Health Information Technologies and Processes

CCD use for promoting interoperability score for CMS

  • 1.  CCD use for promoting interoperability score for CMS

    Posted 05-04-2020 11:11
    Do any of you currently receive CCD's from other facilities/physician offices?
    CMS requires that these CCD's be reconciled and compared to the hospital record before an inpatient stay. So basically a physician office would send it to the hospital prior to an inpatient stay and the hospital would compare the CCD to the hospital record (if there is a previous hospital record) to make sure everything is up to date in the record.

    If you do this currently, who preforms the reconciliation? We are seeing that the med list, med allergies, and problem list needs to be reconciled. We were trying to figure out the best person to do this efficiently and accurately.

    Mikki Medine
    Him Director
    Thibodaux Regional Medical Center

  • 2.  RE: CCD use for promoting interoperability score for CMS

    Posted 05-05-2020 10:08
    I help clinics with meeting this measure and would say who performs it is a two fold answer.  Partly it will depend on your physicians comfort level.  The other part will depend on what your EHR allows in the measure build.  Some clinics I work with the physician does it all because they are more hands on with documentation.  For the vast majority I work with, the nurse will do all the reconciliations.  I have seen some EHRs though that will not count a nurses reconciliation towards the numerator measure credit namely for the problem list reconciliation part of of the measure.  However, if you don't meet all three reconciliations, you can't pass the measure.  I am assuming the reason for this is because the measure states "the MIPS eligible clinician conducts clinical information reconciliation" however if you look further down in the measure specs, it has a bullet point that states "Non-medical staff may conduct reconciliation under the direction of the MIPS eligible clinician so long as the clinician or other credentialed medical staff is responsible and accountable for review of the information and for the assessment of and action on any relevant CDS".

    Also, just to note, this only needs to be done if the physician has never seen that patient before so depending on setting of care, you could be under 100 for the denominator and be excluded from the measure.  I have seen where some EHRs can flag a patient for being "new" to indicate to staff to do all these reconciliations but there are some that do not offer that functionality.

    I hope that is helpful!

    Diana Flood
    Clinical Consultant Ii

  • 3.  RE: CCD use for promoting interoperability score for CMS

    Posted 05-05-2020 13:09
    Edited by Loritta Black 05-05-2020 13:13
    It should be a person qualified to enter this type of information (problems, allergies, meds) into the medical record (i.e. physician, advanced practice nurse, etc.) Many EHRs have a provider workflow or module to enable receipt and reconciliation of CCDs.

    Lori Black, RHIA, CCS, CHTS-IM
    HIM Director
    INTEGRIS Health