ToC+-+Challenge+Statement

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3.0 Challenge Statement
Meaningful Use Stage 1 and anticipated Stage 2 criteria require information to be exchanged in transitions of care. Implementers are often confused on how to adopt the specifications for exchange of the required data. The content of any exchange is only as good as its fidelity to source, assured identity, provenance, completeness, audit/traceability, full context, along with permissions and qualifications. Without ensuring these characteristics across information exchanges such that all are fully evident to the receiver (and ultimate user), no exchange is valid. Furthermore, this exchange is dependent on a secure, interoperable environment.

Different transition scenarios may require different types of artifacts (e.g. a transition from inpatient to ambulatory may require a discharge summary; a transition from primary care provider to specialist may require a referral summary, etc). All of these artifacts should draw from a common framework. As part of that framework, we should allow for different data elements to be communicated as needed. Ultimately, the data needs of the patient and caregivers should be considered because it is the patient and/or legal representative that are the recipients and users of the data.

The exchange of clinical summaries is challenged by the selection of a single format for all transfers of care that does not support the various requirements for the data elements of different stakeholders. The current requirements that these all be communicated in either the CCD or CCR format may exclude data not supported by those standards. On the other hand, the use of a variety of formats for each different type of transfer of care would make it extremely difficult for systems to exchange and communicate the necessary data.

The challenge then is to:
 * Identify the kinds of data needed for various transfers of care by all the stakeholders.
 * Based on that result, agree to a minimum subset that is needed for most common transfers of care.
 * To define a uniform way how commonly used information is structured
 * To provide a robust tool-set to aid in the development and validation of conforming implementations to support widespread adoption.

Previous Versions
__**Click on the version number in the table below to download the Word document for previous iterations of the Challenge Statement.**__
 * **Previous Versions** ||
 * [|v 0.1] ||
 * [|v 0.2] ||
 * [|v 0.3] ||

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