OpenEMR Certification Stage III Meaningful Use

From OpenEMR Project Wiki

Overview

Successfully completed testing on 6/30/22 and final certification was completed on 7/8/22. Released OpenEMR 7.0.0, which is ONC certified on 7/19/22. See the blog article on this monumental feat at: OpenEMR Achieves ONC Certification with Groundbreaking Release 7.0
Testing body is SLI.
Links:

Forums and Discussion


Funding and Sponsors

Barometer

Required to Pay for Testing and Certification - $16,125

$5,000 $10,000 $13,125 $16,000 $16,125
$5,000 $10,000 $13,125 $16,000 $16,125


Required to support development efforts and timely delivery - $116,000

$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $97,600 $100,000 $110,000 $113,709 $116,000
$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $97,600 $100,000 $110,000 $113,709


Legend Description:
  • Funds Raised - Funds raised.
  • Not Funded - Unfunded Goal.
  • Expended Funds - Funds that have been spent.
  • Funds Contracted Out - Funds that have been contracted out.



Fund Drive for ONC Certification

Help OpenEMR obtain Certification by donating here.

For lower processing fees please email hello@open-emr.org for wire transfer instructions.

Major sponsors

Completion Barometer

  • This barometer is tracking the progress of the ONC Certification (ie. Stage 3 MU) project. See below Certification Criteria section for criteria titles and further details on progress tracking.
  • The below items were chosen as the minimum to support ONC certification with CEHRT (although note CEHRT is dependent on CMS).
a1* a2* a5* a12* a14* b1 b10 b11 c1* c2* c3* d1* d2* d3* d4* d5* d6* d7* d8* d9* d12* d13* e3* g2* g3* g4 g5 g6 g7* g9 g10 h1


Legend Description:
  • Not Yet Analyzed - Has not been analyzed yet.
  • Not Ready - Not ready for certification testing and waiting for somebody to work on this.
  • Not Ready (actively working on) - Not ready for certification testing, but are actively working on this.
  • Ready - Ready for certification testing. ( F means is Finalized (has been checked thoroughly and has an associated wiki page detailing why it is ready) and officially ready ready to self-declare or test.)
  • Failed Test - Issues found during certification testing.
  • Certification Pass - Passed certification and in official codebase.
  • * - Self-declaration (this involves self-declaration rather than formal testing with the testing body).


Certification Criteria Reference and Tracking

  • Owner(s) - This is the "current" person/group(s) that are working on the criteria (or building block) and can be found in parenthesis next to the item.
  • Building Blocks:
  • CQM
  • CCDA
  • FHIR
  • API
  • OAuth
  • SMART
  • FINALIZED means items is finalized (has been checked thoroughly and has an associated wiki page detailing why it is ready) and is ready to self-declare or test.

Clinical (170.315(a))

a1. Computerized provider order entry (CPOE) – medications (forum | wiki): FINALIZED
a2. CPOE – laboratory (forum | wiki): FINALIZED
a3. CPOE – diagnostic imaging (forum | wiki):
a4. Drug-drug, drug-allergy interaction checks for CPOE (forum | wiki):
a5. Demographics (forum | wiki): FINALIZED
a6. Problem list (forum | wiki):
a7. Medication list (forum | wiki):
a8. Medication allergy list (forum | wiki):
a9. Clinical decision support (forum | wiki): FINALIZED
a10. Drug-formulary and preferred drug list checks (forum | wiki):
a11. Smoking status (forum | wiki):
a12. Family health history (forum | wiki): FINALIZED
a13. Patient-specific education resources (forum | wiki):
a14. Implantable device list (forum | wiki): FINALIZED
a15. Social, psychological, and behavioral data (forum | wiki):

