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A transition of care is defined as 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. To count toward the Summary of Care objective for providers sharing access to an EHR, the transition or referral may take place between providers with different billing identities such as a different National Provider Identifier (NPI) or hospital CMS Certification Number (CCN).For Measure 1 of the Summary of Care objective, include the transitions of care in which a summary of care document was provided to the recipient of the transition or referral by any means. For Measure 2 of the Summary of Care objective, include the transitions of care in which a summary of care document was transmitted electronically using a Certified EHR Technology (CEHRT) to the recipient, or via exchange facilitated by an organization that is an eHealth Exchange participant, or in a manner that is consistent with the governance mechanism ONC establishes for the nationwide health information network. If the receiving provider already has access to the CEHRT of the initiating provider of the transition or referral, simply accessing the patient's health information does not count toward meeting this objective. However, if the initiating provider also sends a summary of care document, this transition can be included in the denominator and the numerator as long as it is counted consistently across the organization and across both measures If: For Measure 1, a summary of care document is also provided by any means. For Measure 2, a summary of care document is provided using the same technical standards used if the receiving provider did not have access to the CEHRT, To meet Measure 3 of the Summary of Care objective, providers may send a single summary of care document to a provider using a different EHR and EHR Vendor as part of the 10% threshold for measure #2, or, if providers do not exchange summary of care documents with recipients using a different CEHRT in common practice, they may retain documentation on their circumstances and attest "Yes" to meeting measure #3 if they have and are using a certified EHR which meets the standards required to send a CCDA (170.202) Added on 2/10/2014
Updated 4/10/2014
Updated 9/30/2015
(FAQ9690)
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