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| =Meaningful Use Certification= | | =Meaningful Use Certification= |
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| Incentive payments under Medicare will be slower in coming. Physicians who have registered in that program must then report to CMS that they have met meaningful-use requirements over a 90-day period. Because registration begins January 3, the earliest they can attest to this is in April. The first EHR incentive checks under Medicare are expected to go out in May. The last day for physicians to begin a 90-day reporting period in 2011 is October 3.
| | [[OpenEMR 4.1 ONC Complete Ambulatory EHR Certification]] |
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| '''NIST Testing Requirements'''
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| * 170.302 (a-n): General requirements --> Applies to both ambulatory and inpatient EHRs
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| * 170.302 (o-v): Security requirements --> Mandatory for all EHR certifications
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| * 170.302 (w): Security requirement --> Optional
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| * 170.304 (a-j): Ambulatory requirements
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| Preliminary pilot run with ICSA Labs was very successful, all things tested passed. We tested things we thought would pass per ViCare+ and proved that they actually did pass. --[[User:Tmccormi|Tony - www.mi-squared.com]] 01:39, 1 February 2011 (UTC)
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| ==Project Tracking, Testing and QA for ONC Certification==
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| * [[OpenEMR QA against NIST]] - '''QA using NIST Test scripts''' - Barometer and Results notes
| | [[Certification Project Archive]] |
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| * [[ARRA ONC MU Project Issues List]] - Issues list for the tracking spread sheet
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| ''Archive Data''
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| :[[File:ARRA_ONC_MU_Project-Master-20100927.pdf]] - --[[User:Tmccormi|Tony - www.mi-squared.com]] 03:02, 28 September 2010 (UTC), this file is the last one to be tracked externally. All tracking is done here on the wiki pages now.
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| :[[CCHIT_MU_2011_Project]] - Past meeting notes, target dates and SPRINT logs are located here as well as some team decisions about design choices.
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| ==Completion Barometer==
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| ===Meaningful Use===
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| {|
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| |Color Key:
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| |style="color:white; background-color:red"|Not Started
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| |style="color:white; background-color:blue"|In Progress
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| |style="color:white; background-color:orange"|Coded
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| |style="color:white; background-color:green"|Completed
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| |}
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| Status By MU ID
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| {| border = "1"
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| |style="color:white; background-color:green"|1
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| |style="color:white; background-color:green"|2
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| |style="color:white; background-color:orange"|3
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| |style="color:white; background-color:green"|4
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| |style="color:white; background-color:orange"|5
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| |style="color:white; background-color:green"|6
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| |style="color:white; background-color:green"|7
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| |style="color:white; background-color:green"|8
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| |style="color:white; background-color:green"|9
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| |style="color:white; background-color:green"|10
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| |style="color:white; background-color:orange"|11
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| |style="color:white; background-color:orange"|12
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| |style="color:white; background-color:orange"|13
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| |style="color:white; background-color:orange"|14
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| |style="color:white; background-color:blue"|15
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| |style="color:green; background-color:white"|16
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| |style="color:green; background-color:white"|17
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| |style="color:white; background-color:blue"|18
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| |style="color:white; background-color:blue"|19
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| |style="color:white; background-color:blue"|20
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| |style="color:white; background-color:blue"|21
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| |style="color:white; background-color:green"|22
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| |style="color:white; background-color:blue"|23
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| |style="color:white; background-color:blue"|24
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| |style="color:white; background-color:green"|25
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| |style="color:white; background-color:blue"|26
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| |style="color:white; background-color:blue"|27
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| |}
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| Status and Summary - Updated: --[[User:Tmccormi|Tony - www.mi-squared.com]] 03:31, 1 February 2011 (UTC)
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| We are really a lot closer to being ready than the barometer can show in this situation (ie: volunteer).
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| '''TARGET IS END OF MARCH 2011'''
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| === Details, Dependencies and Links to the Individual Items ===
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| :Contributors are encouraged to update this page with information as they know it.
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| == Summary of Projects that cross multiple MU ==
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| ===CPOE===
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| * Order Entry (specifically lab/Xray)
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| ** Basic Testing is OK, Visolve identified some issues re NIST
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| **MI2: Jeremy will own this.
