Hancock Regional Health’s IT leadership team sought an efficient solution to implement Transitions of Care documents, also called Continuity of Care documents (CCD) mandated by the federal government. This care summary document must be sent to the “next in line” provider, regardless of what technology solution they use to support patient care.


From an IT perspective, IHIE has extensive experience with documentation and document management through its DOCS4DOCS Service. The D4D Service provides the backbone to deliver these CCDs to these “next in line” providers. It is the delivery of the document that is the key to meeting the federal requirement, and IHIE can do this efficiently and quickly on behalf of HRH. By partnering with IHIE for this service, HRH leverages its existing connections to IHIE and the connections that IHIE has with 25,000 providers in the state to deliver the information.

From an IT perspective, IHIE has strong project management processes to help support this service. And, from a clinical perspective, IHIE is able to combine the information sent by HRH into a useable and consistent format across the entire IHIE network.

As an added value to HRH, IHIE runs a report of the CCD documents that were actually delivered to the providers. HRH is able to match that up against their report of ToC documents that they sent. This reconciliation process is important for HRH to ensure they are delivering the appropriate percentage to meet the federal requirements, but is also a best practice for patient care.


E. Rush & J. Morin
Hancock Regional Health
Clinical setting: Population Health / Continuity of Care / Transitions of Care


  • Meets Meaningful Use requirements
  • Provides customers with IT project management to help support implementation
  • Knowledge of delivery preferences of providers, providing Transition of Care documents in a manner consistent with existing workflow
  • Provides an electronic delivery mechanism that is traceable and reportable


“(IHIE is) truly very, very good. We’ve worked with a lot of vendors and IHIE has been one of the better ones.”
“If we had to do the CCD (Transitions of Care) requirement on our own, it would be very difficult to do.”


  • Situation: Hospitals must provide electronic delivery of Continuity of Care documents (CCD) to 10% of next in line providers in order to meet federal requirements, or they will miss out on Centers for Medicare & Medicaid Services Incentive Programs. This rule requires the responsibility of not just sending the document, but also knowing whether the other providers received it.
  • Benefits: A CCD can enhance communication and coordination as a patient moves from one facility to another, but its delivery poses a technology challenge that IHIE has been able to overcome with a high percentage of deliverability.
  • What it Means: In Indiana, over 1 million CCDs have been delivered to the “next-in-line” providers, the highest total of any state, providing safer and better care for patients as they transition, for example, from an emergency room to a nursing facility.