Tuesday 15 June 2021
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New Guidelines from CMS to Promote more Interoperability Programs and Tech!

New Guidelines from CMS to Promote more Interoperability Programs and Tech!

The Centers for Medicare & Medicaid Services (CMS) is dedicated to improving interoperability and patients’ access to health information.

To better reflect this focus, they’ve renamed the EHR Incentive Programs to the Promoting Interoperability (PI) Programs. Through this rulemaking, they are also streamlining the programs to reduce the time and cost required of providers to participate.

To find out more on how this rulemaking affects Medicare eligible clinicians participating in the Promoting Interoperability (formerly Advancing Care Information) performance category of the Merit-based Incentive Payment System, visit the Quality Payment Program website at

The Latest News about the CMS: 

Background on EHR Incentives 

In 2011, CMS established the Medicare and Medicaid EHR Incentive Programs to encourage Eligible Professionals EPs, eligible hospitals, and CAHs to adopt, implement, upgrade (AIU), and demonstrate meaningful use of certified EHR technology (CEHRT).

The PI Programs consist of three stages:

  • Stage 1 set the foundation for the PI Programs by establishing requirements for the electronic capture of clinical data, including providing patients with electronic copies of health information.
  • Stage 2 expanded upon the Stage 1 criteria with a focus on advancing clinical processes and ensuring that the meaningful use of EHRs supported the aims and priorities of the National Quality Strategy. Stage 2 criteria encouraged the use of CEHRT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible.
  • In October 2015, CMS released a final rule that modified Stage 2 to ease reporting requirements and align with other quality reporting programs. The final rule also established Stage 3 in 2017 and beyond, which focuses on using CEHRT to improve health outcomes.

For more information about Stage 1 and Stage 2, visit the Requirements for Previous Years page.

Use the navigation bar on the left side of the page to learn more about the PI Programs, including program requirements for specific years, registration and attestation information, payment adjustment & hardship exceptions, clinical quality measures and more.

You can also stay up to date on the latest PI Program news and updates by following us on Twitter and by subscribing to the CMS PI Listserv.

How it works:

A particularly important issue for healthcare orgs is the ability to have seamless, comprehensive data sharing, this ability will enable orgs to earn incentive payments through the CMS Promoting Interoperability (PI) Program, formerly known as meaningful use.

According to the Office of the National Coordinator (ONC), “standards are agreed-upon methods for connecting systems together. Standards may pertain to security, data transport, data format or structure, or the meanings of codes or terms.”

Good intentions are not enough! While good intentioned SDOs have created several well-known standards intended to promote interoperability, the less than enthusiastic adoption and use often are roadblocks to the effectiveness of existing standards. In addition, many differences in the way standards are implemented slow the progress in achieving healthcare interoperability.

What is Interoperability?  Yes, we all think we know what it is:  

Defining Healthcare Interoperability:  (According to an article in EHRIntelligencecom)

“According to HIMSS, interoperability “describes the extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.”

There are three levels of interoperability: foundational, structural, and semantic.

Foundational interoperability

Foundational interoperability is the ability of one IT system to send data to another IT system. The receiving IT system does not necessarily need to be able to interpret the exchanged data — it must simply be able to acknowledge receipt of the data payload. This is the most basic tier of interoperability.

Structural interoperability

Structural interoperability is “the uniform movement of healthcare data from one system to another such that the clinical or operational purpose and meaning of the data is preserved and unaltered,” HIMSS states.

To achieve structural interoperability, the recipient system should be able to interpret information at the data field level. This is the intermediate level of interoperability.

Semantic Interoperability

Semantic interoperability is the ability of health IT systems to exchange and interpret information — then actively use the information that has been exchanged. Semantic interoperability is the highest level of interoperability.

“Semantic interoperability takes advantage of both the structuring of the data exchange and the codification of the data including vocabulary so that the receiving information technology systems can interpret the data,” stated HIMSS.

Achieving semantic interoperability allows providers to exchange patient summary information with other caregivers and authorized parties using different EHR systems to improve care quality, safety, and efficiency.

This level of interoperability allows healthcare organizations to seamlessly share patient information to reduce duplicative testing, enable better-informed clinical decision-making, and avoid adverse health events.

There is Great news though!  

Adoption and implementation of the Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR) standard in health IT is steadily progressing, according to a blog post from leaders at the Office of the National Coordinator for Health Information Technology (ONC).

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