The feds are asking healthcare information technology honchos to help them test pilot a tool to evaluate the efficacy of their clinical messaging systems.
The tool is called a C-CDA Scorecard. It's available online or by download and grades consolidated clinical document architecture documents (C-CDA) that were formatted using standards developed by Health Level Seven.
Grades are given in three ways. One grade is a pass-fail that determines whether the message meets the standards established by the Office of the National Coordinator for Health Information Technology's 2015 Edition Health IT Certification criteria for messages used in transitions of care, such as a hospital discharge summary.
Now that virtually all hospitals and the vast majority of office-based physicians are using EHRs, the feds under the $35.1 billion EHR incentive payment program have shifted emphasis toward "interoperability," that is, using those systems to send and receive patient data to improve the quality of care and reduce cost.
Another overall grade for the message ranges from a high score of A to low scores of F. The letter grades correspond to numeric scores up to 100 as measured against “enhanced interoperability rules developed by HL7,” according to a summary on the tool's web page.
“A higher score (grade) means that information is coded with appropriate structure and semantics and hence has a better chance of interoperating with disparate systems,” according to the ONC.
Finally, the score card provides individual letter grades and numeric scores for component parts of a C-CDA, such as how well it conveys data about vital signs, medications or immunizations.
The tool also seeks to help those who implement health IT systems by highlighting “areas of improvement which can be made today to move the needle forward," the ONC statement said.
The tool's standards for messaging best practices as well as its scoring criteria were developed by HL7 under an agreement with the ONC.
“We hope that providers and health IT developers will use the tool to identify and resolve issues of C-CDA document interoperability in their health IT systems,” the ONC statement said.
The ONC said the scorecard immediately deletes files from the server after processing. The office, however, suggests not including any protected health information or personally identifiable information in submissions.
“We're in the early stages of feedback gathering (and) “getting good information on clarifications and what would make it more valuable,” said Steven Posnack, director of the office of standards and technology at the ONC.