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Support Electronic Referral Loops by Sending Health Information


Measure description

For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider — (1) creates a summary of care record using certified electronic health record technology (CEHRT); and (2) electronically exchanges the summary of care record.

* Reporting this measure, along with the Electronic Referral Loops by Receiving and Reconciling Health Information measure, are an alternative to the HIE Bi-Directional Exchange measure, or the Enabling Exchange Under the Trusted Exchange Framework and Common Agreement (TEFCA) measure (HIE_5, or HIE_6) 

 ObjectiveMeasureMaximum Points
 Health Information ExchangeSupport Electronic Referral Loops by Sending Health Information15 points

Reporting requirements


The number of transitions of care and referrals in the denominator where a summary of care record was created using CEHRT and exchanged electronically.


Number of transitions of care and referrals during the performance period for which the MIPS eligible clinician was the transferring or referring clinician.


Any MIPS eligible clinician who transfers a patient to another setting or refers a patient fewer than 100 times during the performance period.

Definition of terms and additional information

Transition of care – The movement of a patient from one setting of care (hospital, ambulatory primary care practice, ambulatory, specialty care practice, long-term care, home health, rehabilitation facility) to another. At a minimum this includes all transitions of care and referrals that are ordered by the MIPS eligible clinician.

Referral – Cases where one provider refers a patient to another, but the referring provider maintains his or her care of the patient as well.

*Note: A MIPS eligible clinician must verify that the fields for current problem list, current medication list, and current medication allergy list are not blank and include the most recent information known by the MIPS eligible clinician as of the time of generating the summary of care document or include a notation of no current problem, medication and/or medication allergies.

Current problem lists – At a minimum a list of current and active diagnoses.

Active/current medication list – A list of medications that a given patient is currently taking.

Active/current medication allergy list – A list of medications to which a given patient has known allergies.

Allergy – An exaggerated immune response or reaction to substances that are generally not harmful.

Scoring information

• Required for Promoting Interoperability Performance Category Score: Yes, unless submitting one of the alternatives, HIE Bi-Directional Exchange measure (PI_HIE_5) or the Enabling Exchange Under TEFCA measure (PI_HIE_6) • Measure Score: 15 points • Eligible for Bonus Score: No