ONC-ATCB EHR Certification can be conducted for either a Complete EHR or a Modular EHR; the latter only tests criteria which are related to its application. An integration engine falls under the Modular EHR approach.
When an EHR System performs a Complete EHR test, it must pass test criteria related to the exchange of clinical data as well as tests regarding methods to secure the data being exchanged. When an integration engine becomes the main pipeline in and out of the EHR System, it seems appropriate that the integration engine should be tested to the same standards for exchange of data as the Complete EHR.
EHR Certification tests are slightly different depending on whether the EHR application is in an Ambulatory setting or an Inpatient setting. The testing criteria regarding the exchange of data for inpatient settings require some additional tests to exchange discharge instructions and discharge summaries. The tests that are applicable to the exchange of data for each setting are as follows:
- Electronic copy of health information (Ambulatory and Inpatient)
- Electronic copy of discharge instructions (Inpatient only)
- Exchange clinical information and patient summary record (Ambulatory and Inpatient)
In addition to the exchange criteria above, all applications must pass the Privacy and Security tests. The security of the data being exchanged by the integration engine is of the extreme importance, so these tests seem appropriate for an integration engine regardless.
For a provider, using a certified EHR system with a certified integration engine is only the beginning of the criteria to meet Meaningful Use. Once the certified applications are in place, the provider must prove that they are using their EHR as an effective solution in everyday use. There are twenty measures used for this proof, fifteen of which are mandatory and an additional five of ten which can be hand-chosen.
Two tests in particular are related to the use of an interface engine. The first is “Capability to exchange key clinical information” which only needs to be performed once to satisfy the measure. This would most likely involve sending a CCR or CCD (Continuity of Care Record and Continuity of Care Document) to another healthcare entity. The second is “Provide patients with an electronic copy of their health information upon request.” This would involve providing the patient a CCR or CCD, which could be done via secure e-mail or on a USB drive. The interface engine could send the secure e-mail or write the document to a secure folder where it could be copied for the patient.
With both the EHR certification and the measures used to prove effective use, the integration engine is central to exchanging data and keeping it secure. Its role will continue to evolve as regional HIE communication, and even national Direct Project communication, become more prevalent in the industry.
Ensuring the path to Meaningful Use is certified raises a provider’s confidence and capability to stay on track and achieve their strategic and operational objectives.