Care Coordination (170.315(b))

b1. Transitions of care (forum | wiki): CCDA FINALIZED
b2. Clinical information reconciliation and incorporation (forum | wiki):
b3. Electronic prescribing (forum | wiki):
b4. Common Clinical Data Set summary record – create (forum | wiki):
b5. Common Clinical Data Set summary record – receive (forum | wiki):
b6. Data export (forum | wiki):
b7. Data segmentation for privacy – send (forum | wiki):
b8. Data segmentation for privacy – receive (forum | wiki):
b9. Care plan (forum | wiki):
b10. Electronic health information (EHI) export (forum | wiki): FINALIZED
b11. Decision support interventions (forum | wiki): FINALIZED
b12. Data segmentation for privacy – send (forum | wiki):
b13. Data segmentation for privacy – receive (forum | wiki):

Clinical Quality Measures (170.315(c))

c1. Clinical quality measures (CQMs) – record and export (forum | wiki): CQM FINALIZED
  • List of eCQMs undergoing certification
  • Management of Chronic Conditions
  • CMS122v10 Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%) (EP)
  • CMS165v10 Controlling High Blood Pressure (EP)
  • Prevention and Treatment of Opioid and Substance Use Disorders
  • CMS138v10 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention (EP)
  • Preventive Care
  • CMS22v10 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented (EP)
  • CMS69v10 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan (EP)
  • CMS124v10 Cervical Cancer Screening (EP)
  • CMS125v10 Breast Cancer Screening (EP)
  • CMS127v10 Pneumococcal Vaccination Status for Older Adults (EP)
  • CMS130v10 Colorectal Cancer Screening (EP)
  • CMS147v11 Preventive Care and Screening: Influenza Immunization (EP)
c2. CQMs – import and calculate (forum | wiki): CQM FINALIZED
c3. CQMs – report criterion (forum | wiki): CQM FINALIZED
c4. CQMs – filter (forum | wiki):

Privacy and Security (170.315(d))

d1. Authentication, access control, and authorization (forum | wiki): FINALIZED
d2. Auditable events and tamper-resistance (forum | wiki): (estimated work to complete: low/moderate) FINALIZED
d3. Audit report(s) (forum | wiki): FINALIZED
d4. Amendments (forum | wiki): FINALIZED
d5. Automatic access time-out (forum | wiki): FINALIZED
d6. Emergency access (forum | wiki): FINALIZED
d7. End-user device encryption (forum | wiki): FINALIZED
d8. Integrity (forum | wiki): FINALIZED
d9. Trusted connection (forum | wiki): FINALIZED
d10. Auditing actions on health information (forum | wiki):
d11. Accounting of disclosures (forum | wiki):
d12. Encrypt authentication credentials certification criterion (forum | wiki): FINALIZED
d13. Multi-factor authentication (MFA) criterion (forum | wiki): FINALIZED

Patient Engagement (170.315(e))

e1. View, download, and transmit to 3rd party (forum | wiki):
e2. Secure messaging (forum | wiki):
e3. Patient health information capture (forum | wiki): FINALIZED

Public Health (170.315(f))

f1. Transmission to immunization registries (forum | wiki):
f2. Transmission to public health agencies – syndromic surveillance (forum | wiki):
f3. Transmission to public health agencies – reportable laboratory tests and value/results (forum | wiki):
f4. Transmission to cancer registries (forum | wiki):
f5. Transmission to public health agencies – electronic case reporting (forum | wiki):
f6. Transmission to public health agencies – antimicrobial use and resistance reporting (forum | wiki):
f7. Transmission to public health agencies – health care surveys (forum | wiki):

Utilization (170.315(g))

g1. Automated numerator recording (forum | wiki):
g2. Automated measure calculation (forum | wiki): FINALIZED
g3. Safety-enhanced design (forum | wiki): FINALIZED
g4. Quality management system (forum | wiki): FINALIZED
g5. Accessibility-centered design (forum | wiki): FINALIZED
g6. Consolidated CDA creation performance (forum | wiki): CCDA This will automatically pass when b1 passes, so is FINALIZED
g7. Application access – patient selection (forum | wiki): API FHIR FINALIZED
g8. Application access – data category request (forum | wiki):
g9. Application access – all data request (forum | wiki): API CCDA FINALIZED
g10. Standardized API for patient and population services (forum | wiki): OAuth SMART FHIR FINALIZED
g11. Consent management for application programming interfaces (forum | wiki):

