Addendum to the Supporting Statement for 0960-0798

Addendum to the Supporting Statement for Form SSA-680

Social Security Administration Health IT Partner Program Assessment –

Participating Facilities and Available Content Form

20 CFR 404.1614, 416.1014

OMB No. 0960-0798

Revisions to Form SSA-680

All of the information SSA receives from potential partners will reside solely with us. Any healthcare entity that expects to partner with us must complete the form, which specifically provides information about the sections below.

We are making the following revisions to each section of the form:

Partnering Process Overview for the partner organization:

• This section contains explanatory information only. We collect no data in this section.

• Change #1:  We created a more detailed process overview from the original form.

Justification #1:  We received feedback from organizations that utilized this form that the form did not stand on its own merit and required a conference call discussion with SSA prior to utilization. The respondents can now complete the form independently.

Introductory Questions to identify the partner organization:

We are making no changes to this section; however, it collects the following information:

• Health Information Exchange (HIE): Including Regional Health Information Organizations

• Hospital: Including hospitals, medical groups and/or networks

• Physician Group

• Integrated Physician Network

• Identification identify the characteristics that best describe the organization

• Names Addresses and Physician counts for each organization

• Explanation of current health IT electronic data exchange capabilities

• Opportunity to disclose any other data exchange relationship with other Federal entities

• List of document types that the organization can share electronically

Questions to identify the partner organizations’ available clinical documents:

We are making no changes to this section; however, it collects the following information:

• Identify the types and formats of clinical documents that are currently generated within the organization (Report Types, Audiology, Psychology, Cardiac, Neurology, Ophthalmology, Radiology, Respiratory, Surgical, and Other Procedure Reports)

• The documents by report type are listed and format, structure, and characteristics of the documents can be selected.

• STRUCTURED STANDARDS BASED DOCUMENTS: A stand-alone document that contains discrete data elements. A structured standards based document shall have narrative text and discretely coded data. Examples include documents such as Procedure Note, History and Physical, Discharge Summary, Continuity of Care Record, etc.

• UNSTRUCTURED DOCUMENTS: A stand-alone document that does not contain discrete data elements. Examples include natively formatted documents such as TIF, PDF, TXT, JPG, etc. Unstructured documents may also be encapsulated in a CDA wrapper (HITSP/C62 and HL7 Unstructured Docs). (CDA Definition: http://www.hl7.org/implement/standards/cda.cfm)

Questions to identify the CDA/CCDA capability:

We are making the following changes to this section:

• Change #2:  We changed the section title from ‘CCD Continuity of Care’ to ‘CDA/CCDA Capability’ to be consistent with the new header used on the tab of the form

Justification #2:  The change in name for this section is a reflection of how health IT terminology changed since we created the form in 2012. The use of Clinical Document Architecture (CDA) and Consolidated Clinical Document Architecture (CCDA) to discuss clinical continuity of care data are consistent with the language used in the Office of the National Coordinator Meaningful Use Regulations.

• Change #3:  We changed this area of the form from open responses to checkmark selections for each area.

Justification #3:  We classify the data within each of the areas below as Narrative Information, Coded Data, or Data Not Available. We provide a section for comments; however, we do not require comments. We made this change to simplify data collection for respondents. We expect respondents to complete this section of the form in less time than the previous version of the form. The benefit to SSA is to receive consistent answers across respondents that will allow for more consistent evaluation of respondents’ capabilities.

• Change #4:  We updated the listing of categories in Section 4: CDA/CCDA Capability

Justification #4:  We updated the list to reflect the sub-sections in Section 4 to match them in the correct order of the headers of the tab. We listed these items in the previous addendum, but not in the order that matches the revised form.

This section collects the following information:

Data within each of these areas needs to be classified as Narrative Information, Coded Data, or Data Not Available. A section is provided for comments, however comments are not required.

• Identification of the Provider Entity

• Problem Summary Documentation

• Medical Encounter Summary Documentation

• Procedure Summary Information (All interventional, surgical, diagnostic, or therapeutic procedures or treatments)

• Complication Data

• Post Procedure Diagnosis Data

• Lab Data

• Functional Status Data

• Vital Signs Data

• Medical Equipment Data

• Medication Data and History

• Physical Exam Data

• Plan of Care Information

• Social History Information

• Assessment and Plan Information

• Past Illness Information

• Medical Notes (Admission Summaries, ER Notes, Discharge Summaries, Operative Notes, Outpatient Notes, etc.)

• Treatment Data

• Contact Information

• Terminology Information; indicated as either Available or Not Available data