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 CEHRT; and (2) electronically exchanges the summary of care record.

Reporting requirements

Numerator

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

Denominator

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

Exclusions

Any MIPS eligible clinician who transfers patients to another setting or refers patients 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 MIPS eligible clinician refers a patient to another, but the referring MIPS eligible clinician 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 aren’t 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.

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

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 aren’t generally harmful.

Scoring information

• Required for MIPS Promoting Interoperability Performance Category Score: Yes, unless submitting one of the alternative measures: Health Information Exchange (HIE) Bi-Directional Exchange (PI_HIE_5), or Enabling Exchange Under the Trusted Exchange Framework and Common Agreement™ (TEFCA™) (PI_HIE_6)
• Measure Score: 15 points
• Eligible for Bonus Score: No