Transport methods and other protocols (170.315(h))

h1. Direct Project (forum | wiki): (estimated work to complete: low/moderate) FINALIZED
h2. Direct Project, Edge Protocol, and XDR/XDM (forum | wiki):


Instance Specific Requirements Tracking

This will track the settings that a instance needs to use to fulfill ONC Certification. These instructions will go into the install/upgrade instruction sets.
  • You are required to register your Organization name and FHIR endpoint with the OpenEMR Foundation by sending an email with this information to hello@open-emr.org with subject of 'ONC Certification registration'. This information will be posted on OpenEMR_7.0.0_API#Service_Base_URLs, which is a requirement for ONC Certification(the OpenEMR Foundation is required to post this information within 10 days of your request).
  • Required global settings
  • Administration->Globals->Security->Hash Algorithm for Authentication->SHA512 (ONC Certification)
  • Administration->Globals->Security->Hash Algorithm for Token->SHA512 (ONC Certification)
  • Administration->Globals->Logging->Enable Audit Log Encryption->On
  • Administration->Globals->Connectors->Enable OpenEMR Standard FHIR REST API->On
  • To ensure optimal security, users are required to run their OpenEMR client web browser on a end-user device that encrypts entire drive(s) with AES based encryption algorithm.
  • To ensure optimal security, users are required to use a FIPS compliant cipher for the HTTPS/SSL browser connection.
  • To ensure accurate time, server are required to set up a Network Time Protocol server that supports version 4 Network Time Protocol (NTP) as defined by RFC 5905.
  • For users NOT NEEDING ONC Certification, then would consider setting following global setting to improve performance
  • Administration->Globals->Security->Audit Logging SELECT Query->Off
  • Administration->Globals->Security->Printing Log Option->No logging


Acknowledgment Tracking

ONC Certification Project Managers

  • Brady Miller
  • Jerry Padgett
  • Stephen Nielson
  • Stephen Waite

Contributors

  • Arnab Naha
  • Brady Miller* - CCDA, FHIR, API, OAuth, Demographics, Clinical decision support, Implantable device list, Family health history, Auditable events and tamper-resistance, Audit report(s), Integrity, Encrypt authentication credentials certification criterion, Patient health information capture, Safety-enhanced design, Application access – patient selection
  • Brent Boecking
  • Care Management Solutions
  • Columbia University HIT Program - Safety-enhanced design
  • Comlink
  • Community Behavioral Health
  • David Eschelbacher
  • David Zhang
  • EMR Direct
  • Jerry Padgett* - CCDA, FHIR, API, OAuth, CQM, Clinical quality measures (CQMs) – record and export, CQMs – import and calculate, CQMs – report criterion, Transitions of care, Application access – all data request, Standardized API for patient and population services
  • Jocelyn Valenzuela
  • Katy Dovgala
  • Ken Chapple - CQM, Clinical quality measures (CQMs) – record and export, CQMs – import and calculate, CQMs – report criterion
  • Kenn Vincent Kongyingyong
  • Kenneth Newman
  • Lawrence Lo
  • Mariam Mohsin
  • Michael J. Blaho
  • Niru Jani
  • Oak Street Health
  • OpenEMR Foundation
  • Paul Montenegro
  • Rachel Ellison - Implantable device list
  • Salina Chan
  • Samta Jain
  • Sandra Gutierrez
  • Sherron Andrews
  • Stephen Nielson* - SMART, FHIR, API, OAuth, CQM, Transitions of care, Clinical quality measures (CQMs) – record and export, CQMs – import and calculate, CQMs – report criterion, Automated measure calculation, Application access – patient selection, Application access – all data request, Standardized API for patient and population services, Direct Project
  • Stephen Waite* - Quality management system, Clinical quality measures (CQMs) – record and export
  • Sushma Jani
  • Tamara Brantley
  • Theresa Haywood
  • Thuyet Tran - Demographics
  • Tiffany Fludd
  • Vikram Reddy
  • Virginia Lorenzi
  • Vishnu Yarmaneni - FHIR
  • Willy Liu
  • Yash Raj Bothra - FHIR


