In our previous post about Direct Messaging, we covered the major benefits of Direct Messaging. One of which being that Direct Messaging is part of Meaningful Use Stage 2 requirements. In this post we are going to dig into a few of the details behind what criteria is required for Meaningful Use Stage 2 and give a brief description of each, along with how MDToolbox helps with the criteria in our Direct Messaging system.

There are three different Meaningful Use Stage 2 criteria that require Direct Messaging:

 1) 170.314(b)(2) Transitions of care – create and transmit transition of care/referral summaries

In Stage 2, providers must be able to send Continuity of Care Documents (CCD/CDA) formatted summary files using Direct Messaging when they transition a patient or refer a patient to another provider or organization. B2 involves first creating the care summary file, which is required to have a minimum field set as well as be formatted in a certain XML format that all other health record systems will understand. And then secondly, transmitting the document via Direct Messaging. The objective requires that the messages are sent using the Direct Protocol which uses secure direct mail addresses and encryption exchange between the servers.   

Electronic Health Record systems can have a separate “Direct inbox” for sending the message or many implement a Send button right from the Chart workflow for the provider – making transfers of chart records streamlined. Some HISP/Direct Messaging vendors (like MDToolbox) offer an API or web services that allow sending the message from anywhere in the application per the EHRs needs. This allows an EHR testing on B2 to have a process that creates the care document and attaches it to a Direct Messaging email for the provider that not only meets the criteria but is a huge benefits to the end users. When the message is sent it becomes encrypted and can only be decrypted by the intended recipient’s system, keeping the patients data safe and secure.

 2) 170.314(b)(1) Transitions of care – receive, display and incorporate transition of care/referral summaries

In Stage 2, providers must also be able to receive these CCD/CDA and other care summary files from other providers and facilities. The first part of the criteria basically just requires having the ability to receive Direct messages. The messages can be received in a standalone inbox provided by your HISP or an embedded inbox within the EHR. Secondly, for this criteria, the EHR must be capable of displaying the received files (most of them XML formatted) in “Human Readable” or a nice formatted output for providers. The EHR needs to apply a stylesheet or other formatting so that the provider can see what was received for many types of files including the CCD/CDA, and other files like CCR (a different XML format).  And finally the criteria also involves incorporating the received attachments. The EHR must be able to upload both the document itself, and for CCD/CDA files be able to allow clinical information reconciliation of things like allergies and problem lists (allowing providers to optionally import data elements to the chart).

Electronic Health Records can incorporate an inbox right inside of the EHR with built in tools for incorporating when signing up with a HISP that offers an API/Web services (like MDToolbox). This gives huge benefits to the provider and makes this their most important (and best) inbox they monitor on a daily basis. With a few clicks, referral charts can be reviewed and filed in the electronic chart.

 3) 170.314(e)(1) View, download, and transmit to 3rd party

In Stage 2, patients must also have access to their CCD Summary of Care files and chart data. Not only do EHRs have to add the ability to view and download the summary from their “patient portal”, but they also need to give patients and their authorized agents the ability to securely transmit the care summary to other providers. The Transmit of the data is required to be done through direct messaging. Some third party vendors patient portals come with direct messaging, but for EHRs that have their own patient portal this becomes a challenge. EHRs must give their patients a new “Send” button that would allow entering another provider or facilities direct address and send it via the secure Direct messaging method.  

As thousands of providers and facilities around the country start taking advantage of the secure “Direct” messaging, it really gives them more than just a couple of check boxes on their meaningful use attestation - it’s a new and better way to transfer records, discuss patient care and communicate. It's more secure, more efficient and can be a great time saver over the traditional communication methods. 

Want more info on Meaningful Use or Direct Messaging API with MDToolbox? Check out our Direct Messaging page and contact us today at info@mdtoolbox.com. 

 Stay tuned for more posts in our 5 Part Direct Messaging Blog Series:

1. Direct Messaging 101
2. Top 5 Benefits of Direct Messaging
3. Direct Messaging and Meaningful Use Stage 2 – Transition of Care (this article)
4. How does Direct Messaging work – Details on how PHI stays secure
5. Direct Messaging and Data Exchange:  What types of files and data can EHRs exchange?