We too are definitely going thru Cloverleaf-5.8Rev5 for MU2, ELR reporting and Immunizations, Syndromic Surveillance. The interpretation here is as long as Cloverleaf is in compliance with the v2.5.1 standard we can make the necessary adjustments to be conformant at the federal / state levels. We are not passing CDA-R2 (XML) type data thru Cloverleaf at this point, this and DirectExchange are going directly from our EHR.
In this way as an organization we are confident we will meet not only the federal level requirements, but our state level which further constrains the profile for ELR. Ultimately the organization will be penalized not the vendor if submission is not up to spec, so we’d rather have the “last say” if you will.
In HL7 v2.5.1 there is an SFT segment that should be valued for any application/process/software that the message is passing thru that serves as a notice to any endpoint how the data came to them i.e. who/what could have altered the information. Although an optional segment, in my opinion this segment is of significant value. This shows the data originated from a certified system, which I would argue, addresses the SunQuest concerns and meets the requirements. Also, let’s face it point-to-point interfaces are extremely archaic and only warranted in very few situations assuming you have integration staff with experience.
.
.