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| *** LEN working in test site and will be ready for code review this week --[[User:Tmccormi|Tony - www.mi-squared.com]] 01:37, 1 February 2011 (UTC)
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| *** Lab Results need to be mapped back into CCR/CCD, structure is not fixed, so we need to understand this can be identified discrete information.
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| *** May need a higher level way to link up the the reference lab -> then Order type
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| ** MMF: has a Labcorp and Quest LEN in progress
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| ** Xrays
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| *** Sam Sent a config file that includes Xray orders, Tony will upload it for use
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| === E-Prescribing ===
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| * Phyaura --[[User:Tmccormi|Tony - www.mi-squared.com]] 17:53, 27 January 2011 (UTC)
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| *** Update: will be submitting a new code revision soon which will include the Phyaura "Save CCD As XML". You can catch me online tomorrow as I'll be testing against the code sets and NIST. --[[User:Tmccormi|Tony - www.mi-squared.com]] 03:15, 1 February 2011 (UTC)
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| *** OpenEMR tests include, CCD download, save as XML, e-script
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| *** Some MU items are covered by Relay Health e-script: Medication Rec, CCD/with Meds, Med Allergy,
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| *** Drug/Drug Interaction - included
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| *** Drug/Food Interaction - not part of the system
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| *** Demographics are automatically transfered
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| ** MMF --[[User:Tmccormi|Tony - www.mi-squared.com]] 17:53, 27 January 2011 (UTC)
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| *** H2H Integration code posted for review 12-10-2010
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| *** https://github.com/bradymiller/openemr/commit/34afff0116c6af2bc0a37ea7c45855a3e1ac9e4d
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| *** This is a direct contract physician -> H2H, vs reseller model
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| *** MMF and Garden will pursue cost reduction, H2H offers $3000 to sign up and $40/month per Phy + $300 starter at practice (per ZHH email)
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| ** A link to Allscripts work (Modular Certification)
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| *** https://eprescribe.allscripts.com/Login.aspx?ReturnUrl=%2fdefault.aspx
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| === CCD/CCR ===
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| * Need Save As and Print for feeding 18, 19 and 21.
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| ** Connie seems to have done Save As (XML) - ability to upload this to a CCD/CCR compliant portal. This covers 18, 19, 21 and 23.
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| ** MicroSoft Health Vault interface will be released Feb 9th
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| ** Garden will provide a test bed for Visolve to test against
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| ** Print function nominal done, print as PDF would be better - *need owner*
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| * Need people to start helping add data collection modules to the CCD/CCR viewers
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| ** Garden will document how to run the CCD/CCR validator to do testing on the each added module --[[User:Tmccormi|Tony - www.mi-squared.com]] 17:53, 27 January 2011 (UTC)
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| ** Multiple contributors needed to write the feeds. - Visolve: Problems and Medication (maybe)
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| ** Import of CCR/CCD - XML Mime type needs to be fixed: Mike F. owns this
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| * Alfonso is going to be testing this against and HIE he has a relationship with
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| * Garden will add transition of care to CCD/CCR by end of March (this will be ready for stage two)
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| * Garden Demo to Vicare+ HIE CCD/CCR use for NIST.
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| === Clinical Desc Rules ===
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| * MI2 and Ensoftek
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| * Posted Admin UI. Functional Spec and got it approved by Brady
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| ** UI development in progress first code release targeted Feb 7
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| === Patient Educational Resources ===
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| * Meeting with Healthwise to discuss possibilities
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| *: No call back from them yet .. --[[User:Tmccormi|Tony - www.mi-squared.com]] 01:32, 1 February 2011 (UTC)
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| *: Dr Brody said was list some educational websites, like Healthwise and Advancedweb.com
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| === CQM Reporting ===
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| * Ensoftek
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| * Format identified, some new data fields are needed, see wiki links --[[User:Tmccormi|Tony - www.mi-squared.com]] 01:35, 1 February 2011 (UTC)
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| ** Need to identify owners for each report.
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| === Encryption Model SHA -vs- MD5 ===
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| * Visolve working on a report for this
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| ** Will change on Login and Audit to SHA
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| ** Some questions NIST
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| === Ready to Test ===
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| * Public Surveillance : NIST Test Procedure for §170.302
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| == Meaningful Use Requirement Details ==
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| :1. [[Foundations: Security and Privacy]] - '''Done'''
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| :2. [[Computer Physician Order Entry]]
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| ::* Combination of eRx, Lab Results and Transactions Systems meets the requirement.
