to your account rep or me, [email protected], for further information.