The overall process will consist of designating multiple certified EHR technologies as "Test EHRs." All authorized Test EHRs will be installed and running locally at the respective vendor sites and registered on "EHR Randomizer" tool hosted at NIST. Providers will enter information about their current EHR in the Randomizer to obtain a randomly selected Test EHR that is different from their own EHR technology. The provider will establish trust with the Test EHR and send a Direct message that includes a test Consolidated Clinical Document Architecture care summary record (Note: NO Live Data is to be sent, only Test Data) to the Test EHR's designated address (provided by the randomizer). Once the Test EHR successfully receives a Direct message they will be required to send notification to the provider indicating that the Direct message was successfully received. This notification may be in the form of an email to the provider. The provider will be able to use the notification as proof of meeting measure#3 for the purpose of Meaningful Use attestation. Detailed steps can be found in the "Test Instructions for Cross Vendor Exchange [PDF - 486 KB]" document.