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| :3. [[Drug Decision Support]]
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| ::* Resource needed for Lexicomp testing and completion - ''need to review the original test''
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| ::* Phyaura's option: no external dependencies, some cost involved
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| ::** Common interface under development that would be usable for other e-prescribing
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| :4. [[Problem List]]
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| :5. [[Electronic Prescribing]]--[[User:Tmccormi|Tony - www.mi-squared.com]] 03:00, 14 December 2010 (UTC)
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| ::* Phyaura's option: no external dependencies, some cost involved as above
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| ::** Common interface under development that would be usable for other e-prescribing
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| ::** Merged Prescription Table with Medications Lists may cause the need for some tweaks or changes to the UI around the Meds List
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| ::** Connie will look into creating a dummy loopback server for testing e-Rx
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| ::** Code has been posted for review on github by Connie --[[User:Tmccormi|Tony - www.mi-squared.com]] 20:21, 27 December 2010 (UTC)
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| :6. [[Medication List]] - ''visolve has committed code to meet NIST''
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| :7. [[Medication Allergy List]] - ''visolve has committed code to meet NIST''
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| :8. [[Demographics]] - ''visolve has committed code to meet NIST''
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| :9. [[Vital Signs]] - '''Done'''
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| :10. [[Smoking Status]] - ''visolve has committed code to meet NIST''
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| :11. [[Lab Test Results]]
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| ::* Submitted code for review --[[User:Tmccormi|Tony - www.mi-squared.com]] 02:09, 22 February 2011 (UTC)
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| :12. [[Patient Lists]]
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| ::* Tests on the report (clinic_reports.php) find some minor issues with the 'Problem List' output
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| ::* Visolve posted a new design and is working on it. --[[User:Tmccormi|Tony - www.mi-squared.com]] 03:34, 1 February 2011 (UTC)
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| :13. [[CMS Quality Reporting]]
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| ::* Dependent on Clinical Decision Rules
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| ::* Primary Report is coded, need XML (official) output format
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| ::* Need to confirm the hard stop list that is required - Tony will confirm with ICSA
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| :14. [[Patient Reminders]]
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| ::* Code is waiting review as part of CDR project
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| ::* MI2:Ensoftek
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| :15. [[Clinical Decision Rules]]
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| ::* Project Kick-off happened last week, team meeting 12/27, project page updated --[[User:Tmccormi|Tony - www.mi-squared.com]] 20:13, 27 December 2010 (UTC)
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| :16. [[Insurance Eligibility]] - '''Not Needed for Cert'''
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| :17. [[Electronic Claims Submission]] - '''Not Needed for Cert'''
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| :18. [[Patient Electronic Copy of Health Information]]
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| ::* Dependent on ability to produce on CCR/CCD format (Garden), supposed to be coming from Phyaura
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| ::* Could just save a standard report as PDF
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| :19. [[Patient Electronic Access to Health Information]]
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| ::* Interface to Microsoft Health Vault demonstrated vi Garden's HIE
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| ::* Dependent on ability to display in Human Readable (CCD/CCR already does this)
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| :20 [[Patient Clinical Summaries]]
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| ::* Dependent on ability to produce on CCR/CCD format (Garden)
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| ::* Dependent on ability to display in Human Readable (CCD/CCR already does this)
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| :21. [[Exchange Clinical Information]]
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| ::* Dependent on ability to produce on CCR/CCD format (Garden)
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| ::* Dependent on Data Element Review
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| ::** Documents posted for review, but process stalled. --[[User:Tmccormi|Tony - www.mi-squared.com]] 03:00, 14 December 2010 (UTC)
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| ::** Produce specs for any UI/DB changes needed
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| ::* Import and view CCR/CCD (coded) (Garden)
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| :22. [[Medication Reconciliation]]
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| ::* Updates posted for review by Visolve --[[User:Tmccormi|Tony - www.mi-squared.com]] 02:09, 22 February 2011 (UTC)
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| :23. [[Summary Care Record for Transition of Care/Referral]]
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| ::* Dependent on CPOE tests above and integration with existing referral
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| ::* Dependent on CCR for data exchange and UI changes to support it.
