In the spirit of the season, I’d like to offer any physician with an EMR system our help in fulfilling one of the more difficult tasks of meaningful use.  One of the tasks you will have to perform prior to achieving meaningful use is #14:

“Capability to exchange key clinical information (for example problem list, medication list, allergies, and diagnostic test results) among providers of care and patient authorized entities electronically.”

This criterion is one of the core measures for achieving meaningful use.  To fulfill it you have to perform a test of your system’s ability to export patient information to a file, and upload it into another physician’s EMR system.  The test doesn’t have to be successful, but you do have to demonstrate that you tried.

The hard part of this criterion is finding another physician with an EMR that is not the same as yours who is willing to try uploading the file you exported from your system.  Most physicians still don’t have EMRs, and your local hospital may not either.

Here’s the easy way.  Export a CCD or CCR from your EMR (your vendor can help you with this).  Go to www.ccdccrviewer.com to upload your file.  This is the way we view CCD and CCR files from within our EMR.  Browse to the file and click Upload, then click on the button CCRTOHTML or CCDTOHTML as appropriate.  The file will upload and then display in human readable HTML.  If it doesn’t, don’t worry too much, because you’ve done your test and you fulfilled this criterion for meaningful use.  Take screen shots and print them for your file in case you are audited.

Technical stuff:  I think I’m the only practicing physician in the world who actually knows what a CCR and CCD are.  I’m exaggerating of course, but if you ask around I’m sure you’ll find exactly zero of your colleagues have heard of these things.

CCDs (continuity of care documents) and CCRs (continuity of care records) are files that can be exported by all certified EMRs.  They are ways to share information between EMRs sold by different vendors and at least theoretically provide some interoperability.  In practice, they are quite cumbersome to use, and provide only limited information sharing.  Most of the information they share is in the form of lists of medications, allergies, procedures, visits, labs etc.  They don’t capture the subtleties of the physician’s plan or narrative notes, and have no graphical elements so you can’t use them to share imaging.

These files may become more important as time goes on and more physicians adopt EMRs.  They do provide some capability to share information and upload it directly into another system.  I’m dubious of the value of this, though.   I personally would not want to upload information on a patient directly into my EMR in case some of it is incorrect or irrelevant.  Ophthalmologists don’t need the same information in their EMR as cardiologists and vice versa.  A better export format would have been .pdf, because we can all read those.  Hopefully, as more of us use EMRs, CCDs and CCRs will fade away.  For now, it’s good to have a passing familiarity with them.