For use with CEHRT certified to the 2015 edition.
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient’s health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programming Interface (API) in the MIPS eligible clinician’s certified electronic health record technology (CEHRT).
|Provider to Patient Exchange||Provide Patients Electronic Access to Their Health Information||40 points|
The number of patients in the denominator (or patient authorized representative) who are provided timely access to health information to view online, download, and transmit to a third party and to access using an application of their choice that is configured meet the technical specifications of the API in the MIPS eligible clinician’s CEHRT.
The number of unique patients seen by the MIPS eligible clinician during the performance period.
Definition of Terms & Additional Information
API or Application Programming Interface – A set of programming protocols established for multiple purposes. APIs may be enabled by a health care provider or provider organization to provide the patient with access to their health information through a third-party application with more flexibility than is often found in many current “patient portals.”
Provide Access – When a patient possesses all of the necessary information needed to view, download, or transmit their information. This could include providing patients with instructions on how to access their health information, the website address they must visit for online access, a unique and registered username or password, instructions on how to create a login, or any other instructions, tools, or materials that patients need in order to view, download, or transmit their information. Information that must be made available to patients:
- Patient name
- Provider’s name and office contact information
- Current and past problem list
- Encounter diagnosis
- Laboratory test results
- Current medication list and medication history
- Current medication allergy list and medication allergy history
- Vital signs (height, weight, blood pressure, BMI, growth charts)
- Smoking status
- Functional status, including activities of daily living, cognitive and disability status
- Unique device identifier(s) for a patient’s implantable device(s)
- Demographic information (preferred language, sex, race, ethnicity, date of birth)
- Care plan field(s), including goals, health concerns, assessment, plan of treatment and instructions
- Any known care team members including the primary care provider (PCP) of record
Timely Access – CMS defines “timely” as within 4 business days of the information being available to the MIPS eligible clinician.
Unique Patient – If a patient is seen by a MIPS eligible clinician more than once during the performance period, then for purposes of measurement, that patient is only counted once in the denominator for the measure. All the measures relying on the term ‘‘unique patient’’ relate to what is contained in the patient’s medical record. Not all of this information will need to be updated or even be needed by the MIPS eligible clinician at every patient encounter. This is especially true for patients whose encounter frequency is such that they would see the same MIPS eligible clinician multiple times in the same performance period.