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| :24. [[Immunization Registries]]
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| ::* Dependent on Minor Data Changes
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| ::* Dependent on CVX Coding
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| ::* Dependent on HL7 output required
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| :25. [[Electronic Syndromic Surveillance]] - '''Done'''
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| :26. [[Patient Specific Education resources]]
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| ::* Can reference known sites with kind of database
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| :27. [[CMS Quality Reporting | Automatic Measure Calculation]]
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| ::* This can be done with the CDR engine (as the CQM reporting), however the rules need to be entered and some algorithm modifications will be required(this is analogous to the CQM reporting).
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| ==CQM/PQRI and Patient Data Mappings==
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| [[Mapping_OpenEMR_Data_for_CCD/CCR_and_CQM]] - This page has a table for each of 17 basic CCD/CCR data structures that need to be extracted from OpenEMR. It also has the discrete data elements (selection lists) required for much of MU Certification.
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| =Direct Interface=
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| This interface will be needed as a standard model to allow communication of CCR/CCD and other messages meet electronic exchange of data requirement.
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| [http://wiki.directproject.org/ Direct Project Wiki]
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| The interface is basic SMTP interface to a known target with directory list of know targets
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| * phpmailer can be used to send a TLS (secure attachment) is a possibility
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| * Receiving responses need to be fetched and analyzed for routing. This could happen in any number of ways similar to EDI clearing houses
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| * Key management is handled by the HISP or a similar keystore
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| * Delivery to the end target is pull model, internally HISP talk to each talk bi-directionally
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| =Dropped MU Items= | | =Dropped MU Items= |
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| # [[Advance Directives]] - Completed and included in 4.x release | | # [[Advance Directives]] - Completed and included in 4.x release |
| # Progress Note - Already part of OpenEMR | | # Progress Note - Already part of OpenEMR |
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| ===Full 'C' Certification===
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|
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| This project follows successful Meaningful Use certification.
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|
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| {| border = "1"
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| |Funding
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| |Requirements
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| |Teams Identified
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| |Development Started
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| |Submitted to and ONC Certification Body
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| |}
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|
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| ==OSCON Presentation by Tony and Sam==
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| Dr Sam Bowen and Tony McCormick were speakers at the O'Rielly Open Source Convention in Portland. I have attached the presentation.
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|
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| Slide Show PDF + notes, Taking OpenEMR, a GPL EMR to ARRA Meaningful Use Certification and beyond Presentation:
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| * [[File:OpenEMR-MUCert.pdf]]
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|
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| It was recorded for video and is available on YouTube: Watch it at 240p resolution or it freezes up after about 16 minutes ,,,,
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| * http://www.youtube.com/watch?v=zxd-ZJuiCEk
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| Blog Posts:
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| * Day One: http://radar.oreilly.com/2010/07/day-one-of-the-health-care-it.html
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| * Day Two: http://radar.oreilly.com/2010/07/vista-scenarios-and-other-cont.html
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| * Wrap Up: http://radar.oreilly.com/2010/07/wrap-up-of-the-health-care-it.html
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| ==Links== | | ==Links== |
| | * [http://onc-chpl.force.com/ehrcert/chplhome Full List of Certified EHR's] |
