How will the CCD affect my exam?

Inquiring minds want to know. How will the CCD (Continuity of Care Document) affect my exam? In a word, significantly.

At the end of the exam, any provider who is meeting meaningful use is giving the patient a CCD. Simply doing that meets the MU requirement but, if we expand our thinking a bit, we can use the same technology to benefit your office as well as further the goals of connected care. Health care reform is all about improving quality and saving cost in delivering care. The CCD does that if we simply combine it with the communications requirement: to share it with other providers. Ask your patients to have their primary care physician send you an electronic copy of their CCD, and you can take off about 10 minutes from every exam. This assumes, of course, that you are using an EHR that has the ability to consume the data from the CCD.

We’d all agree, I’m sure, that there’s not an ECP in the country who wouldn’t want to stop making patients come into the office early to fill out paperwork that they don’t want to fill out. Paperwork then data entry. Who wouldn’t want to eliminate paying staff to enter that information? By asking for electronic CCDs, with one mouse click, you can have data that's more accurate than asking the patient, less time consuming, and more efficient.  Certainly, there are steps in this process you may not know how to accomplish today. Fortunately, we have groups of providers of ECPs that are doing this and are willing to assist other providers in learning the steps.

Jim Grue, O.D.

Note 1: We saw when e-prescribing was being adopted that complete and reliable patient records were not always available, that it took time for the nationwide eRX system to populate and become truly useful. It took doctors getting on board, using the system as designed. We’ll see a similar situation here. Stage 1 certification mandated the CCD but only on a test basis and only in a humanly readable format. Until Stage 2 certification arrives, consumable CCDs will be the exception rather than the rule. If you’re enjoying this capability today, even on a limited basis, thank your software vendor. You’re way ahead of the curve! 

Note 2: The CCD, with which you may be familiar today if you're using certified EHRs, will morph in Stage 2. The Stage 1 CCD and CCR will be replaced with a new Summary of Care Record. You may see it referred to as a CDA document. CDA means Clinical Document Architecture. Regardless of the acronym, the Summary of Care Record will include the structured allergy, medication and problem lists.

Note 3: Moving to the CDA standard from the current CCD format will require only minor programming changes for vendors who prepared well at Stage 1. The CDA standard may prove to be superior one for both providers and patients, an outcome we would expect from a process given as much public and industry review as is being afforded through the HITECH Act.

Alistair Jackson, M.Ed.