Promoting Interoperability (PI)
Promoting Interoperability, formerly Meaningful Use, is the MIPS performance category weighted at 25% of the composite score, measuring electronic health information sharing, e-prescribing, health information exchange, and patient engagement through portals.
What is Promoting Interoperability?
Promoting Interoperability (PI) replaced Meaningful Use in 2018 under the MACRA/MIPS framework and represents 25% of the MIPS composite performance score. Four PI objectives exist: e-Prescribing (required — clinicians must electronically prescribe ≥50% of eligible prescriptions, with a bonus for EPCS — electronic prescribing of controlled substances), Health Information Exchange (required — including patient care summary exchange and receipt of ADT alert notifications), Provider to Patient Exchange (required — enabling patient access to their health information through a certified portal), and Public Health and Clinical Data Exchange (optional — reporting to immunization registries, electronic case reporting, syndromic surveillance, and cancer registries). Hardship exceptions are available for clinicians who lack internet access, are in their first year of Medicare participation, or experience extreme circumstances. Specialty-based exclusions are available for practices with fewer than 100 electronic prescriptions annually. A score of zero in the PI category (from non-reporting without an approved exclusion or hardship) zeroes out the entire 25% weight in the MIPS composite — a significant penalty risk for any MIPS-eligible clinician.
Why It Matters for Healthcare Analytics
PI performance is directly tied to EHR utilization rates — practices must track e-prescribing rates, portal activation rates, and HIE transaction counts to validate that required thresholds are being met throughout the performance year. Discovering a reporting gap in December is far more costly than monitoring monthly.
How Vizier Tracks PI
Upload your EHR utilization report and ask "Are we on track to meet the e-prescribing threshold for Promoting Interoperability this year?" — Vizier calculates your current rate, projects your year-end position, and identifies which providers are below threshold with enough time to correct course.