Why the Interoperability Hub Must be Enabled for MIPS in Version 11

If you have upgraded to eClinicalWorks Version 11 or plan on upgrading to Version 11 and you are participating in the Merit-based Incentive Payment System, there's one more thing you need to add to your checklist - the Interoperability Hub. Here's why.

Let's start with the Base Score measures for Promoting Interoperability (formerly known as Advancing Care Information - ACI) for the 2018 Performance Year. Participants must submit collected data for 4 or 5 Base Score measures (depending on the CEHRT Edition) for 90 days or more during 2018. This means that before October 1, 2018, you should be completing 4 or 5 of the below Base Score measures if you plan on avoiding a reimbursement penalty.

As a quick refresher, here are the 2018 Performance Year 5 Base Score measures and their description from the CMS Quality Payment Program website.

(If you aren't interested and want to skip to the Interoperability Hub info, click here)

1. e-Prescribing

Objective Name: Electronic Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.


2. Provide Patient Access

Objective Name: Patient Electronic Access

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 Programing Interface (API) in the MIPS eligible clinician's certified EHR technology.


3. Request/Accept Summary of Care

Objective Name: Health Information Exchange

For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an electronic summary of care document.


4. Security Risk Analysis

Objective Name: Protect Patient Health Information

Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.


5. Send a Summary of Care

Objective Name: Health Information Exchange

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


PI Measures vs PI Transition Measures

There are two sets of measures for the Promoting Interoperability MIPS category: 2018 MIPS PI Measures and 2018 MIPS PI Transition Measures. 

If your CEHRT is certified to the 2014 Edition, you must use the Promoting Interoperability Transition Objectives and Measures set.

Otherwise, you may use either set, or any combination of the two sets. However, the required for base score measures that are included in the 2018 MIPS PI Measures are:

  • Patient Electronic Access-Provide Patient Access - Measure ID: PI_PEA_1
  • Electronic Prescribing-E-Prescribing - Measure ID: PI_EP_1
  • Health Information Exchange-Send a Summary of Care - Measure ID: PI_HIE_1
  • Health Information Exchange-Request/Accept Summary of Care - Measure ID: PI_HIE_2
  • Protect Patient Health Information-Security Risk Analysis - Measure ID:PI_PPHI_1

Which means that if your CEHRT is certified to the 2014 Edition, you can use the transition objectives and measures but eClinicalWorks Version 11 is a 2015 Edition ONC Certified Health IT product.

If you upgrade to Version 11 of eCW, you must attest to all 5 of the base score measures listed above in order to meet the MIPS criteria for Promoting Interoperability.

The Role of the Interoperability Hub

The Interoperability Hub supports the Patient Electronic Access-Provide Patient Access measure (Measure ID: PI_PEA_1). Therefore, you must activate the Interoperability Hub in Version 11 of eClinicalWorks in order to complete this measure. There is no cost to activate but you must do so before October 1, 2018.

You will be required to submit data for at least one patient via the Interoperability Hub and while the cost has not been released to do so, eCW has stated the cost will be minimal.

How to Activate the Interoperability Hub

To activate the Interoperability Hub you will need to navigate to Admin > Product Activation > Interoperability Hub > Activate. 

Here is more information on the numerator criteria and how to document for this measure in eClinicalWorks.

Numerator Criteria 1 Area to Document within eClinicalWorks
They (or their patient-authorized representative) have been web-enabled on their initial visit during the PI (formerly ACI) reporting period and were provided access within four (4) business days of the visit.

Record this information from one of the following locations:

  • Appointment window > enter e-mail address in e-mail field > check the W box.
  • Appointment window > set visit status to arrived > enter their e-mail address in the E-mail field or check the Don't Web Enable box, then select a reason from the reason drop-down list.
They (or their patient-authorized representative) were provided access to their health information within four (4) business days through the use of an API during the ACI (formerly ACI) reporting period.

Patients should contact the practice and use the practice enabled API.

IMPORTANT! Practices must enable the Interoperability Hub for patients to have access to their health information through an API. 

This can be enabled from Admin > Product Activation > Interoperability Hub > Activate.

There may be additional costs associated with building an interface.

IMPORTANT! Any patient with multiple encounters during the PI (ACI) reporting period must have access to the information related to their care for each encounter where they are seen by the EC. Therefore, patients MUST be web-enabled or opted-out from their very first visit during the PI (ACI) reporting period.

Patients may opt out if they do not have an e-mail address or they choose not to disclose this information to your practice. Patient MUST be opted out from the Appointment window (NOT the Patient Information window) to satisfy this numerator. For more information, refer to Documenting Patients that Opt Out of Being Web Enabled.



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