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Staying ahead of regulatory trends and keeping our partner hospitals up-to-date and compliant has put MEDHOST at the forefront of community healthcare for over 40 years. That’s because we believe rising to meet the challenges of today means securing a healthy future for tomorrow.

In this post, we’ll discuss HT1-1, what it means to you, and how we’re prepared to help our partner facilities stay ahead of regulatory updates.

What is HTI-1?

The ONC published the final rule for “Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing” (HTI-1) on January 9, 2024, to update implementations related to the 21st Century Cures Act, expand interoperability, and promoting health equity.

From a certification perspective, an impactful component of the HTI-1 rule is “editionless” certification. This update has been perceived to provide a consistent, transparent, and incremental update cycle.

Just like other iterative regulatory requirements participating facilities must adhere to, compliance with HTI-1 is mandatory.

How Can You Prepare?

In the coming years, programs like HTI-1 will redefine government requirements across the healthcare industry, putting increased demands on providers and opening the door for new technologies and advanced care modalities.

Staying ahead of technological evolution, embracing software innovation, and ensuring regulatory compliance requires a strategy driven by leading practices, a focus on end-user adoption, and execution through partnerships between facilities and their IT vendors.

MEDHOST Elevate: Your Path to Compliance and Modernization

Extremely tight timeframes complicate the path to meaningful use. In response, MEDHOST has launched our most ambitious customer support initiative yet—MEDHOST ElevateTM—to sustain and prepare our partner hospitals for these changes while empowering them with greater financial, clinical, and operational resiliency than ever before.

For customers participating in the HTI-1 program, we offer comprehensive guidance and expert support, assisting them every step of the way—from their current state to successful implementation.

If you're interested in learning more about how we can help your facility stay ahead of regulatory trends, email us at inquiries@medhost.com or call 1.800.383.6278.

Since their introduction in January 2021, healthcare providers have largely overlooked the Centers for Medicare and Medicaid Services (CMS) price transparency regulations.

However, with CMS now imposing substantial fines for non-compliance, rural hospitals stand to gain from competitive pricing and enhanced digital engagement.

Understanding CMS Price Transparency Rules

Healthcare providers are required to compile and publicly display extensive billing data, including a machine-readable file of all standard charges and a consumer-friendly list of 300 shoppable services.

Shoppable services refer to non-emergency care where prices can vary among providers. For example, a patient requiring an MRI could compare costs for this procedure at different facilities in their region based on their insurance coverage.

Why Have Healthcare Providers Been Hesitant to Adopt Price Transparency?

A recent JAMA study found that about 51% of hospitals do not comply with CMS requirements.

Healthcare providers have been slow to comply with CMS price transparency rules because it is a complex and demanding process. Facilities must gather and update a wide range of information annually for each chargeable item, including gross charges, contracted prices with each payer, a discounted cash price, and the minimum and maximum negotiated prices.

Compliance also carries financial risks, such as revealing competitive disadvantages.

The healthcare sector's recovery from the pandemic has also influenced CMS's initial hesitation to enforce the penalty of $300 per day against non-compliant hospitals.

Increased Enforcement by CMS

Recently, CMS imposed significant fines on two Georgia healthcare providers, Northside Hospital Cherokee and Northside Hospital Atlanta, totaling over $1 million. This action indicates a more assertive approach to enforcement.

Going forward, CMS will audit hospital websites and review public complaints to assess compliance. Non-compliant providers will receive a warning, a request for corrective action, and potentially a civil monetary penalty, which will be publicized.

This development is an alert for larger providers lagging in compliance, but it offers an opportunity for rural hospitals to improve their market position.

Benefits for Rural Hospitals

Competitive Pricing

Rural healthcare providers frequently offer lower prices than urban hospitals, rendering them more appealing to cost-conscious patients.

Enhanced Revenue

An increased customer base can significantly benefit remote hospitals struggling financially. Adopting price estimation and contract management technologies can provide accurate financial expectations for patients and ensure correct payer reimbursements.

Better Digital Patient Experience

Providing online price estimates can increase customer satisfaction. A comprehensive digital patient experience includes eStatements, online bill payment, and digital support, as well.

MEDHOST Price Transparency Solution

MEDHOST offers a solution to help hospitals display accurate, current pricing and leverage digital tools for improved patient care and revenue.

