Surescripts

Ownership

Privately owned by the National Association of Chain Drug Stores (NACDS), National Community Pharmacists Association (NCPA), CVS Health and Express Scripts.

Governance

Record Locator & Exchange (formerly National Record Locator Service): Governed by the Carequality Connected Agreement & Participant Agreements

Clinical Direct Messaging: Governed by DirectTrust & Participant Agreements

Geographic Reach (within US)

Nationwide

Mission

Surescripts’s purpose is to serve the nation with the single most trusted and capable health information network, built to increase patient safety, lower costs and ensure quality care.

How does this approach facilitate exchange?

Through the Surescripts Network Alliance and these solutions that support interoperability, Surescripts allows healthcare professionals to share prescription and clinical information to manage the care of patients. This includes, but is not limited to, discharge and visit summaries, patient charts, referrals, lab orders and results.

Surescripts offers HISP services to enable exchange of clinical direct messages via the Surescripts network. Surescripts also offers a nationwide Record Locator & Exchange service, which discovers historical patient visit locations and facilitates the exchange of clinical documents to provide the treating provider or care team a more comprehensive view of a patient's medical history. Surescripts Record Locator & Exchange also sends care managers and other healthcare providers proactive notifications of care events to ensure timely interventions.

Access Method (Use Cases)

Peer-to-peer query-based exchange

Admit, Discharge, Transfer (ADT) notifications for patients

Transitions of Care

Immunization notifications

Primary Goals/Objectives

Establish the most comprehensive access and exchange of patient information at a national scale.

Give providers and care managers the patient information they need to make more informed care decisions.

Enable better communication across care settings to improve care coordination.

Provide innovative, proactive notifications to eliminate gaps in care and improve care transitions for better outcomes.

Embed critical clinical history into all EHR and health information systems so that providers and caregivers have information at their fingertips and at the point of care.

Be the preferred connectivity solution for providers and technology vendors to connect to Carequality.

Type

Record Locator Service & query based exchange; Direct messaging; ADT notifications

Number of Live Connections and/or Participants

Record Locator & Exchange provides clinical history and patient record information for 233 million patients (71% of the US population). Over 3,000 health systems and physician practices – 61,000 providers – have enabled these services. Over 5.3 million messages that identify and enable the exchange of patients’ clinical documents are processed through Record Locator & Exchange every day across 600,000 providers, 35,000 clinics, and 1,250 hospitals in Carequality.

Clinical Direct Messaging gives physicians and other healthcare providers a seamless and secure electronic means for communicating and coordinating care with other members of a patient’s care team. Surescripts delivered nearly 26 million clinical messages in 2017—32 percent more than in 2016. Nearly 50,000 healthcare organizations are connected to the service with access to more than half a million validated directory addresses. Each month on average, Clinical Direct Messaging reports nearly 110,000 unique sending addresses and nearly 230,000 unique recipient addresses.

(As of July 2018)

Members

Participants are EHR/EMR vendors and their health system customers who are part of the Surescripts Network Alliance, as well as all participants in Carequality.

Primary Participants

Providers, care managers, pharmacists, and other healthcare professionals involved in care delivery are the primary participants and beneficiaries of the exchange made possible through these solutions.

Costs (Amount and/or Party Incurring Cost)

Record Locator & Exchange: Beginning in 2019, health systems will incur a nominal fee based on the size of their facilities.

Clinical Direct Messaging: Cost varies depending on organization, type, size, and expected level of use.

Directory/MPI Details

Provider directory & Master Patient Index (MPI) populated by Surescripts Network Alliance members, representing 233 million patients and 1.5 million healthcare professionals

Standards Leveraged

Record Locator & Exchange: Industry standard IHE profiles for XCA and XCPD as well as FHIR® document and patient resource searches. ADT HL7 messages for patient notifications.

Clinical Direct Messaging: Direct Applicability Statement v1.2, Direct XDR Edge Protocol, Direct SMTP Edge Protocol

Onboarding Process (Requirements to connect)

These solutions integrate directly into Electronic Health Record/Electronic Medical Record software. The customer receives network guides/requirements documentation, and their account is set up to access the Surescripts network.

The integration process includes testing to ensure that the customer meets all Surescripts's requirements. Surescripts provides a detailed plan outlining the necessary milestones for integration and moving into production.

Data Persistance

Hybrid Model: Surescripts stores basic demographic information, provided by healthcare providers, for purposes of patient matching and identification. Patient demographics include: Patient ID / Medical Record Number Patient name (first, middle, last, prefix, suffix), Patient Address (line 1 & 2, city, state, zip code), Patient date of birth, Patient gender. If a patient has chosen to opt-out of Record Locator & Exchange, this demographic information will still be stored in the Surescripts database in order to ensure information is not exchanged through the service. Surescripts does not store clinical records. Clinical records are stored and maintained by healthcare providers. Surescripts simply provides secure electronic transmission of records between providers.

Certification Requirements for Participation

Record Locator & Exchange: There is no certification process. Customers will perform message validation.

Clinical Direct Messaging: There is no certification process. Customers will perform message validation and Identify Proofing.

Testing

Customers will pass message validation prior to transitioning to production.

Surescripts message validation focuses on patient safety, efficiency of the electronic messaging process and ease of use by end-users.

In addition, Clinical Direct Messaging message validation focuses on message format, and when appropriate, application workflow and display in accordance with Surescripts's implementation guides.

Future Plans

Innovations in 2018 bring proactive patient notifications to providers and care managers in Record Locator & Exchange service for health systems in 2019. This advancement will arm healthcare providers with alerts of care events so that they have information to analyze and intervene in care without waiting on patients to present for encounters.

Surescripts will continue to serve the nation as the single most trusted and capable health information network.

Current Collaboration across Efforts

Surescripts is accredited by and a member of DirectTrust. DirectTrust accredited organizations can exchange clinical messages with Surescripts users. (source)

Surescripts is a founding member of Carequality and Record Locator & Exchange operates under the Carequality framework. (source)

Some EHR vendors have selected Surescripts as their HISP and have enabled their users to exchange clinical messages of the Surescripts network. (source)