Meaningful Use Stage 3 (MU3) Objective 7

1. Introduction 

• Purpose: This guide provides comprehensive, step-by-step instructions on how to achieve compliance and obtain credit for Objective 7: Health Information Exchange (HIE) under the Meaningful Use Stage 3 (MU3) framework. 

• Key Features: Summary of care creation and exchange, incorporation of external patient data, and clinical information reconciliation. 

2. MU3 Objective 7: Health Information Exchange (HIE) 

Overview 

Objective 7 focuses on the secure exchange and reconciliation of patient health information across healthcare systems. Providers must satisfy at least two out of the three measures to receive credit. 

3. Measure 1: Creating and Exchanging a Summary of Care Record 

Requirements 

• Submit more than 50% of referral letters electronically, including the Summary of Care Record during transitions of care. 

Exclusion Criteria 

• Fewer than 100 referral letters sent during the reporting period. 

• Conducting 50% or more patient encounters in counties where 50% or more housing units lack 4 Mbps broadband availability. 

Steps to Achieve Compliance 

1. Create a Referral or Consultation Letter:  

• Navigate to Lab/Imaging/Letter Order in the patient’s current office visit. 

• Click New Referral Letter or New Consultation Letter. 

2. Complete the Letter:  

• In the letter editor, select the recipient provider from the Referral To dropdown. 

• Choose the Date of Service. 

• Ensure the box labeled “Attach Patient Transition of Care” is checked. 

• Click Save Letter. 

3. Send the Letter Electronically:  

• Click Print (a new tab will open in iClinic). 

• For MDLand providers, click MD Network. 

• For non-MDLand providers, click Secure Message. 

4. Measure 2: Incorporating New Patient Summary of Care into EHR 

Requirements 

• More than 40% of referrals received and patients not previously seen must have a Summary of Care Record incorporated into their chart. 

Exclusion Criteria 

• Fewer than 100 referral letters sent during the reporting period. 

• Conducting 50% or more patient encounters in counties where 50% or more housing units lack 4 Mbps broadband availability. 

Steps to Achieve Compliance 

1. Verify Office Visit:  

• Ensure the patient has an office visit within the reporting period. 

2. Check the Inbox for Transition of Care (TOC) Documents:  

• Go to the Inbox. 

• Filter messages by Message Type → Transition of Care. 

• Match TOC documents (highlighted in yellow) to the correct patient:  

• Click Match (blue text on the right). 

• Search for the patient by name or date of birth. 

• Select the patient from the search results. 

3. Reconcile Transition of Care:  

• In the patient’s office visit, click Reference on the right panel. 

• Select Reconciliation Panel. 

• Choose the TOC date. 

• Set Reconciliation Status to Reconciled for each section. 

• Click Save Status. 

5. Measure 3: Clinical Information Reconciliation for New Patients 

Requirements 

• More than 80% of transitions or referrals received must have the following reconciled:  

• Medication List 

• Medication Allergy List 

• Current Problem List 

Exclusion Criteria 

• Conducting 50% or more patient encounters in counties where 50% or more housing units lack 4 Mbps broadband availability. 

Steps to Achieve Compliance 

1. Reconcile via Office Visit: 

• Go to Inbox. 

• Filter messages by Transition of Care. 

• Match TOC documents to patients (click Match). 

• In the patient’s office visit, click Reference → Reconciliation Panel. 

• Select the TOC date. 

• Click Set All Items to Reconcile OR manually set:  

• Medication → Reconciled 

• Medication Allergy → Reconciled 

• Problem List → Reconciled 

• Click Save Status. 

2. Reconcile via Patient Home: 

• Go to Patient Home. 

• Click CCDA Reconciliation. 

• Set all items to Reconciled or adjust manually for the three required sections. 

• Click Save Status. 

3. Reconcile via Inbox: 

• Filter Inbox by Transition of Care. 

• Match TOC documents. 

• Open the document. 

• Click Set All Items to Reconciled. 

• Click Save Status. 

• Mark the patient as Checked In. 

6. Troubleshooting Tips 

• Issues Sending Summary of Care: 

• Ensure the “Attach Patient Transition of Care” box is checked. 

• Confirm secure messaging settings are active. 

• Refresh the page if the MD Network option isn’t appearing. 

• TOC Matching Errors: 

• Verify patient information (name, DOB) is accurate. 

• Check for duplicate records in the system. 

• Reconciliation Problems: 

• Confirm all three sections (medication, allergies, problems) are set to Reconciled. 

• Click Save Status after making changes. 

7. Support Guidelines 

• In-App Support: Use the iClinic help feature for immediate assistance. 

• Compliance Officer: Contact your organization’s compliance officer for regulatory guidance. 

• Technical Support: Reach out to IT support for technical issues related to secure messaging, TOC documents, or reconciliation. 

Thank you for following the MU3 compliance process. This guide ensures regulatory compliance while enhancing patient care coordination and health information exchange.