Meaningful Use Update: Immunization Registries and Syndromic Surveillance Public Health Agency Data Submission and Connectivity

McKesson released the following documentation today for Medisoft Clinical and LytecMD clients discussing the population health measure requirement for meaningful use objectives and the current status of Medisoft Clinical and LytecMD collecting and exchanging information with an immunization registry and/or providing syndromic surveillance data to a public health agency.

Meaningful Use Stage 1

In Meaningful use Stage 1, the menu set of meaningful use objectives require eligible professionals (EPs) to satisfy at least one measure related to population health. Specifically, EPs must attempt to exchange information with an immunization registry and/or provide syndromic surveillance date to a public health agency. 1

Meaningful Use Stage 2

In Meaningful use Stage 2, the Submission electronic data to a state immunization registry requirement has been moved from the menu set to the core set. Now, along with testing the submission, successful submission must be maintained for the entire reporting period.

An EP can be excluded from the population health measure:

Immunization Exclusions

(1) The EP, eligible hospital or CAH does not administer any of the immunizations to any of the populations for which data is collected by their jurisdiction’s immunization registry or immunization information system during the EHR reporting period;

(2) The EP, eligible hospital or CAH operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required for CEHRT at the start of their EHR reporting period;

(3) The EP, eligible hospital or CAH operates in a jurisdiction where no immunization registry or immunization information system provides information timely on capability to receive immunization data; or

(4) The EP, eligible hospital or CAH operates in a jurisdiction for which no immunization registry or immunization information system that is capable of accepting the specific standards required by CEHRT at the start of their EHR reporting period can enroll additional EPs, eligible hospitals or CAHs.

The second exclusion will not apply if an entity designated by the immunization registry or immunization information system can receive electronic immunization data submissions.

Syndromic Surveillance Exclusions

Any EP, eligible hospital or CAH that meets one or more of the following criteria may be excluded from this objective:

(1) The EP is not in a category of providers that collect ambulatory syndromic surveillance information on their patients during the EHR reporting period;

(2) The eligible hospital or CAH does not have an emergency or urgent care department;

(3) The EP, eligible hospital, or CAH operates in a jurisdiction for which no public health agency is capable of receiving electronic syndromic surveillance data in the specific standards required by CEHRT at the start of their EHR reporting period;

(4) The EP, eligible hospital or CAH operates in a jurisdiction where no public health agency provides information timely on capability to receive syndromic surveillance data; or

(5) The EP, eligible hospital or CAH operates in a jurisdiction for which no public health agency that is capable of accepting the specific standards required by CEHRT at the start of their EHR reporting period can enroll additional EPs, eligible hospitals or CAHs.

Note: HL7 v2.3.1 has been removed as an acceptable message type. However, if an EP began using HL7 v2.3.1 in Stage 1 and the IIS continues to accept it, the EP fulfills its Stage 2 objective using this version.

Registry Availability

Not all states have implemented electronic submission to their immunization registries or public health agencies. Additionally, some larger metropolitan areas have multiple registries.

In some cases a registry does accept electronic submission, but does not support the government mandated standards. In these cases, submission of data is not required to successfully meet the meaningful use objective.

Thus, McKesson will not develop non-standard interfaces to those registries. If the customer wants to request the development of a non-standard interface, McKesson will evaluate the customer’s need and may provide customization or services packages to enable transmission.

Caveats

Uni-directional vs. bi-directional interfaces

Some registries (North Carolina, Kansas, Pennsylvania and Tennessee) require the use of bi-directional interfaces in order to allow electronic submissions to occur. This requirement exceeds the requirements for the demonstration of meaningful use, which is a uni-directional interface. Medisoft Clinical and LytecMD do not currently support a bi-directional communication pathway.

Additional information required by registries

Registries may require information that Medisoft Clinical and LytecMD may not be able to collect. As with bi-directional interfaces, from a compliance perspective eligible professionals in these locales will meet the requirements and thus be incentive eligible, even though the submission “failed” due to local registry/PHA policies. The client will be provided documentation of the failed attempt, which will be adequate proof of meeting the objective.

1 The rule states the EP must perform at least one test of a certified EHR technology¡¦s capacity to submit electronic data to an immunization registry and/or provide electronic syndromic surveillance data to public health agencies, and follow up submission if the test is successful (unless none of the immunization registries or public health agencies to which the EP submits such information have the capacity to receive the information electronically), except where prohibited.
Disclaimer: AZCOMP Technologies, Inc, (AZCOMP) is providing this material as an informational reference for eligible professionals. Although every reasonable effort has been made to assure the accuracy of the information within these pages at the time of posting, the Medicare program is constantly changing, and it is the responsibility of each provider to remain abreast of the Medicare program requirements.