This includes a web-based search page for the 300 shoppable services, automatic generation of comprehensive, standard charges, integration with contract management tools, and minimal disruption to existing customer workflows.

For more information, reach out to us at inquiries@medhost.com or call 1.800.383.6278.

At MEDHOST, we take pride in supporting and guiding our customers throughout the continuous evolution in the healthcare environment. Essential to that duty is helping our customers meet compliance on critical regulations like the Cures 2023 Promoting Interoperability Act (PI) and Electronic Case Reporting (eCR).

To help them in ensuring compliance with both of these federally mandated regulations, we have launched the MEDHOST Cures 2023 Interoperability and Electronic Case Reporting (eCR) solutions. Both these solutions help strengthen our customers’ ability to comply with these mandates and reduce workflow disruptions related to achieving compliance to avoid costly noncompliance penalties.

The MEDHOST Cures 2023 Interoperability Solution facilitates the access and exchange of electronic health information (EHI). The eCR solution helps the Promoting Interoperability program participants meet new CMS public health reporting requirements by enabling them to generate and transmit case reports for specific reportable conditions.

Read the full press release to get more information.

The Promoting Interoperability (PI) program continues to evolve with the changing healthcare landscape.

Driven by the COVID-19 Pandemic, the Opioid Crisis, and the continued integration of EHRs into clinical workflows, this ongoing transformation is reflected in the 2022 reporting requirement updates made by the Centers for Medicare and Medicaid Services (CMS). These updates include modifications to the Public Health and Clinical Data Exchange Objective, revised eCQM reporting requirements, and the addition of an attestation requirement regarding the SAFER Guides.

Public Health and Clinical Data Exchange Objective

The Public Health and Clinical Data Exchange Objective requirements for 2022 have increased from two to four measures. The four required objectives are:

  1. Syndromic Surveillance Reporting
  2. Immunization Registry Reporting
  3. Electronic Reportable Laboratory Result Reporting
  4. Electronic Case Reporting (eCR)

To meet this objective, a hospital must have the certified software installed and be engaged with the appropriate registries during their 90-day reporting period.

MEDHOST supports the reporting of all four of these requirements. Syndromic Surveillance, Immunization, and Electronic Lab Result reporting have been long-standing reporting functionalities available in the MEDHOST platform, while eCR functionality is available beginning with the MEDHOST Enterprise 2021 R1 release.

eCQM Reporting

In 2022 participants in the PI program must submit three-quarters of data on four clinical quality measures. Unlike previous years, CMS now requires submission of the measure CMS506: Safe use of Opioids – Concurrent Prescribing.

The following graphic outlines the one required measure and a list of additional measures from which facilities can choose to achieve full compliance.

Important Promoting Interoperability Requirements for 2022 graphic EHR

To solve for the newly mandated Safe Use of Opioids reporting requirement, the MEDHOST Business Intelligence (BI) tool will extract all information relevant to that measure from existing documentation points in the MEDHOST Enterprise system.

SAFER Guides

In 2022 participants in the PI program are required to attest to completing an annual assessment rating the use of their EHR using all nine SAFER guides.

Developed by the ONC in 2014 and revised in 2016, the SAFER guides evaluate the implementation and incorporation of EHR functionalities in the clinical setting. This requirement is a yes/no attestation; hospitals and CAHs do not need to demonstrate that they have implemented the guidelines. The facility is only required to complete an evaluation using the guides. These guides can be completed at any point in 2022; they do not have to be completed during the reporting period.

Recognizing that the initial completion of these guides is likely to be challenging, MEDHOST has developed a SAFER Guide Toolkit which is available in MEDHOST Community in the Regulatory and Compliance section.

To learn more about how MEDHOST can help you meet these updated Promoting Interoperability requirements, please reach out to your Customer Success Executive or inquiries@medhost.com.

Public Health Reporting requirements on conditions specified by The Centers for Disease Control (CDC), The Centers for Medicaid and Medicare (CMS), and other related healthcare organizations have been part of Promoting Interoperability (PI)—formerly known as Meaningful Use1—since its inception. While public health reporting requirements have changed throughout program iterations, it was likely that some requirements would become obsolete around 2019.  

