A Practical Guide to Understanding HIE, Assessing Your Readiness and Selecting HIE Options in Minnesota

Plan and Select: Comparing HIE Options in Minnesota

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Mapping HIE Requirements and Priorities to Services Offered/Available
More Information on the Exchange of a Care Summary (e.g. Consolidated CDA or CCD/CCR document)

Mapping HIE Requirements and Priorities to Services Offered/Available

If you are interested in comparing the State-Certified HIE Service Providers, make sure you understand the services they each offer.

Below are a few of the scenarios presented earlier in this guide as well as a few new examples. You will see that there are explicit HIE transactions listed within the scenarios to demonstrate what is occurring at different stages related to HIE. Those HIE transactions are possible options included in the State-Certified HIE Service Provider HIE Services/Offerings table. You can use this as a way to start matching what you have identified as your HIE priorities with what the State-Certified HIE Service Providers offer. Having this information will help you when you contact the service providers for more detailed information about their offerings including rates.

Scenario: Provider Sends/Pushes Immunization Record to the State Immunization Registry
A child arrives for a routine appointment and through the EHR, and the State-Certified HIE Service Provider, the provider’s office staff determines that immunizations are due (see State-Certified HIE Service Provider HIE Services/Offerings table for electronic reporting of immunizations). After the vaccines are administered, the information is recorded in the EHR system, which, through the State-Certified HIE Service Provider, automatically sends an update to Minnesota Immunization Information Connection (MIIC), Minnesota’s immunization registry (electronic reporting of immunizations).

Scenario: Sending/Pushing Reportable Lab Results to the Minnesota Department of Health
The laboratory creates a standard message, such as an HL7 message, containing reportable lab results to submit to the state public health agency - the Minnesota Department of Health. The lab sends the reportable lab results directly, through the State-Certified HIE Service Provider, to the Minnesota Department of Health’s electronic laboratory reporting system and it sends the results to the ordering provider. As required, the provider may then use the clinic or hospital’s EHR system, and the State-Certified HIE Service Provider, to send the reportable lab results to the Minnesota Department of Health’s electronic laboratory reporting system (electronic submission of reportable lab results to public health). 

Scenario: Provider Queries/Pulls for Information for a New Patient
Dr. Miller has a new dental patient, Ms. Jones. As part of the workflow for that patient Dr. Miller needs more information about Ms. Jones’ cardiac condition before scheduling dental implants. A secure message, through the State-Certified HIE Service Provider, is sent to Ms. Jones’s cardiology clinic requesting a summary of patient’s current conditions and medications. The cardiology clinic, through the State-Certified HIE Service Provider, provides (pushes) the information back to the dental clinic. Depending on the format of the clinical care summary received, it may be incorporated into that patient’s record at the dental clinic (summary of care record exchange– e.g. consolidated CDA or CCD/CCR document).  

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More Information on the Exchange of a Summary of Care (e.g. Consolidated CDA or CCD/CCR document)

A summary of care record (sometimes also referred to as a Consolidated CDA or Continuity of Care Document/CCD or Continuity of Care Record/ CCR document), is a patient health summary that providers eligible for meaningful use are required to exchange. However, providers not eligible for meaningful use often find this information useful to be able to exchange.

The summary of care record provides a means for one health care provider, system or setting to aggregate pertinent data about a patient and forward it to another provider, system or setting to support the continuity of care. Its primary use case is to provide a snapshot in time containing the pertinent clinical, demographic and administrative information for a specific patient. For example, it can include: patient name, referring or transitioning provider’s name and contact information, procedures, relevant past diagnoses, lab test results, vital signs, demographic information, care plan, and active medication list and allergy list. These types of information could be particularly useful in situations like those described in scenarios 3 and 4 earlier in the guidance where the provider needs more detailed or complete patient health information.

Most EHRs can produce, and all certified EHRs must have the ability to produce, a summary of care record that is machine-readable, meaning it is in a format such as XML that can be read by and incorporated directly into another EHR system. Often, a human-readable format, such as in PDF, can be produced as well. Both types can be exchanged between providers or settings.

Examples of each of these types of formats:

XML format example (PDF 28KB/ 3pg)
PDF format example (PDF 149KB /1pg)

Things to consider:


Questions for your EHR vendor:

  • What formats of a summary of care record (Consolidated CDA or CCD/CCR document) can your EHR generate?
  • How does your EHR incorporate the summary of care record (Consolidated CDA or CCD/CCR document) when you receive one?

Question for the HIE service provider you may sign up with as an intermediary:

  • Do you need to determine what format your trading partners can accept/prefer before sending a summary of care record (Consolidated CDA or CCD/CCR document)?
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Updated Thursday, July 11, 2013 at 10:28AM