EMDI Program Guides

Electronic Medical Documentation Interoperability (EMDI) Program Guides and Pilots

The Centers for Medicare & Medicaid Services (CMS) EMDI Initiative develops use cases, pilot protocols, implementation guides, and other documents identifying necessary standards and specifications based upon business scenarios and system functional requirements. The primary goal of the EMDI Initiative is to reduce provider burden through effective piloting and implementation of nationally recognized health IT standards. The EMDI Initiative includes voluntary participation by healthcare providers to adopt health IT standards and develop pilot activities. 

EMDI Guides 

The EMDI Program Guide and the Post-Acute Orders (PAO) Implementation Guide provide background information, guidelines, and resources to support the implementation of the EMDI use cases. The use cases are designed to promote provider-to-provider communications in a healthcare environment.

The EMDI Program Guide is 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 Program Guide supports 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 orders, home health and hospice referrals, medical documentation requests, and digital or electronic signature requests. The EMDI Program Guide also encourage FHIR as a data standard that uses an Application Programming Interface for exchanging electronic health records.

To view the latest version of the EMDI Program Guide, click the following link: Download the EMDI Program Guide Now.

The Post-Acute Orders (PAO) Implementation Guide defines a framework for ordering post-acute services and provides for the inclusion of appropriate documentation to support the medical necessity of the orders, refining the order based on clinical information, and communicating specific reviews or approvals to support appropriate billing. Additional details about the PAO Implementation Guide can be found on the HL7 FHIR webpage for post-acute orders.

EMDI Pilot Program 

The CMS EMDI Pilot Program facilitates and advances a secure and seamless exchange of electronic information between provider organizations. It is encouraged for healthcare providers and stakeholders that are interested in leveraging their existing data infrastructure to increase their interoperable exchange of electronic medical documentation to participate in an EMDI pilot. The EMDI team supports these pilots by hosting pilot discussions, conducting workgroup discussions, identifying pilot performance goals, collecting metrics, and creating pilot support documentation. Collaboration between EMDI participants through piloting promotes the adoption of standards in the healthcare industry, enhances data quality, streamlines medical documentation transactions, and improves patient care.

To learn more about how to conduct a pilot with the EMDI Initiative, please select the following link: Download the EMDI Pilot 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 (PDF)).