OpenEMR QA against NIST

NIST Meaningful Use Test Method by Criteria

Status Summary:

NIST Meaningful Use Test Method
§170.302	§170.304	§170.306

Links to individual testing procedures where pulled from Approved Test Procedures Version 1.1 Effective October 24, 2010 and could become stale. If so, please edit this page and to link to the most recent, approved, and effective version(s).

§170.302 General Certification Criteria

Status Summary:

General Certification Criteria

a

b

c

d

e

f

g

h

i

j

k

l

m

n

o

p

q

r

s

t

u

v

w

(a) Drug-grug, drug-allergy interaction checks

NIST Test Procedure for §170.302 (a) Drug-drug, drug-allergy interaction checks

No test results.

Currently unimplemented in OpenEMR.

(b) Drug formulary checks

NIST Test Procedure for §170.302 (b) Drug formulary checks

Currently unimplemented in OpenEMR.

(c) Maintain up-to-date problem list

NIST Test Procedure for §170.302 (c) Maintain up-to-date problem list

Fail (8/9). Detailed test results

Mostly implemented by OpenEMR. Fix for remaining issues is in Git commit fc72 and later versions of OpenEMR. Please re-test and update this page with results.

(d) Maintain active medication list

NIST Test Procedure for §170.302 (d) Maintain Active Medication List

Pass (10/10). File:Medication List.pdf

Currently implemented in OpenEMR. Please edit this page to include information about the implementation location in the source tree.

(e) Maintain active medication allergy list

NIST Test Procedure for §170.302 (e) Maintain active medication allergy list

Fail (3/6). File:Medication Allergy.pdf (Note: The quoted section of the Final Rule is incorrect, but the test results are for §170.302 (e))

Mostly implemented by OpenEMR. Fix for remaining issues is in Git commit fc72 and later versions of OpenEMR. Please re-test and update this page with results.

(f) Record and chart vital signs

Status Summary:

Record and chart vital signs
1	2	3

File:Vital sign.pdf

(1) Vital signs

NIST Test Procedure for §170.302 (f) (1) Vital Signs

Pass (16/16). All test results for (f) Record and chart vital signs are combined in one document linked above.

Currently implemented by OpenEMR. Please edit this page to include information about the implementation location in the source tree.

(2) Calculate body mass index

NIST Test Procedure for §170.302(f) (2) Calculate Body Mass Index

Pass (5/5). All test results for (f) Record and chart vital signs are combined in one document linked above.

Currently implemented by OpenEMR. Please edit this page to include information about the implementation location in the source tree.

(3) Plot and display growth charts

NIST Test Procedure for §170.302(f) (3) Plot and Display Growth Charts

Pass (9/9). All test results for (f) Record and chart vital signs are combined in one document linked above.

Currently implemented by OpenEMR. Please edit this page to include information about the implementation location in the source tree.

(g) Smoking status

NIST Test Procedure for §170.302 (g) Smoking Status

Pass (10/10). File:Smoking status.pdf

Currently implemented in OpenEMR. Please edit this page to include information about the implementation location in the source tree.

(h) Incorporate labratory test results

NIST Test Procedure for §170.302 (h) Incorporate labratory test results

Currently unimplemented in OpenEMR.

(i) Generate patient lists

NIST Test Procedure for §170.302 (i) Generate patient lists

Currently unimplemented in OpenEMR.

(j) Medication reconciliation

MedicationReconciliation_v1.1.pdf NIST Test Procedure for §170.302 (j) Medication reconciliation

Currently unimplemented in OpenEMR.

(k) Submission to immunization registries

NIST Test Procedure for §170.302 (k) Submission to immunization registries

Currently unimplemented in OpenEMR.

(l) Public health surveillance

NIST Test Procedure for §170.302 (l) Public health surveillance

Currently unimplemented in OpenEMR.

(m) Patient specific education resources

NIST Test Procedure for §170.302 (m) Patient specific education resources

Currently unimplemented in OpenEMR.

(n) Automated measure calculation

NIST Test Procedure for §170.302 (n) Automated measure calculation

Currently unimplemented in OpenEMR.

(o) Access control

NIST Test Procedure for §170.302 (o) Access Control

Pass (8/8). File:Access Control.pdf

Currently implemented by OpenEMR. Please edit this page to include information about the implementation location in the source tree.

(p) Emergency access

NIST Test Procedure for §170.302 (p) Emergency Access

Pass (9/9). File:Emergency-Access.pdf

Currently implemented in OpenEMR. Please edit this page to include information about the implementation location in the source tree.

(q) Automatic log-off

NIST Test Procedure for §170.302 (q) Automatic log-off

Pass (2/2). File:Automatic Log Off.pdf

Currently implemented in OpenEMR. Please edit this page to include information about the implementation location in the source tree.

(r) Audit log

NIST Test Procedure for §170.302 (r) Audit Log

Fail (14/15). File:Audit log.pdf

Mostly implemented by OpenEMR. Fix for remaining issues is in Git commit e97e and later versions of OpenEMR. Please re-test and update this page with results.

