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EMDI Implementation Guides

Electronic Medical Documentation Interoperability (EMDI) Implementation Guides and Pilots

The Centers for Medicare & Medicaid Services (CMS) EMDI program develops use cases, pilot protocols, implementation guides, and other documents identifying necessary standards and specifications based upon business scenarios and system functional requirements.

The EMDI program includes:

  1. Voluntary participation by healthcare providers to adopt data standards and develop pilot activities
  2. Open support of various data standards by CMS and EMDI stakeholders

EMDI Implementation Guides

The EMDI Implementation Guides provide background information, guidelines, and resources to support the implementation of use cases. The use cases are designed to promote provider-to-provider communications in a healthcare environment.

The EMDI Implementation Guides are standards-based and consistent with the Health Level Seven International (HL7) Attachments Implementation Guide and the Health Insurance Portability and Accountability Act (HIPAA) Electronic Data Interchange X12 275 standards.

Additionally, the EMDI Implementation Guides support the use of CONNECT or Direct transport mechanisms to reduce the use of fax and physical mail. This facilitates the submission of Durable Medical Equipment and Home Health orders, medical documentation requests, and Digital and Electronic signature requests. The EMDI Implementation Guides also encourage Fast Healthcare Interoperability Resources (FHIR) as a data standard that uses an Application Programming Interface for exchanging electronic health records.

EMDI Pilots

The CMS EMDI program supports each pilot organization, organizes pilot development calls, and leads workgroups to discuss pilot criteria, performance goals, and metrics. Collaboration serves to increase the adoption of standards in the healthcare industry, enhance data quality, streamline medical documentation transactions, and improve patient care.

To review the details of the EMDI use cases, download the current version of the EMDI Implementation Guide.

CMS review contractors cannot target providers for medical review just because they participate in EMDI pilots (CMS Program Integrity Manual Chapter 3, Section 3.2.1).

EMDI pilots help improve medical documentation submissions and prevent claim denials. Improved provider documentation via electronic submission may help make the claims a low priority for review.