Interfaces/Electronic Transmissions

I have an engine that is owned and maintained by my IT staff. Can I configure the interfaces required for Meaningful Use or do I have to purchase an Evident-configured interface?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

The universal feeds do not include the internal mapping and/or translations utilized to meet the implementation guidelines/criteria outlined in the Meaningful Use objectives and therefore cannot be used for Meaningful Use attestation.

How far in advance do I need to place orders for required interfaces?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

Orders need to be placed as soon as possible. The minimum lead time for all interface orders is 90 days. Interfaces must be purchased in production prior to the start of the Meaningful Use reporting period.

Why is a separate interface order needed for each AR?
  • MU-EP-Stage 1-System Requirements
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-System Requirements
  • MU-EP-Stage 2-Interfaces

Interfaces are configured on an AR basis – meaning the company, all directories/sub-directories and associated setup for the HIS functionality must be in place and then the interface configuration in Linux, in the software tables and in the Interface Management System (IMS) can be set up. Each company has an ARID and a FACID which drive the interface configuration as all HL7 messages must contain these identifiers to ensure the data in the message is routed appropriately. Interface setup/configuration/maintenance and support all starts with an order as we have to schedule and allocate the appropriate resources to make the interface work, as well as ensure documentation reflects what is set up and expected to be supported/managed with software updates and changes.

My facility utilizes a separate product for patient access to our website for accounting needs and well-being instructions. Can the Thrive Patient Portal be linked to this portal product for the View/Download/Transmit objective that Evident plans to implement through the portal?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

No, the email triggers, statistic tracking, etc. require use of the Thrive Patient Portal to meet the View, Download & Transmit objective.

If my public health agency is unable to accept the reporting data in an HL7 v2.5.1 message, or requires validation of multiple transmissions before allowing my facility to move to a production status, can Evident provide a letter of exclusion for that objective?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

Only the public health agencies or an authorized entity of the state can provide exemption or exclusion status. This documentation must be stored with the rest of your attestation information for audit purposes. It is also recommended that the facility provide a copy of the exclusion to Evident for audit/tracking purposes.

We participate in a Regional Health Information Organization (RHIO) and they have the ability to submit public health reporting data for the RHIO participants. Can I use the interface to the RHIO to satisfy all the public health reporting objectives?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

A Health Information Exchange (HIE) or Regional Health Information Organization (RHIO) is not required to certify for Meaningful Use and may not meet the federal requirements that are included in the Meaningful Use audits. Keep in mind that the interface is typically developed per the HIE/RHIO specifications, not the federal guidelines. Given this, Evident recommends that you confirm with the RHIO/HIE, and with the state to whom the reportable data is sent, that use of the HIE/RHIO for attestation to the public health reporting objectives will comply with federal regulations and standards and ensure you pass an Meaningful Use audit should one be issued for your facility.

How can I make sure the Syndromic Surveillance interface includes all the required data for public health reporting?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

Syndromic Surveillance interfaces typically send demographic data as well as the patient’s chief complaint. It is Evident’s recommendation that each facility transition the chief complaint field in the Census tab to a required field, thereby ensuring it’s included with every registration.

Do third party vendors that send data to the Thrive System have to be Meaningful Use certified?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

No, the third party systems do not have to be certified since the Thrive EHR is the certified product for attestation. However, if Thrive is using data received from a third party system to meet interoperability requirements, all data elements and formatting must comply with the implementation guidelines needed to attest. For instance, in order for Thrive to transmit lab results to the public health agencies in the manner outlined in the implementation guide, ie: structured and with LOINC/SNOMED-CT, that information must be received from any laboratory vendor that sends results to the HIS.

I have a third party vendor that sends data to Evident in HL7 v2.3 and this data will be included in what is transmitted for public health reporting. Does that vendor have to start sending the data in HL7 v2.5.1 or can we up-convert the current data stream to meet the criteria that requires HL7 v2.5.1 for interfaces?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

Technically, yes. We can convert HL7 v2.3 to v2.5.1 but all of the required data elements must be included in the v2.3 message for it to be successfully updated to the public health agency.

How are immunizations sent to the state registry? Is this interface performed automatically, or does the staff need to select a certain option when charting?
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

Transmission depends on the public health agency. Some states utilize Public Health Information Network Messaging System (PHIN-MS), File Trasnfer Protocol (FTP) or batch transmissions and others that require real-time updates – all via an HL7 v2.5.1 message. For immunization reporting, the software is designed with logic that automatically generates a message in the background so charting of immunizations is all that the staff need to do to initiate. There is setup in the software at the item level to ensure administration charting includes lot number and expiration date.