| * [http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=3120 Approved Certification Bodies] | | * [http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=3120 Approved Certification Bodies] |
| * [http://healthcare.nist.gov/use_testing/effective_requirements.html Final of NIST Test Scripts for 2011] | | * [http://healthcare.nist.gov/use_testing/effective_requirements.html Final of NIST Test Scripts for 2011] |
| * [http://healthit.hhs.gov/portal/server.pt?open=512&objID=1153&mode=2 Main HHS Site for ONC Rules] | | * [http://healthit.hhs.gov/portal/server.pt?open=512&objID=1153&mode=2 Main HHS Site for ONC Rules] |
| ** [[media:2009-31216_PI.pdf|Initial Certification Criteria for EHR Technology (ONC)]] *deprecated PDF*
| | * [http://en.wikipedia.org/wiki/American_Recovery_and_Reinvestment_Act_of_2009 Wikipedia ARRA] |
| ** [[media:2009-31217_PI.pdf|Electronic Health Record Incentive Program (CMS)]] *deprecated PDF*
| | == How to Register / Attest for Certified EHR use == |
| ** [[media:E9-31216.pdf|Interim Final Rule (HHS)]] *deprecated PDF*
| | '''How do I obtain a CMS EHR Certification ID? ''' |
| * [[media:CCHIT_Gap_Analysis.pdf|CCHIT Preliminary and IFR Gap Analayis (CCHIT)]]
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| * NIST awards contract to create EHR certification system: http://www.govhealthit.com/newsitem.aspx?nid=72951
| | The unique ONC EHR Certification ID issued by the certifying body is associated with the CMS EHR Certification ID but distinct from it. The ONC EHR Certification ID is one of the “inputs” into the calculation and creation of the CMS EHR Certification ID. However, it is ultimately the CMS EHR Certification ID number which providers will use for the incentive payments. |
| * Drummond Group Inc (DGI) EHR blog: http://www.drummondgroup.com/blog/
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| * [[media:HIT_MU_Recommendations_021710.pdf|HITPC's Recommended Changes to Meaningful Use]]
| | The ONC Certified Health Product Listing functionality was updated December 24, 2010 and it now has the addition of a shopping cart to create CMS EHR Certification ID number. Users can obtain the CMS EHR Certification ID number by following these steps: |
| * Wikipedia ARRA: http://en.wikipedia.org/wiki/American_Recovery_and_Reinvestment_Act_of_2009
| | *[source: http://www.emrandehr.com/tag/ehr-product/] |
| * [[media:2010-14999_PI.pdf|Establishment of the Temporary Certification Program for Health Information (ONC)]]
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| ===Summary===
| | :1. Go the ONC CHPL website: http://onc-chpl.force.com/ehrcert |
| | :2. Following the instructions on the site, search for the certified EHR products. There are many ways to search, but one option is to search by the ONC EHR Certification ID assigned to the vendor. |
| | :3. When the EHR product(s) is found, select the link on its row called “Add to Cart”. There is a shopping cart icon next to it. |
| | :4. When all EHR products used by the provider have been added to the cart, select the “View Cart” link at the top right which also has a shopping cart icon next to it. |
| | :5. Now in the Certification Cart section, verify the products in the cart are correct. Then, select the “Get CMS EHR Certification ID” button in the top right corner to request a CMS EHR Certification ID. However, the button will not be activated until the items in your cart meet 100% of the required criteria. If your EHR product(s) do not meet 100% of the Meaningful Use incentives, then a CMS EHR Certification ID number can not be issued. |
| | :6. Finally, you will see the CMS EHR Certification ID. It is typically a 15 digit string made up alphanumeric characters. |
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| ==Bradford-Scott Summary== | | ==Bradford-Scott Summary== |
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| * http://community.advanceweb.com/blogs/nurses_17/archive/2010/06/23/onc-establishes-temporary-certification-program-for-ehrs.aspx | | * http://community.advanceweb.com/blogs/nurses_17/archive/2010/06/23/onc-establishes-temporary-certification-program-for-ehrs.aspx |
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| == CCHIT Summary ==
| | Archived Pages |
| The Certification Commission for Healthcare Information Technology (CCHIT) has published ambulatory certification criteria on their web page: [http://cchit.org/ CCHIT Web Site] - look here for for the most current information. CCHIT has been in existence since about 2006 and the criteria have been revised several times.
| | * [[CCHIT Topics - Archived]] |
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| * http://www.cchit.org/get_certified/open_eligible_providers
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| The United States Department of Health and Human services and the Office of the National Coordinator of Health Information Technology have published a definition of what they consider to be Meaningful Use
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| of Electronic Health Records. These criteria have divided into five very broad policies:
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| # Improve quality, safety, efficiency, and reduce health disparities
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| # [[Engage Patients And Families|Engage Patients And Families.]]
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| # [[Improve Care Coordination|Improve Care Coordination.]]
