Required Test 15

Program Name: Merit-based Incentive Payment System (MIPS) Promoting Interoperability Performance Category Measure

Measure Objective: Health Information Exchange

2026 Promoting Interoperability Measure: Support Electronic Referral Loops By Receiving and Reconciling Health Information:For at least one electronic summary of care record received for patient encounters during the performance period for which a MIPS eligible clinician was the receiving party of a transition of care or referral, or for patient encounters during the performance period in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician conducts clinical information reconciliation for medication, medication allergy, and current problem list.

Notes:

1: The Promoting Interoperability measure require reconciliation of medications, medication allergies, and the current problem list in order to populate and record the numerator.

2: The scenarios require the provider to receive an electronic a summary of care document and perform reconciliation during the reporting period and submit data for any continuous 180-day period within the calendar year

3: Test data supply: ONC and Vendor-supplied. ONC provides the Test Data Scenarios and parameters; the Vendor supplies the summary of care records, where applicable.

4: Starting in 2019, for the Promoting Interoperability measure an EP may use any document template within the C-CDA standard for the purposes of the measure.

5: The Promoting Interoperability measure only requires the reconcillation of current information, not historic.

6: If the health IT module supports the reconciling of all current information from multiple electronic summary of care records in a single instance this combined information may be considered a single instance in the denominator. If the health IT module supports the reconciliation of each individual electronic summary of care record received separately, then each current record received may be considered a separate instance in the denominator. For either workflow, the completion of the reconciliation in either workflow would increment the numerator. ATLs may use different test data for health IT modules that supports the reconciling of all current information from multiple electronic summary of care records in a single instance.

Scenarios:

	Denominator Criteria	Numerator Criteria			Results
Patient	Number of Electronic Summary of Care Records Received	Number of Electronic Summary of Care Records Where Medication Reconciliation Occurred During the Performance Period	Number of Electronic Summary of Care Records Where Medication Allergy Reconciliation Occurred During the Performance Period	Number of Electronic Summary of Care Records Where Current Problem List Reconciliation Occurred During the Performance Period	Records Total
Cathy Greene 5/26/1984 Sex: F	5	5	4	5	4
Doris Barnett 1/26/1980 Sex: F	2	1	0	2	0
Debbie Nichols 8/15/1984 Sex: F	1	1	1	1	1
Tom Warner 6/7/1983 Sex: M	0	N/A	N/A	N/A	0
Rosa Gonzales 7/18/1998 Sex: F	2	2	2	2	2
				Cumulative Total	7

No actions are required for this scenario

	Denominator Criteria	Numerator Criteria			Results
Patient	Number of Electronic Summary of Care Records Received	Number of Electronic Summary of Care Records Where Medication Reconciliation Occurred During the Performance Period	Number of Electronic Summary of Care Records Where Medication Allergy Reconciliation Occurred During the Performance Period	Number of Electronic Summary of Care Records Where Current Problem List Reconciliation Occurred During the Performance Period	Records Total
Oscar Garza 4/26/1966 Sex: M	2	2	2	2	2
Theresa Henry 8/23/1997 Sex: F	3	3	3	3	3
Gabriel Burton 11/2/1978 Sex: M	1	1	1	1	1
Tom Warner 6/7/1983 Sex: M	8	8	8	8	8
				Cumulative Total	21