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Please Note: CMS has completed and closed EMDI pilot programs. Any new pilot applications will not be accepted. Providers, Document Transfer Vendors, EHRs, and Health IT systems willing to implement provider-to-provider interoperability can find documentation, resources, and reference pilot findings on EMDI Collaboration Website and HL7 FHIR based Post-Acute Order (PAO) (DME-Orders) Implementation guide. For further guidance on involvement in other interoperability initiative, please visit ‘Other Related Interoperability Initiatives’ section.
This space will no longer be updated as of 01/17/2021. Contact Information: onc-jira-questions@healthit.gov
EMDI Pilot Overview
The EMDI Program conducts provider-to-provider pilots related to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Home Health Agency (HHA) supplies/services. All EMDI participants are encouraged to conduct pilots that implement the EMDI use cases. These pilots assist the EMDI program in identifying and measuring provider-to-provider interoperable solutions that reduce provider burden when exchanging medical documentation that is applicable in post-acute care settings.
Figure 1: EMDI Participants
The EMDI pilot program consists of a tier building approach where pilots can take gradual steps to advancing interoperability. This approach is designed to accept pilots that plan an incremental approach to adopting the identified EMDI use cases and interoperability standards. The EMDI pilot program consists of five tiers that closely align with the HIMSS model of Interoperability. The tiers are identified as Tier 0 or No Interoperability, Tier 1 or Foundation Interoperability, Tier 2 or Structural Interoperability, Tier 3 or Semantic Interoperability, and Tier 4 or Organizational Interoperability. The EMDI Initiative encourages organizations to evaluate their workflow to identify their current level of interoperability to identify their desired level of interoperability through participation in the EMDI program.
| EMDI Tier | Interoperability Details |
|---|---|
| Tier 0 | No Interoperability: Usually characterized by a stand-alone system that does not have the ability to communicate with other systems electronically. |
| Tier 1 | Foundational Interoperability: This is the ability to establish the inter-connectivity requirements needed for one system or application to securely communicate data to and receive data from another. |
| Tier 2 | Structural Interoperability: This is the ability to define the format, syntax, and organization of the data exchange including at the data field level for interpretation. |
| Tier 3 | Semantic Interoperability: This is the ability to provide common models and codification of the data including the use of data elements with standardized definitions from publicly available value sets and coding vocabularies, providing shared understanding and meaning to the user. |
| Tier 4 | Organizational Interoperability: This is the ability to include governance, policy, social, legal and organizational considerations to facilitate the secure, seamless and timely communication and use of data both within and between organizations, entities and individuals. These components enable shared consent, trust and integrated end-user processes and workflows. |
Pilot Measures
The EMDI Pilots are expected to measure and identify successful interoperable standards and processes that acute and post-acute providers can use when implementing an interoperable workflow. Each pilot is expected to collect measures that apply to their current and expected workflow. These measures will be captured before the pilot is conducted and after the pilot has been completed. The measures collected will assist the EMDI Program in evaluating the success of the implemented interoperable solution and identify scalable provider-to-provider interoperable workflows.
Pilot information will be collected by the EMDI team and only approved pilot information will be shared on the EMDI Collaboration website. Participating organizations will be recognized on the EMDI Collaboration website and the ONC HealthIT Interoperability Proving Grounds website for their participation in the EMDI program. Each EMDI pilot is vital to reaching the goal of provider-to-provider interoperability and we encourage all organizations to consider the EMDI program when implementing interoperability.
Figure 2: EMDI Pilot Measurement
EMDI Use Cases
The EMDI Program Guide addresses the content and transport specifications needed to implement the following three use cases:
Use Case 1: Order
• An ordering provider sends a referral containing an order and other needed medical documentation to a service provider/supplier.
• The service provider/supplier decides whether to accept or reject the order. The service provider/supplier communicates this decision back to the ordering provider.
Use Case 2: Request for Medical Documentation
• The service provider/supplier requests additional medical documentation from the ordering provider.
• The ordering provider sends the requested documentation to the service provider/supplier.
Use Case 3: Request for Signature
• The service provider/supplier sends a document requiring a physician signature to the ordering provider and requests that the ordering physician sign, date, and return the document.
• The ordering provider sends the signed/dated document to the service provider/supplier.
Figure 3: EMDI Use Cases
EMDI Pilots
Tier 1 Pilots
Tier 2 Pilots
Tier 3 Pilots
Other Related Interoperability Initiatives
| Interoperability Initiative | Point of Contact |
|---|---|
| Da Vinci Project | jocelyn.keegan@pocp.com |
| PACIO Project | info@pacioproject.org |
| Blue Button | Visit CMS.gov or Medicare.gov websites |
| Carin Alliance | mark.roberts@leavittpartners.com |
| Social Determinants of Health/ Gravity Project | |
| Patient Generated Health Data | Maria.moen@advoltinc.com |
Pilot Documents
| Document | Purpose | Submission Method | Download |
|---|---|---|---|
| EMDI Participation Request Sheet | The EMDI Participation Request Sheet allows various healthcare organizations the opportunity to participate in the Electronic Medical Documentation Interoperability (EMDI) program. This is not a legally binding agreement and is to be used to outline the program guidelines and expectations for participation. All organizations participating in EMDI initiatives are expected to complete and submit this document to the EMDI team for review and approval. | CLOSED | Click Here |
| Pilot Update Template | The Pilot Update Template will be used to provide pilot updates to CMS and the EMDI Team. EMDI participants may submit the Pilot Update template to the EMDI team at any time for review. | CLOSED | Click Here |
| EMDI Program Guide | The EMDI Program Guide is intended for health IT stakeholders who volunteer to participate in the EMDI program and will build the architecture and the supporting infrastructure necessary for interoperability, and for those who will use that infrastructure. | CLOSED | Click Here |
| EMDI Pilot Measures | EMDI Measures are designed to capture the efficiencies of the EMDI Use Cases and report the aggregate metrics to CMS. | CLOSED | Click Here |