However, along with other considerations, the onset of the COVID-19 pandemic amplified the value in electronic reporting, resulting in a volte-face in CMS’ stand around the need for its continued use and certification. As part of the 2022 Inpatient Prospective Payment System (IPPS) rule, CMS mandated that health care facilities participating in PI must report for at least 90 days in Calendar Year 2022 (CY2022) on the following to qualify for federal healthcare incentives and avoid penalties. 

Why Mandate Electronic Case Reporting for Public Health? 

In mandating electronic case reporting on these specified conditions, CMS hopes to improve monitoring for public health emergencies while simultaneously providing a pathway for speedier and more efficient responses to such outbreaks.  

While there are no specific content exchange standards per the regulation, the mandate will require:  

What eCR 2022 Means for Healthcare Providers 

One of the main challenges this mandate presents to the facilities is short on-boarding time. The quick turnaround needed to meet a CY2022 deadline is further complicated when considering state-specific variations in their ability to accept case reports. 

How MEDHOST Helps Hospitals Prepare 

MEDHOST has supported the capability to report on the first three requirements (immunization registries, syndromic surveillance, and reportable lab tests and values/results) since the onset of the Meaningful Use Program. To ensure customers meet the program’s requirements, MEDHOST is also introducing support for 170.315 (f)(5) – Transmission to public health agencies – electronic case reporting.  

In its current state, the MEDHOST Electronic Case Reporting solution features: 

In keeping with MEDHOST’s endeavors to offer the best solutions to our customers, the MEDHOST 2022 R1 release will support the eCR Now application that will rely on FHIR integration. eCR is now a recommended solution from the ONC as a standardized mechanism of case reporting and will keep our customers on par with the industry. This integration will be available for adoption in CY2022 and is a MEDHOST best practice recommendation. 

To address any concern over the 90-day reporting requirement in CY2022, MEDHOST is offering this functionality in MEDHOST Enterprise 2021 R1 by modifying the Continuity of Care Document (CCD) to include information on reportable conditions. The functionality will also exist to maintain the list of reportable conditions automatically. 

To learn more about ECR and this critical Promoting Interoperability capability, please reach out to your Customer Success Executive or inquiries@medhost.com 

1 MEDHOST Enterprise 2019 R1, The Business Intelligence v5.5, MEDHOST EDIS 2019 R1 MEDHOST Enterprise, The Business Intelligence, MEDHOST EDIS 1 and MEDHOST Cloud Services Patient Portal with YourCareEverywhere ® App products and MEDHOST Cloud Services API are ONC 2015 Edition-compliant and have been certified by an ONC-ACB in accordance with the applicable certification criteria adopted by the Secretary of the US Department of Health and Human Services. This certification does not represent an endorsement by the US Department of Health and Human Services or guarantee the receipt of incentive payments. For a complete review of the EHR certification and accompanying "Cost and Limitations" statements, visit https://www.medhost.com/about-us/regulatory-and-compliance/"https://www.medhost.com/about-us/regulatory-and-compliance/.  

A version of this article was originally published by our ePCS (electronic prescribing of controlled substances) partner, Surescripts.

Our partnership with Surescripts plays a critical role in helping our hospital customers remain compliant with several healthcare IT-related regulations.

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As Congress reconvenes in Washington this week, here are six healthcare regulatory and policy issues we’re keeping our eyes on. We hope this primer will help demystify the state of the health IT regulatory environment and give readers a deeper understanding of the impact and import of this activity.

  1. The 21st Century Cures Act, Interoperability and Patient Access Rules

The gist: In 2020, the Department of Health and Human Services (HHS) issued two related rules to implement the 21st Century Cures Act to encourage interoperability among health information technology systems, improve patient access to their health care information, and discourage practices that unreasonably prevent the access, exchange or use of such information. These rules, among many other things:

Background: The intent of these rules is to address concerns that healthcare organizations may make it unnecessarily difficult for patients and providers to obtain electronic health information, whether it's upon a patient's request, or for purposes already permitted under applicable law, such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Status: These rules are in effect. We expect the HHS Office of Inspector General (OIG) to release its final rule regarding the enforcement of the information blocking provision early this year.