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| # Improve population and public health
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| # Ensure adequate privacy and security protections for personal health information
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| ==== Other References====
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| Ronald Leemhuis did some early testing of how OpenEMR stacks up against the 2008 criteria: [[Initial CCHIT Functionality Testing|Initial CCHIT Functionality Testing]]
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| This topic had been much discussed by the OpenEMR project at SourceForge:
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| * http://sourceforge.net/forum/forum.php?thread_id=2154323&forum_id=202506
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| * http://sourceforge.net/forum/forum.php?thread_id=2042768&forum_id=202504
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| ===Organizational Meeting Notes===
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| We have had four organizational teleconferences and here are the transcripts: <br>
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| * [[CCHIT Organizational Teleconference|CCHIT Organizational Teleconference #1 07/10/2009]]
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| * [[CCHIT Organizational Teleconference 2|CCHIT Organizational Teleconference #2 07/14/2009]]
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| * [[CCHIT Organizational Teleconference 3|CCHIT Organizational Teleconference #3 08/24/2009]]
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| * [[CCHIT Organizational Teleconference 4|CCHIT Organizational Teleconference #4 10/24/2009]]
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| ===Criteria Breakdown Categories===
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| The Criteria are further subdivided into the large categories of Functionality, Interoperability, and Security:
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| ====Functionality====
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| The ability to create and handle electronic records for all of a physician practice's patients, as well as computerize the flow of work in the office. There are approximately 400 functionality criteria. The areas covered are:
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| *Organizing patient data<br>
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| *Compiling lists<br>
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| *Receiving and displaying information<br>
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| *Creating orders<br>
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| *Supporting decisions<br>
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| *Authorized sharing<br>
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| *Administrative and billing support<br>
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| *Graphical reports<br>
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| *Automatic alerts<br>
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| *Maintaining documents and guidelines<br>
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| *Disease and drug management<br>
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| ====Interoperability====
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| The ability to receive and send electronic data between an EHR and outside sources of information such as labs, pharmacies and other EHRs in physician offices and hospitals. There are approximately two dozen Interoperability criteria.
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| The broad areas required are:
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| *Laboratory results<br>
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| *Electronic medication prescribing<br>
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| *Exchange summary of documents<br>
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| * [[Improve Population Public Health|Improve Population and Public Health.]]
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| ====Security====
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| * Ensure adequate privacy and security protections for personal health information
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| ** The ability to maintain patient information safe and private. CCHIT requires ambulatory EHR products to provide state-of-the-art technical capabilities.
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| The broad areas covered are:
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| * [[User Authentication|User Authentication.]]
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| * [[Controlling Access|Controlling Access.]]
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| * [[Auditing Changes|Audit Control.]]
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| * [[Encryption Transmission|Encryption During Transmission.]]
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| * [[Protection Ephi|Protection at Rest.]]
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| * [[Encounter Integrity|Practitioner Data Integrity.]]
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| * [[Backup Scripts|Backup Strategies.]]
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| * [[Patient Information Access|Individual Patient Access.]] | |
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| [[OpenEMR CCHIT ToDo|CCHIT Security To Do List]] - Created by Visolve
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| ===Exchange Clinical Information===
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| * [[Requirements of Exchange Clinical Information|Requirements]]
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| * [[HIE User Interface|HIE User Interface]]
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| * [[Interoperability with openpixpdq and openxds]]
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| * [[Workflow Diagrams]]
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| ===Provide Patient with Timely Electronic Access to Health Information===
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| * [[Requirements of Provide Patient with Timely Electronics Access|Requirements]]
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| ===Provide Patient with Electronic copy of their Health Information upon Request===
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| * [[Requirements of Provide Patient Electronic Health Information|Requirements]]
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| ===Capability to Submit Electronic Data to Immunization Registries===
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| * [[Capability to Submit Electronic Data to Immunization Registry|Requirements]]
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| ===Capability to Provide Electronic Syndromic Surveillance Data to Public Health Agencies===
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| * [[Capability to Provide Electronic Syndromic Surveillance|Requirements]]
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| ===Testing and QA for ONC Certification===
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| [[CCHIT_Project_QA_Testing_Page]]
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| =HHS Certification Updated for 2010=
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| ==Current Status==
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| * Test Scripts: [[Media:ARRAIFR01-EP_0.zip]]
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| ==Certification Criteria==
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| The Certification Criteria for Meaningful Use Stage 1 by [[Eligible Professionals]]:
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| # Use Computerized Provider Order Entry (CPOE)
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| # Implement drug-drug, drug-allergy, drug-formulary checks
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| # Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®