How should I help my physicians select menu objectives for the Meaningful Use Incentive Programs?
  • MU-EP-Stage 1-Interfaces

EPs are required to report on a total of five Meaningful Use objectives from the menu set. Of the five menu objectives, EPs must choose at least one option from the public health menu set. The general recommendation is that if an EP is able to meet the measure of one of the public health menu objectives but can be excluded from the other, the EP should select and report on the public health menu objective they are able to meet. CMS further clarifies with the following statement:

"If an EP can be excluded from both public health menu objectives, the EP should claim an exclusion from only one public health objective and report on four additional menu objectives from outside the public health menu set."

With the increased demand for EHR integration, what is Evident doing to facilitate this process between third party systems and the Thrive system?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

Evident is doing everything we can to encourage interoperability opportunities, to accelerate development and to deploy our piece of the integration progression in a timely manner. Every interface requires the coordination of three different organizations: Evident (the EHR vendor), the third party vendor and the facility, along with the various timelines of each group. In addition, it is the responsibility of the facility to validate every interface. While it may only take a week or two to actually deploy the interface, the testing and validation process can take much longer.

Do I have to purchase a separate interface for immunizations if the clinic runs as a department of the hospital?
  • MU-EP-Stage 1-System Requirements
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-System Requirements
  • MU-EP-Stage 2-Interfaces

No, clinics that are considered to be departments of the hospital (housed within the hospital AR) are not required to purchase an additional immunization interface. Separate interface orders are needed for each additional clinic AR.

If the immunization registry that I am required to submit information to only accepts transmissions using the HL7 2.3.1 standard, will I qualify for an exclusion since Evident was certified using HL7 2.5.1 standard?
  • MU-EH-Stage 1-Interfaces
  • MU-EP-Stage 1-Interfaces

Technically, yes because the transmissions sent from the Thrive system must be per the configuration and format utilized in the EHR certification. However, keep in mind that in Stage 1, the CMS guideline includes provisions for an unsuccessful test to submit electronic data to public health agencies to be considered valid.

CMS addressed a similar question with the following:

"If the immunization registry does not accept information in the standard to which your EHR technology has been certified-that is, if your EHR is certified to the HL7 2.3.1 standard and the immunization registry only accepts HL7 2.5.1, or vice versa-and if the immunization registry is the only immunization registry to which you can submit such information, then you can claim an exclusion to this Meaningful Use objective because the immunization registry does not have the capacity to receive the information electronically. The capacity of the immunization registry is determined by the ability of the immunization registry to test with an individual EP or eligible hospital. An immunization registry may have the capacity to accept immunization data from another EP or hospital, but if for any reason (e.g. waiting list, on-boarding process, other requirements, etc) the registry cannot test with a specific EP or hospital, that EP or hospital can exclude the objective. It is the responsibility of the EP or hospital to document the justification for their exclusion (including making clear that the immunization registry in question is the only one it can submit information to). If the immunization registry, due to State law or policy, would not accept immunization data from you (e.g., not a lifespan registry, etc), you can also claim the exclusion for this objective. Please note, this FAQ applies in principle to all of the Stage 1 public health meaningful use measures (syndromic surveillance and reportable lab conditions)."

Where can I find a list of public health agencies and immunization registries to submit my data as required by the public health objectives for the Medicare and Medicaid EHR Incentive Programs?
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

For information and/or instructions on where to submit your public health-related data, please contact your local or state public health agencies and immunization registries.

When a patient is registered in Thrive and upon inquiry they respond that they have not received any immunizations since their last visit, should I document that no vaccine was administered in the immunizations menu?
  • MU-EH-Stage 1-Interfaces
  • MU-EH-Stage 2-Interfaces
  • MU-EP-Stage 1-Interfaces
  • MU-EP-Stage 2-Interfaces

No. If the patient has not had any vaccines administered since their last visit, no new entry should be added to the immunization entry menu. Each entry made in this menu creates a record that is subsequently sent to your immunization registry via the public health interface. Each record should contain the vaccine that was received by the patient, or an explanation as to why the patient did not receive a vaccination. For example, CVX code 998 is utilized in the CPSI software to document that no vaccine was administered due to evidence of immunity. Evidence of immunity indicates that a person has plausible evidence that they have already developed immunity to a particular disease and further immunization against the disease is not likely to provide benefit. When a user selects "No vaccine administered" (CVX 998) in immunization entry, the Evidence of Immunity field should be addressed to attach an applicable SNOMED code and description to indicate that a patient is immune to a specific disease.

In summary, if the patient has not received any vaccines at any other facility since their last visit at your facility, no entry should be made in the immunization entry menu.