2. The Trusted Exchange Framework and Common Agreement (TEFCA)

The gist: TEFCA is intended to establish the infrastructure model and the governing approach for users in different networks to securely share basic clinical information with each other—all under commonly agreed-to expectations and rules. In August 2019, the Office of the National Coordinator for Health Information Technology (ONC) awarded a cooperative agreement to The Sequoia Project to serve as the Recognized Coordinating Entity (RCE) to administer a new nationwide network based on the Common Agreement. Visit ONC’s TEFCA website for more detail.

Status: The RCE recently finalized the common agreement,  standard operating procedures as well as the Qualified Health Information Network (QHIN) technical framework. ONC expects to begin reviewing QHIN applications and onboarding QHINs to the network by the second half of 2022.

3. HIPAA Notice of Proposed Rule Making and Care Management

The gist: The current HIPAA regulation limits the ability to access protected health information (PHI) for purposes of care coordination and case management with entities that are not health care providers. HHS is looking to change that. The HIPAA Notice of Proposed Rule Making modifies the current regulation in order to support individuals' engagement in their health care, remove barriers to coordinated care, and decrease regulatory burdens on health care providers and health plans.

More background: These modifications address impediments to the transition to value-based health care by limiting or discouraging care coordination and care management communications among individuals and covered entities (including hospitals, physicians, and other health care providers, payers, and insurers) or posing other unnecessary burdens. The NPRM includes proposals to address these burdens while continuing to protect the privacy and security of individuals' PHI.

Status: This is a proposed rule, pending the publication of a final rule by the HHS Office of Civil Rights.

  1. Real-Time Prescription Benefit Tools

The gist: The Consolidated Appropriations Act of 2020 included three provisions aimed at accelerating adoption and use of a real-time benefit tool (RTBT) for prescription drugs by 1) requiring that all Part D insurers provide for a RTBT that enables electronic transmission of eligibility, formulary and benefit information to each enrollee’s prescribing clinician; (2) adding use of a RTBT to the Merit-Based Incentive Payment System (MIPS) measures, and (3) requiring qualified EHRs under the ONC Health IT Certification Program to include a RTBT that conveys patient-specific cost and coverage information.

Status: The requirement on Part D plans was implemented on January 1, 2021. The second provision regarding MIPS took effect January 1, 2022. However, HHS’ implementation of the third provision, which requires qualified EHRs to include RTBT functionality that conveys patient-specific cost and coverage information, has been delayed. The delay is due to the requirement that rulemaking be conducted by CMS and ONC prior to implementation We don’t expect rulemaking to be complete before the third quarter of 2022 at the earliest.

Context and commentary: The requirement that insurers make an RTBT available in the Part D context is already in place. Surescripts Real-Time Prescription Benefit enables prescribers to be compliant with these legislative and regulatory actions. As of October, more than 550,000 prescribers were using Real-Time Prescription Benefit, which speaks to the technology’s utility and value. This year, we also expanded the reach of Real-Time Prescription Benefit among pharmacy benefit managers and health plans, covering more than 97% of U.S. patients in October 2021, up from 82% in 2020.

  1. Electronic Prior Authorization Requirement

The gist: On Dec 31, 2020, CMS issued a final rule that, for the first time, requires Part D prescription drug plans and prescribers to support a new electronic prior authorization transaction standard for their Part D e-prescribing programs. The rule, which has an effective date of January 1, 2022, but allowed plans to begin adopting it on January 1, 2021, also requires Part D plans to adopt NCPDP SCRIPT standard v2017071.

Status: This rule took effect on January 1, 2022 and adoption is underway.

Context and commentary: We are glad that CMS has recognized the value of the NCPDP standard for electronic prior authorization by mandating it for the patient populations they serve, specifically those in Medicare Part D plans and prescribers. Surescripts Electronic Prior Authorization utilizes NCPDP SCRIPT standard v2017071.

  1. EPCS Federal Mandate

The gist: On December 1, 2020, CMS announced in a final rule its decision to require that Part D providers use e-prescribing of controlled substances (EPCS) effective January 1, 2021. The rule implements a provision of the SUPPORT for Patients and Communities Act, which became law in 2018.

Status: While the rule is in effect, CMS has delayed the start date for compliance actions by one year to January 1, 2023. The start date for compliance actions for Part D prescriptions written for beneficiaries in long-term care facilities has also been delayed to January 1, 2025. CMS will initially enforce compliance by sending compliance letters to prescribers violating the EPCS mandate.

