> ## Documentation Index
> Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Promoting Interoperability (MIPS 2025) - Health Information Exchange (HIE) - Bi-Directional Exchange

> This article describes the Health Informational Exchange, Bi-directional Information Exchange measure for the MIPS Promoting Interoperability performance category.

## Measure Details

This measure is an alternative measure in the Health Information Exchange Objective in the Promoting Interoperability category and is not a required measure. The alternate measures for this are:

* [Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) - (2 measures with performance numerator/denominator metrics)
* [Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-2025-TEFCA)

## Measure Parameters

The MIPS eligible clinician or group must attest that they engage in bi-directional exchange with an HIE to support transitions of care. The MIPS eligible clinician must attest YES to the following:

* I participate in an HIE in order to enable secure, bi-directional exchange to occur for every patient encounter, transition or referral, and record stored or maintained in the electronic health record (EHR) during the performance period in accordance with applicable law and policy.
* The HIE that I participate in is capable of exchanging information across a broad network of unaffiliated exchange partners including those using disparate EHRs, and does not engage in exclusionary behavior when determining exchange partners.
* I use the functions of certified electronic health record technology (CEHRT) to support bi-directional exchange with an HIE.

## Elation Workflows

Using the bidirectional integration with [Carequality](/articles/Carequality-Integration-Introduction) will satisfy this measure. A bidirectional connection with a regional HIE will also satisfy this measure.

## Related Articles

* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
* [Promoting Interoperability - Health Information Exchange (Sending & Receiving)](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS 2025) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-2025-TEFCA)