Promoting Interoperability/Meaningful Use of Electronic Health Records

The Texas Department of State Health Services (DSHS) supports the exchange of data with health care providers consistent with programs such as the Centers for Medicare and Medicaid Services’ (CMS’) Promoting Interoperability programs.

This page includes a table with information about DSHS programs’ capabilities for exchanging data to help providers meet Promoting Interoperability programs’ requirements and serves as DSHS’ declaration of readiness to exchange information.

Public Health Reporting Options and DSHS Declaration of Readiness

The table below presents opportunities known to DSHS for health care providers to collaborate with public health entities to assist the provider in meeting Promoting Interoperability program requirements.

Program participants should contact other public health agencies serving their area and professional societies for additional options.

Options for Interoperability Program Participants

Program Measure Name

Exchange Options Available for Eligible Clinicians (ECs)

Exchange Options Available for Eligible Hospitals (EHs)/Critical Access Hospitals (CAHs)

Electronic Case Reporting (eCR)

DSHS has not declared readiness for eCR reporting for ECs at this time.

On September 1st, 2023 DSHS declared its readiness to receive eCR submissions from all EHs and CAHs in Texas, consistent with federal Promoting Interoperability requirements.

To submit data, EHs and CAHs must first register with DSHS and complete onboarding and validation activities. Data exchange will occur through the Association of Public Health Laboratories Informatics Messaging Services (AIMS) platform.

Please see complete program information on the Electronic Case Reporting webpage.

Reporting to an Immunization Registry

ImmTrac2 is making bidirectional data exchange of immunization information available to authorized users using current data exchange standards specified in the federal rules supporting Promoting Interoperability programs.

By announcing DSHS’ ability to support bidirectional exchange on June 26, 2020, DSHS is providing health care providers more than six months’ notice to be actively engaged with DSHS for Promoting Interoperability program reporting periods beginning on or after January 1, 2021.

Please see the Immunization Bidirectional Data Exchange page for additional information.

ImmTrac2 is making bidirectional data exchange of immunization information available to authorized users using current data exchange standards specified in the federal rules supporting Promoting Interoperability programs.

By announcing DSHS’ ability to support bidirectional exchange on June 26, 2020, DSHS is providing health care providers more than six months’ notice to be actively engaged with DSHS for Promoting Interoperability program reporting periods beginning on or after January 1, 2021.

Please see the Immunization Bidirectional Data Exchange page for additional information.

Syndromic Surveillance Reporting

DSHS began accepting registrations from practitioners in urgent care settings on May 5, 2016.

DSHS is accepting information consistent with the applicable federal rule, using the Public Health Information Network (PHIN) Messaging Guide for Syndromic Surveillance: Emergency Department, Urgent Care, Inpatient and Ambulatory Care Settings, Release 2.0 (April, 2015) and the Erratum, available on the PHIN Messaging Guide web page, as described in the 2015 Edition Health IT Certification Criteria.

Please see the syndromic surveillance detail page for additional information.

DSHS began accepting registrations from EHs and CAHs beginning May 5, 2016.

DSHS is accepting information consistent with the applicable federal rule, using the PHIN (PHIN) Messaging Guide for Syndromic Surveillance: Emergency Department, Urgent Care, Inpatient and Ambulatory Care Settings, Release 2.0 (April, 2015) and the Erratum, available on the PHIN Messaging Guide web page, as described in the 2015 Edition Health IT Certification Criteria.

Please see the syndromic surveillance detail page for additional information.

Specialized Registry Reporting 
Public Health Registry Reporting
Clinical Data Registries

The Texas Cancer Registry, operated by DSHS is currently accepting information from providers who diagnose or treat cancer.

DSHS is able to accept messages compliant with 2015 Edition Health IT Certification Criteria standards, including support for the HL7 Implementation Guide for CDA© Release 2: Reporting to Public Health Cancer Registries from Ambulatory Healthcare Providers, Release 1. 
No other registries are currently provided by DSHS to support Promoting Interoperability requirements.

The National Center for Health Statistics (NCHS) conducts national health care surveys and is accepting registrations from EPs and ECs to participate in the National Ambulatory Medical Care Survey.

ECs should contact relevant specialty medical societies for other options.

No registries are currently provided by DSHS to support Promoting Interoperability requirements.
The National Center for Health Statistics (NCHS) conducts national health care surveys. Surveys conducted by NCHS include:

  • The National Hospital Ambulatory Medical Care Survey and
  • The National Hospital Care Survey.

National Healthcare Safety Network (NHSN) Antimicrobial Use (AU) and Antimicrobial Resistance (AR) (AUR) reporting have been identified as a new option for public health registry reporting under Stage 3. For additional information see the CDC's NHSN Meaningful Use Overview.

EHs and CAHs should contact relevant specialty medical societies for other options.

Clinical Data Registry Reporting 

DSHS provides no connections to clinical data registries in support of the Promoting Interoperability programs.

DSHS provides no connections to clinical data registries in support of the Promoting Interoperability programs.

Electronic Reportable Laboratory Results Reporting 

Not applicable.

Electronic Laboratory Reporting (ELR), is operated by DSHS.

DSHS supports the 2015 Edition Health IT Certification Criteria currently accepting messages consistent with the HL7 2.5.1 Implementation Guide, Electronic Laboratory Reporting to Public Health, Release 1.

If a program participant determines that they meet exclusion criteria specific to any applicable measure, or any available alternate exclusions identified by CMS, they may claim an exclusion during the attestation/data submission process. Federal regulations do not authorize DSHS to grant exemptions from meeting Interoperability Program requirements.

Active Engagement

To attest to meeting any of the above measures, the program participant must be actively engaged with the public health authority (PHA) or, where applicable, the clinical data registry (CDR) operating the registry. “Active Engagement” means that the eligible hospital or CAH is in the process of moving towards sending "production data" to a PHA or clinical data registry (CDR), or is sending production data to a PHA or CDR.

Production data refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and “test data” which may be submitted for the purposes of enrolling in and testing electronic data transfers.

Active Engagement Option 1: Pre-production and Validation: The eligible hospital or CAH registered to submit data with the PHA or, where applicable, the CDR to which the information is being submitted; registration was completed within 60 days after the start of the EHR reporting period; and the eligible hospital or CAH is awaiting an invitation from the PHA or CDR to begin testing and validation. Then, the eligible hospital or CAH begins the process of testing and validation of the electronic submission of data. Eligible hospitals or CAHs must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within an EHR reporting period would result in that eligible hospital or CAH not meeting the measure.

Note: This option allows eligible hospitals or CAHs to meet the measure when the PHA or the CDR has limited resources to initiate the testing and validation process. Eligible hospitals or CAHs that have registered in previous years do not need to submit an additional registration to meet this requirement for each EHR reporting period.

Active Engagement Option 2: Validated Data Production: The eligible hospital or CAH has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR.

Questions

Questions about public health reporting should be sent to  MeaningfulUseTX@dshs.texas.gov.

Information about the Quality Payment Program is available at CMS’ website.

DSHS Program-Specific Information

Other Texas Resources on Meaningful Use

National Promoting Interoperability/Meaningful Use Websites

Contact

For more information please email MeaningfulUseTX@dshs.texas.gov.