Background

Contributing data back to the networks is a requirement for all organizations who participate in Carequality, CommonWell, and eHealth Exchange. It is imperative to sustain and build trust in the networks - if all organizations only retrieved data and did not contribute data, the networks would collapse. Lastly, and most importantly, contributing data back ensures that other participating organizations receive critical patient data from your organization to help guarantee that patients receive the most informed, high-quality care.

Requirements

Particle customers must be actively treating any patients that you create and / or query via Particle. As such, Particle expects that our customers are collecting or generating treatment data for all patients you create and/or query.

In order to fulfill bi-directionality / reciprocity requirements, Particle customers must contribute data back to the networks for 100% of the patients that you create and / or query via Particle within 30 days of first creating or querying the patient.

This 30-day compliance window is rolling, beginning the date that a customer creates and / or queries the individual patient. It accounts for the fact that many customers query in advance of appointments scheduled in the coming month.

Data Sufficiency

Customers are required to submit all new data that you collect or generate on the patient, such that you continue to fully and completely represent all data and resources available in your systems* for the patient. Any new data or resources must be contributed within 24 hours of when the data was collected or generated.

The data you contribute should align as closely as possible to the data elements and requirements outlined in the USCDI V5 specifications. For patient encounters, customers should provide a clinical encounter summary and the full set of USCDI V5 data elements captured in your systems* from the encounter. For any patient interactions that occur in between full encounters (e.g., phone calls, refills), customers should contribute any net-new clinical data captured, including care plan updates, call notes, refills, changes to the patient’s care team, etc.

Net-new clinical data not only includes all data captured by the care team directly from the patient, but also any derived data (e.g., AI-generated care plans, patient summaries, etc.).

Data should be contributed in the form of CCDA documents whenever possible. If there are limitations in your ability to support CCDA, we can accept PDF in certain instances. Reach out to your Particle Health representative to discuss CCDA vs. PDF vs. other data format options.

*Customers are required to contribute the full extent of net-new clinical data in your systems. There is no expectation that you must return the full set of data captured in any other applications that the provider uses during the patient encounter. For example, if you are a lab company and your application collects lab result data, you are only expected to contribute the lab result data collected in your application. You are not expected to contribute the full clinical encounter notes captured separately in the provider’s EHR. In fact, it is important that you do NOT contribute data that is already captured and contributed via other applications, in order to reduce duplicative data on the networks.

Data Contribution Timelines & Implementation

Before going live in production on Carequality, CommonWell, and eHealth Exchange, customers must successfully complete testing of the bi-directionality workflows in Particle’s Sandbox environment for at least one test patient, including patient creation and upload of at least one test document that is representative of expected production documents.**

Once you have completed testing in Sandbox and a directory listing is activated for your organization on Carequality, CommonWell, and eHealth Exchange in production, you must successfully upload at least one compliant document for at least one patient within 2 weeks of the date of your first query in production to provide proof of bi-directionality compliance.

Additionally, you must meet the requirement to contribute data back to the networks for 100% of the patients that you create and / or query via Particle within 30 days of first creating or querying the patient.

As mentioned above, this 30-day window is rolling, beginning the date that a customer creates and / or queries the individual patient. It accounts for the fact that many customers query in advance of appointments scheduled in the coming month.

These contribution timelines & implementation requirements apply to each new, individual directory listing that your organization adds.

**Please note that NO PHI should be submitted to Particle’s Sandbox environment.

Canceled and Rescheduled Appointments

As customers must be providing treatment to any patients that you create and / or query via Particle, we do expect and require customers to capture and contribute data for 100% of your patients that you create and / or query via Particle.

We recognize, however, that there are instances where a customer may query a new patient in advance of a scheduled appointment, and the appointment is subsequently rescheduled to a later date (i.e., outside of the 30-day bi-directionality compliance window) or canceled entirely.

In these instances, if it is a new patient for whom you do not yet have any historical patient history to contribute, customers are expected to provide a more limited set of patient information, including: patient demographics, insurance coverage, the care team assigned to the patient, upcoming appointment(s) scheduled, and if, relevant, notification of appointment cancellation.

Particle can provide a template to share this information in CCDA upon customer request (templates in additional formats coming soon).

Non-Compliance

Particle will monitor and address any non-compliance with customers. In the event of sustained non-compliance, Particle will suspend a customer’s ability to query. If you have questions or are looking to better understand your organization’s current compliance, please reach out to your Particle Health account representative and we can provide you with a report.

Exceptions

Particle Health reserves the right to grant exceptions to this policy in extenuating circumstances on a case-by-case basis. Please reach out to your Particle Health representative if you believe an exception may apply to your organization.