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In partnership with Surescripts, MEDHOST is dedicated to helping hospitals across the nation remain in compliance with new healthcare IT regulations, optimize patient care, maximize reimbursements, and avoid penalties.

To learn more about how we can support your hospital reach out to us at inquiries@medhost.com or call 1.800.383.6278.

Patients and their providers both expect and need unfettered access to critical health data from multiple care settings. Patients also desire to have greater control over their health information. This shift in electronic health information (EHI) management and usage creates an even greater need to broaden healthcare’s digital doorway. The 21st Cures Act stands as a significant piece of regulation that will help improve EHI access, promote interoperability, and meet the demands of healthcare consumers, providers, and regulatory bodies.  

Hospitals need to prepare for this Promoting Interoperability regulation well before the 2023 reporting period, and MEDHOST can help.  

Keys to Cures Compliancy 

The Cures Act advances Promoting Interoperability by requiring hospitals to give patients and providers a way to securely access and share healthcare data stored in electronic health records (EHR) and other health information technology (HIT) systems.  

Most importantly, Cures prohibits information blocking that restricts access to specified personal healthcare data. For that reason, the ability to allow open access to healthcare data across the spectrum of care and move that data between different healthcare settings is critical to compliance.  

These are two major technology areas a Cures compliant solution must focus on. 

How MEDHOST Gets You Cures Compliant 

As an integral portion of our current HIT products and solutions, the MEDHOST Cures 2023 Interoperability Solution incorporates all of the features mentioned above into a single deliverable. This solution creates a framework for the seamless and secure access, exchange, and use of electronic health information for our customers.  

By leveraging the existing MEDHOST platform, the MEDHOST Cures 2023 Interoperability Solution empowers our customers and their patients with improved access to electronic health record (EHR) systems across various healthcare settings. 

Need more information on how MEDHOST can help you fulfill all Cures Act and Promoting Interoperability requirements? Please reach out to your Customer Success Executive or at inquiries@medhost.com 

In the most recent Medicare Program, Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) rule, CMS focuses on Glycemic Control with two new electronic clinical quality measures (eCQMs) for 2023.

CMS will add these two clinical quality measures to the list of existing options for hospitals to choose from for reporting in CY 2023, emphasizing the importance of glycemic control in patient care.

Poor glycemic control can have an adverse impact on a patient’s health, increasing the potential for complications and the overall length of stay. The measure specifications point to both hypo- and hyperglycemia rates as indicators of the quality of care provided by a facility. The discrepancies regarding glycemic control among hospitals indicate opportunities for quality improvement in this area. The inclusion of two new measures in the eCQMs encourages participating hospitals to target these opportunities.

What You Should Know About CMS Glycemic Management Measures

The first of these two measures focuses on hypoglycemic events, which are among the most common adverse drug events in hospitals.

Hospital Harm—Severe Hypoglycemia identifies the proportion of patients who experience a severe hypoglycemic event, defined as blood glucose less than 40mg/dL within 24 hours of receiving an antihyperglycemic agent. According to CMS, research has shown that patients who experience a hypoglycemic event have a longer length of stay and higher medical costs than similar patients who do not experience an adverse event.

The second measure focuses on hyperglycemia, which can result in an increased risk of mortality, higher infection rates, and an increased length of stay.

Hospital Harm—Severe Hyperglycemia evaluates the number of days in which a patient experienced a severe hyperglycemic event, defined as a blood glucose reading above 300mg/dL, or a day when there was no blood glucose documented, but the preceding two days had values above 200mg/dL—for patients with a diagnosis of diabetes mellitus receiving anti-diabetic medications or admitted with an elevated blood glucose level.

How New Glycemic Management Measures Impact Your Business

While these two measures are optional and reported separately, they complement each other by simultaneously evaluating information regarding the administration of specific medications and patient blood glucose results. In both cases, a lower score indicates a higher quality of care.

In order to prepare to report on these two measures, hospitals should start reviewing their glucose management guidelines and any related orders in order sets or standing protocols.

For more on how we can help you prepare for the annual eCQM updates, contact your MEDHOST Account Executive or reach out to us at inquiries@medhost.com or call 1.800.383.6278.