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| # Generate and transmit permissible prescriptions electronically (eRx)
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| # Maintain active medication list
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| # Maintain active medication allergy list
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| # Record demographics
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| ## Preferred language
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| ## Insurance type
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| ## Gender
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| ## Race
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| ## Ethnicity
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| ## Date of birth
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| # Record and chart changes in vital signs:
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| ## Height
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| ## Weight
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| ## Blood pressure
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| ## Calculate and display: BMI
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| ## Plot and display growth charts for children 2-20 years, including BMI
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| # Record smoking status for patients 13 years old or older
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| # Incorporate clinical lab-test results into EHR as structured data
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| # Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, and outreach
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| # Report ambulatory quality measures to CMS or the States
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| # Send reminders to patients per patient preference for preventative / follow up care
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| # Implement 5 clinical decision support rules relevant to specialty or high clinical priority, including diagnostic test ordering, along with the ability to track compliance with those rules
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| # Check insurance eligibility electonically from public and private payers
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| # Submit claims electronically to public and private payers
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| # Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, allergies) upon request
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| # (Not Applicable to Eligible Physicians) Provide patients with an electronic copy of their discharge instructions and procedures at time of discharge, upon request
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| # Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies) within 96 hours of the information being available to the eligible professional
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| # Provide clinical summaries for patients for each office visit
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| # Capability to exchange key clinical information (for example problem list, medication list, allergies, diagnostic test results) among providers of care and patient authorized entities electronically
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| # Provide summary care record for each transition of care and referral
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| # Perform medication reconciliation at relevant encounters and each transition of care
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| # Capability to submit electronic data to immunization registries and actual submission where required and accepted
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| # Capability to provide electronic submission of reportable lab results (as required by state or local law) to public health agencies and actual submission where it can be received
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| # Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice
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| # Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities
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| ==Gap Analysis==
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| The gap analysis will be started once the certification criteria have been reviewed.
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| ==Project Plan==
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| The project plan will completed following the gap analysis.
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| ==Action Items & Backlog==
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|
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| The outstanding items for HHS Certification process will be tracked here.
| | [[Category:Certification]][[Category:Certification Stage I]] |
Meaningful Use Certification
OpenEMR 4.1 ONC Complete Ambulatory EHR Certification
Certification Project Archive
Dropped MU Items
As of 12/30/2009, the following MUs are no longer required:
- Advance Directives - Completed and included in 4.x release
- Progress Note - Already part of OpenEMR
Links
How to Register / Attest for Certified EHR use
How do I obtain a CMS EHR Certification ID?
The unique ONC EHR Certification ID issued by the certifying body is associated with the CMS EHR Certification ID but distinct from it. The ONC EHR Certification ID is one of the “inputs” into the calculation and creation of the CMS EHR Certification ID. However, it is ultimately the CMS EHR Certification ID number which providers will use for the incentive payments.
The ONC Certified Health Product Listing functionality was updated December 24, 2010 and it now has the addition of a shopping cart to create CMS EHR Certification ID number. Users can obtain the CMS EHR Certification ID number by following these steps:
- 1. Go the ONC CHPL website: http://onc-chpl.force.com/ehrcert
- 2. Following the instructions on the site, search for the certified EHR products. There are many ways to search, but one option is to search by the ONC EHR Certification ID assigned to the vendor.
- 3. When the EHR product(s) is found, select the link on its row called “Add to Cart”. There is a shopping cart icon next to it.
- 4. When all EHR products used by the provider have been added to the cart, select the “View Cart” link at the top right which also has a shopping cart icon next to it.
- 5. Now in the Certification Cart section, verify the products in the cart are correct. Then, select the “Get CMS EHR Certification ID” button in the top right corner to request a CMS EHR Certification ID. However, the button will not be activated until the items in your cart meet 100% of the required criteria. If your EHR product(s) do not meet 100% of the Meaningful Use incentives, then a CMS EHR Certification ID number can not be issued.
- 6. Finally, you will see the CMS EHR Certification ID. It is typically a 15 digit string made up alphanumeric characters.
Bradford-Scott Summary
By 2011:
* use computerized physician order entry for all orders including medications;
* incorporate lab tests and results into EHRs and share results electronically with public health agencies;
* generate lists of patients by specific condition to use for quality improvement;
* provide clinical summaries for patients after each encounter;
* exchange key clinical information among health professionals.
By 2013:
* generate and transmit prescriptions electronically;
* manage chronic conditions using patient lists and decision support tools;
* use bar coding for medication administration;
* offer secure patient-physician messaging capability;
* record patient preferences in EHR.
By 2015:
* achieve minimal levels of performance on quality, safety and efficiency;
* give patients access to self-management tools;
* access comprehensive patient data from all available sources;
* conduct automated real-time surveillance on occurrences such as adverse events, disease outbreaks and bioterrorism;
* incorporate clinical dashboards into EHR.
