There are many moving parts to achieving Meaningful Use, and using a certified Electronic Health Record (Electronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conform...) application is at the core. Moving – or exchanging – is also essential since patient data needs to get from Point A to Points B, C, D, plus more. Exchanging patient data is the role an integration engine plays, and this solution can be a key application in your strategic and operational IT plans as the march toward Meaningful Use continues.
ONC-ATCB EHR Certification can be conducted for either a Complete EHR or a Modular EHR; the latter only tests criteria which are related to its application. An integration engine falls under the Modular EHR  approach.
When an EHR System performs a Complete EHR test, it must pass test criteria related to the exchange of clinical data as well as tests regarding methods to secure the data being exchanged. When an integration engine becomes the main pipeline in and out of the EHR System, it seems appropriate that the integration engine should be tested to the same standards for exchange of data as the Complete EHR.
EHR Certification tests are slightly different depending on whether the EHR application is in an Ambulatory setting or an Inpatient setting. The testing criteria regarding the exchange of data for inpatient settings require some additional tests to exchange discharge instructions and discharge summaries. The tests that are applicable to the exchange of data for each setting are as follows:
- Electronic copy of health information (Ambulatory and Inpatient)
- Electronic copy of discharge instructions (Inpatient only)
- Exchange clinical information and patient summary record (Ambulatory and Inpatient)
In addition to the exchange criteria above, all applications must pass the Privacy and Security tests. The security of the data being exchanged by the integration engine is of the extreme importance, so these tests seem appropriate for an integration engine regardless.
For a provider, using a certified EHR system with a certified integration engine is only the beginning of the criteria to meet Meaningful Use. Once the certified applications are in place, the provider must prove that they are using their EHR as an effective solution in everyday use. There are twenty measures used for this proof, fifteen of which are mandatory and an additional five of ten which can be hand-chosen.
Two tests in particular are related to the use of an interface engine. The first is “Capability to exchange key clinical information” which only needs to be performed once to satisfy the measure. This would most likely involve sending a CCR or CCD (Continuity of Care Record and Continuity of Care Document ) to another healthcare entity. The second is "Provide patients with an electronic copy of their health information upon request.” This would involve providing the patient a Continuity of Care Record (CCR) is an XML-based standard for the movement of “documents” between clinical applications. Furthermore, it responds to the need to organize and make transportable a set of basic information about a patient’s health ... or Continuity of Care Document (CCD) The HL7 CCD is the result of a collaborative effort between the Health Level Seven and American Society for Testing Materials (ASTM) to “harmonize” the data format between ASTM’s Continuity of Care Record (CCR)..., which could be done via secure e-mail or on a USB drive. The interface engine could send the secure e-mail or write the document to a secure folder where it could be copied for the patient.
With both the EHR certification and the measures used to prove effective use, the integration engine is central to exchanging data and keeping it secure. Its role will continue to evolve as regional Health Information Exchange (HIE) focuses on the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move clinical information between disparate health... communication, and even national The Direct Project was launched by the ONC within Health and Human Services (HHS) on March 1, 2010. It was initially called NHIN Direct. The object of the Direct Project is to replace the use of faxes, phones, and paper transactions with a simple and... communication, become more prevalent in the industry.
Ensuring the path to Meaningful Use is certified raises a provider's confidence and capability to stay on track and achieve their strategic and operational objectives.