Anyone sending MU Stage 3 info to CDC w/ tclCurl

Please confirm with the CDC that the Direct Address they are talking about is a file-based protocol.

We use Direct Addressing for Meaningful Use to send Summary of Care (CCDA) documents to referred-to providers, through our local HIE. These Direct Addresses are similar to email but it is secure email. The technology must be MU CEHRT.

We connect to our HIE using the Direct protocol (using the Cloverleaf Direct Adapter), and they forward the email using secure mail (again, using Direct).

If you are using Curl to connect to a Direct endpoint (known as a HISP), you would have to ensure that you are using secure SMTP, and you may need to prove that your technology is certified (CEHRT).

I don’t know for sure about this requirement for the CDC, we are certifying on other objectives with our state. I just wanted to be sure you don’t go down the wrong path.

I can’t answer that specifically – we did not choose that particular function (sending data to the CDC) to meet our MU objectives. I’m not up on MU 100%, but I think sending to the CDC was part of a menu objective where you can pick from a group of objectives, or pick from a group of approaches to meet the objective. For our reporting, we are sending to our state department of health (immunizations, lab results and syndromic surveillance data) using the state’s required technology.

But it was because you said that you needed Direct Addresses, that I was concerned that the CDC was requiring the use of Direct transport/protocol (which is secure SMTP). I’ll admit that I was confused because you also said there was a file being transferred. So from those two things, I’m kind of jumping to a conclusion that this may be a lot like another MU measure – for CCDA or Transfer of Care documents – where we are required to send these documents using Direct transport, and what is done is to attach the CCDA file to the email (as a file attachment) and use Direct to securely send that email to a secure receiver (a HISP). We have to either rely on our EMR vendor to supply the Direct transport or we have to supply it ourselves. We chose to supply it ourselves (Direct) by using the Cloverleaf Direct option. We made that decision because we can automate it using Cloverleaf instead of using the EMR software which is a manual process for our providers. Also, the actual CCDA content generated by the EMR did not meet the requirements of our largest  (by patient referral volume) recipients. So by running it through Cloverleaf we are able to reformat it (adding the XML object IDs and reformatting the discrete data – but not changing any clinical data. Sorry to make this a long-winded answer.

So my recommendation is to get more detail on this requirement for sending data to the CDC – do they want to get a file, and receive that file as an attachment in a secure email which is sent via Direct?