It’s tough to measure the accuracy and quality of paper prescriptions. But thanks to the innovation of electronic prescribing, we can now track medications digitally to see gaps and errors more clearly.

Simply put, e-prescribing has changed the way clinicians, pharmacists, and patients administer drug therapy—and we are now poised to fully leverage this technology to improve quality and reduce costs in healthcare.

However, challenges remain. Each new prescription transaction involves various elements. If not appropriately coordinated, these elements can affect patient safety, add administrative burden, and cause delays in getting medications into patients’ hands. All these obstacles can add up quickly and cause patients not to take the needed medication as intended.

Medication nonadherence alone creates up to $290 billion in avoidable healthcare costs in the U.S. each year. Pharmacists and healthcare experts have also expressed concerns that the recent COVID-19 pandemic will only make medication nonadherence a more significant problem.

We must reduce the error rate and improve efficiency in e-prescribing. Doing so will significantly improve the healthcare system’s operational performance by streamlining workflows and clarifying prescriber intent.

Through our partnership with Surescripts, MEDHOST is committed to improving e-prescription accuracy for the benefit of prescribers, pharmacists, and, most importantly, patients.

Improving the Practice of e-Prescribing

According to Surescripts, nearly two billion e-prescriptions travel across their network every year. Each e-prescription is measured for accuracy and further supplemented with quality benchmarks and reporting. These metrics provide actionable intelligence to health systems, retailers, mail-order pharmacists, and electronic health records (EHR) vendors like MEDHOST, enabling them to effectively identify problem areas and make corrections.

Surescripts has increased the accuracy of e-prescription transactions by more than 80 percent since 2016 by eliminating errors, inconsistencies, and incompleteness. In addition, they have also increased the adoption of enhanced transaction types, improving alignments with the Surescripts directory.

Error Reduction:

Mismatched drug descriptions and identifiers, such as National Drug Code (NDC) and RxNorm, put patient safety at risk. Surescripts’ ability to pinpoint these discrepancies enables MEDHOST to update their systems and ensure drug descriptions and NDC identifiers match.

Reduced Administrative Burden:

“Take one tablet by mouth two times daily” can be written in more than 800 different ways, confusing the patient, who may take the wrong dose. To further complicate matters, medications come in various forms—tablets, pills, packages—so it can be difficult for pharmacists to know the prescriber's intent.

Standardizing language (Structured and Codified Sig) helps patients avoid adverse health events and reduces the administrative burden for those working within the MEDHOST e-prescription platform. An Appropriate Potency Unit Code (PUC) built into the Surescripts integration also helps pharmacists understand prescriber intent: not one package, but one tablet, for example.

The end result: clear directions and increased speed to therapy.

Improved Efficiency:

Surescripts also helps reduce administrative burdens and increase operational efficiency by allowing prescribers to replace or modify prescriptions from inside their MEDHOST EHR workflow—rather than making phone calls and sending faxes to pharmacies.

Pharmacists can also make modification requests to prescriptions electronically and within their workflow, streamlining communication with prescribers.

In addition, EPCS (Electronic Prescribing for Controlled Substances) ensures a single, efficient e-prescribing workflow for all prescriptions, including opioid prescriptions.

More Digital, Less Paper:

An up-to-date and accurate directory data feed to MEDHOST from Surescripts helps to ensure that e-prescriptions are sent efficiently, without the need for phone calls and faxes. Surescripts assesses the alignment of 10 key prescriber fields in their directory and is working to increase the use of the Learning Directory among EHRs and pharmacies.

The Path To Progress

For years the industry’s focus was on moving prescriptions efficiently, safely, and reliably.

MEDHOST and Surescripts’ partnership helps bring together hundreds of individuals representing EHR vendors, pharmacies, pharmacy benefits managers, health systems, and drug compendia to improve patient care by enhancing e-prescribing accuracy and efficiency.

To learn how e-prescribing can help improve the accuracy of prescriptions and medication adherence rates at your facility, please reach out to us at inquiries@medhost.com or call 1.800.383.6278.

 

About Surescripts

Surescripts’ 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. Since 2001, Surescripts has led the movement to turn data into actionable intelligence, and convened the Surescripts Network Alliance® to enhance prescribing, inform care decisions and advance the healthcare industry.