(s) Integrity

NIST Test Procedure for §170.302 (s) Integrity

Fail (6/6). File:Data Integrity.pdf Failure Reason: The hashing algorithm currently in use is MD5. The standard requires an algorithm at last as strong as SHA-1. According to Wikipedia SHA-1 has 51 bits of effective security, while MD5 has less than 21. In fact, (unsalted) MD5 collisions can be found in seconds on GHz-class 32-bit PCs.

Currently implemented poorly in OpenEMR. Please edit this page to include information about the implementation location in the source tree.

(t) Authentication

NIST Test Procedure for §170.302 (t) Authentication

Pass (10/10). File:Authentication.pdf

Currently implemented by OpenEMR with using client SSL certificates. Please edit this page to include information about the implementation location in the source tree.

(u) General encryption

NIST Test Procedure for §170.302 (u) General encryption

Currently unimplemented in OpenEMR.

(v) Encryption when exchanging electronic health information

NIST Test Procedure for §170.302 (v) Encryption when exchanging electronic health information

Pass (5/5). File:Encryption For Exchanging Health Information.pdf

Currently implemented by OpenEMR when using Apache configured for SSL. Please edit this page to include information about the implementation location in the source tree.

(w) Accounting of disclosures (optional)

NIST Test Procedure for §170.302 (w) Optional. Accounting of Disclosures

Pass (5/5). File:Disclosure.pdf

Currently implemented in OpenEMR. Please edit this page to include information about the implementation location in the source tree.

§170.304 Ambulatory Certification Criteria

Status Summary:

Ambulatory Certification Criteria
a	b	c	d	e	f	g	h	i	j

(a) Computerized provider order entry

NIST Test Procedure for §170.304 (a) Computerized provider order entry

Currently unimplemented in OpenEMR.

(b) Electronic Prescribing

NIST Test Procedure for §170.304 (b) Electronic Prescribing

Currently unimplemented in OpenEMR.

(c) Record demographics

NIST Test Procedure for §170.304 (c) Record Demographics

Virtually identical to §170.306 (b).

Fail (11/12). File:Record demographics.pdf

Mostly implemented by OpenEMR. Patch for remaining features submitted via SourceForge Tracker Item 3122211. In addition, the patch is being tracked in at least one Git repository, but the commit SHA(s) may change before before the merge into 4.0 development.

(d) Patient reminders

NIST Test Procedure for §170.304 (d) Patient reminders

Currently unimplemented in OpenEMR.

(e) Clinical decision support

NIST Test Procedure for §170.304 (e) Clinical decision support

Currently unimplemented in OpenEMR.

(f) Electronic copy of health information

NIST Test Procedure for §170.304 (f) Electronic copy of health information

Currently unimplemented in OpenEMR.

(g) Timely access

NIST Test Procedure for §170.304 (g) Timely access

Currently unimplemented in OpenEMR.

(h) Clinical summaries

NIST Test Procedure for §170.304 (h) Clinical summaries

Currently unimplemented in OpenEMR.

(i) Exchange clinical information and patient summary record

NIST Test Procedure for §170.304 (i) Exchange clinical information and patient summary record

Currently unimplemented in OpenEMR.

(j) Calculate and submit clinical quality measures

NIST Test Procedure for §170.304 (j) Calculate and submit clinical quality measures

Currently unimplemented in OpenEMR.

§170.306 Inpatient Certification Criteria

Status Summary:

Inpatient Certification Criteria
a	b	c	d	e	f	g	h	i

(a) Computerized provider order entry

NIST Test Procedure for §170.306 (a) Computerized provider order entry

Currently unimplemented in OpenEMR.

(b) Record demographics

NIST Test Procedure for §170.306 (b) Record demographics

Virtually identical to §170.304 (c).

(c) Clinical decision support

NIST Test Procedure for §170.306 (c) Clinical decision support

Currently unimplemented in OpenEMR.

(d) Electronic copy of health information

Status Summary:

Electronic copy of health information
1	2

(1) Clinical Information

NIST Test Procedure for §170.306 (1) Clinical Information

Currently unimplemented in OpenEMR.

(2) Discharge summary

NIST Test Procedure for §170.306 (2) Discharge summary

Currently unimplemented in OpenEMR.

(e) Electronic copy of discharge instructions

NIST Test Procedure for §170.306 (e) Electronic copy of discharge instructions

Currently unimplemented in OpenEMR.

(f) Exchange clinical information and patient summary record

NIST Test Procedure for §170.306 (f) Exchange clinical information and patient summary record

Currently unimplemented in OpenEMR.

(g) Reportable lab results

NIST Test Procedure for §170.306 (g) Reportable lab results

Currently unimplemented in OpenEMR.

(h) Advance directives

NIST Test Procedure for §170.306 (h) Advance directives

Currently unimplemented in OpenEMR.

(i) Calculate and submit clinical quality measures

NIST Test Procedure for §170.306 (i) Calculate and submit clinical quality measures

Currently unimplemented in OpenEMR.