Notes

Below is how we derived the items to include in the main barometer:
  • Based on analysis incorporating finalized proposed changes and onc certified: drop a6, a7, a8, a11, b4, b5; revise b1, b2, b3, b7, b8, b9, c3, d2, d3, d10, e1, f5, g6, g9; new b10, d12, d13, g10.(note goal is to only list the required items)
  • Note the following OR items: a2 or a3, g1 or g2, h1 or h2
  • EXTRAPOLATED EHR gap items are a1, a2 or a3. EHR non-gap items are a5, a9, a14, b1, b6, c1, g7, g8, g9, h1 or h2.
  • EXTRAPOLATED Bonus items need for MIPS are a12, e3, g1 or g2, c2, c3, (c4 is optional).
  • Above 2 lists distill to a1, a2 or a3, a5, a9, a12, a14, b1, b6, c1, c2, c3, e3, g1 or g2, g7, g8, g9, h1 or h2
  • onc certified specific items are: a1, a2 or a3, a5, a9, a14, b1(standard or onc certified(onc certified is mandatory after 5/2/22)), c1, g7, g8 or g10(g10 is mandatory after 5/2/22), g9(standard or onc certified(onc certified is mandatory after 5/2/22)), h1 or h2
  • New distilled list including onc certified stuff that is mandatory after 5/22/22: a1, a2 or a3, a5, a9, a12, a14, b1(onc certified version), b6, c1, c2, c3, e3, g1 or g2, g7, g9(onc certified version), g10(onc certified), h1 or h2
  • Dependency items also needed are b10, d1-d9, d12, d13, g3-g6(g6 is considered completed when b1 and b6 is completed)
  • Final listing (above 2 lists combined): a1, a2 or a3(will do a2), a5, a9, a12, a14, b1(onc certified version), b6, b10, c1, c2, c3, d1-d9, d12, d13, e3, g1 or g2(will do g2), g3-g6(g6 is considered completed when b1 and b6 is completed), g7, g9(onc certified version), g10(onc certified), h1 or h2(will do h1)
  • Final adjustment after discussion with testing body: e3 not needed, g8 is needed, no more gap certification eligibility
  • The real Final listing (above 2 lists integrated): a1, a2 or a3(will do a2), a5, a9, a12, a14, b1(onc certified version), b6, b10, c1, c2, c3, d1-d9, d12, d13, g1 or g2(will do g2), g3-g6(g6 is considered completed when b1 and b6 is completed), g7, g8, g9(onc certified version), g10(onc certified), h1 or h2(will do h1)
  • Since doing onc certified.
  • Complete b10, so can drop b6.
  • Complete g10, so can drop g8.
  • Research if following items are not part of BASE (ie. are they required for CEHRT and MIPS and onc certified): a12, b10, c2, c3, g2

Redo analysis from scratch (to ensure on right path)

  • a1, a2 or a3, a5, a9, a14, b1, c1, g7, g9, g10, h1 or h2
  • Dependencies for above items:
  • d1, d2, d3, d4, d5, d6, d7, d8, d9, d12, d13, g3, g4, g5, g6
  • a12, e3, c2, c3, (g1 or g2)
  • Items that can drop:
  • b10
  • Items that plan to add on first cert:
  • e3
  • Items that plan to add on second cert (per SN analysis):
  • a3 (not clear and plan d/w SN), a10, a13, b2, b3, e1 (was gonna do this on first round, but looks like significant work may be involved), e2 (not clear and plan d/w SN),
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