Home Forums Discussions Meaningful Use Old CCD v. New C-CDA

In an effort to actually make MU meaningful to both me and my patients I would like my patients to have full electronic access to all medical records. With AC 6.6.1, I would simply export a CCD that included all encounters, and send it to their portal in Updox.

Well, now I've upgraded to 7.1.3, and I am attempting to do the same thing. However, I see that when I export a "clinical summary", whether for one encounter or the full record, AC doesn't actually include any encounter data (HPI, PMH, Assessment, etc.) and what I will be sending to the portal as a CCD or C-CDA really is not very meaningful for my patients.

The CCD, which can still be exported, but doesn't count towards MU2, includes a section of encounters that has the complete note that I typed. This should be included in an export of "Full Patient Record" when exporting from the clinical summary section.

What am I missing? How do I do this?

I share your frustration--I have yet to have a patient say, "Gee that clinical summary was so helpful!" As Victor Frankl observed man's search for meaning is not easy. In medicine I think the closest I get to doing something meaningful is the time I spend face-to-face with the patient.

John,

I agree with your sentiment about being face-to-face with the patient. I refuse to put a computer in my exam rooms for just that reason. (As an aside, one of the top complaints about physicians today is that they don't engage with the patient because they are too busy typing into the computer/EHR.)

It turns out that the contents of the C-CDA are mandated by CMS, and AC is simply including the data as specified by them.

Before we upgraded to 7.1.3, we manually sent the CCD to the patient's portal, and I think that we'll still be doing this. It's the right thing to do for the patients who want access to all their information. If only there were a way to batch this, so that I could just say export all CCDs for patients seen today (pie in the sky dreaming).

Luckily, we can turn on the automatic sending of the clinical summary (C-CDA) to the portal (the POS that it is), so we're not actually doing more work than we were doing before, at least for this requirement for MU2.

BTW, There really isn't much difference between "full patient record" clinically summary, and the clinical summary for an individual appointment. I am hoping that someday the C-CDA will have all the encounter data (CC, HPI, PE, A/P) including in the file.

Currently the only difference between a clinical summary that contains data for one visit or all visits is that the one visit C-CDA includes a "reason for visit" section that prints the chief complaint and the "instructions" section, and the full patient record C-CDA includes neither of those two things but includes all vitals entered.