HHS Definition Summary
The Secretary adopts the following certification criteria for
Complete EHRs or EHR Modules designed to be used in an ambulatory
setting. Complete EHRs or EHR Modules must include the capability to
perform the following functions electronically and in accordance with
all applicable standards and implementation specifications adopted in
this part:
Sec. 170.304 Specific certification criteria for Complete EHRs or EHR
Modules designed for an ambulatory setting.
The Secretary adopts the following certification criteria for
Complete EHRs or EHR Modules designed to be used in an ambulatory
setting. Complete EHRs or EHR Modules must include the capability to
perform the following functions electronically and in accordance with
all applicable standards and implementation specifications adopted in
this part:
(a) Computerized provider order entry. Enable a user to
electronically record, store, retrieve, and manage, at a minimum, the
following order types:
(1) Medications;
(2) Laboratory;
(3) Radiology/imaging; and
(4) Provider referrals.
(b) Electronically exchange prescription information. Enable a user
to electronically transmit medication orders (prescriptions) for
patients in accordance with the standards specified in Sec.
170.205(c).
(c) Record demographics. Enable a user to electronically record,
modify, and retrieve patient demographic data including preferred
language, insurance type, gender, race, ethnicity, and date of birth.
(d) Generate patient reminder list. Electronically generate, upon
request, a patient reminder list for preventive or follow-up care
according to patient preferences based on demographic data, specific
conditions, and/or medication list.
(e) Clinical decision support.
(1) Implement rules. Implement automated, electronic clinical
decision support rules (in addition to drug-drug and drug-allergy
contraindication checking) according to specialty or clinical
priorities that use demographic data, specific patient diagnoses,
conditions, diagnostic test results and/or patient medication list.
(2) Alerts. Automatically and electronically generate and indicate
in real-time, alerts and care suggestions based upon clinical decision
support rules and evidence grade.
(3) Alert statistics. Automatically and electronically track,
record, and generate reports on the number of alerts responded to by a
user.
(f) Electronic copy of health information. Enable a user to create
an electronic copy of a patient's clinical information, including, at a
minimum, diagnostic test results, problem list, medication list,
medication allergy list, immunizations, and procedures in:
(1) Human readable format; and
(2) On electronic media or through some other electronic means in
accordance with:
(i) One of the standards specified in Sec. 170.205(a)(1);
(ii) The standard specified in Sec. 170.205(a)(2)(i)(A), or, at a
minimum, the version of the standard specified in Sec.
170.205(a)(2)(i)(B);
(iii) One of the standards specified in Sec. 170.205(a)(2)(ii);
(iv) At a minimum, the version of the standard specified in Sec.
170.205(a)(2)(iii); and
(v) The standard specified in Sec. 170.205(a)(2)(iv).
(g) Timely access. Enable a user to provide patients with online
access to their clinical information, including, at a minimum, lab test
results, problem list, medication list, medication allergy list,
immunizations, and procedures.
(h) Clinical summaries.
(1) Provision. Enable a user to provide clinical summaries to
patients for each office visit that include, at a minimum, diagnostic
test results, problem list, medication list, medication allergy list,
immunizations and procedures.
(2) Provided electronically. If the clinical summary is provided
electronically it must be:
(i) Provided in human readable format; and
(ii) On electronic media or through some other electronic means in
accordance with:
(A) One of the standards specified in Sec. 170.205(a)(1);
(B) The standard specified in Sec. 170.205(a)(2)(i)(A), or, at a
minimum, the version of the standard specified in Sec.
170.205(a)(2)(i)(B);
(C) One of the standards specified in Sec. 170.205(a)(2)(ii);
(D) At a minimum, the version of the standard specified in Sec.
170.205(a)(2)(iii); and
(E) The standard specified in Sec. 170.205(a)(2)(iv).
[[Page 2047]]
(i) Exchange clinical information and patient summary record.
(1) Electronically receive and display. Electronically receive a
patient's summary record, from other providers and organizations
including, at a minimum, diagnostic tests results, problem list,
medication list, medication allergy list, immunizations, and procedures
in accordance with Sec. 170.205(a) and upon receipt of a patient
summary record formatted in an alternate standard specified in Sec.
170.205(a)(1), display it in human readable format.
(2) Electronically transmit. Enable a user to electronically
transmit a patient summary record to other providers and organizations
including, at a minimum, diagnostic test results, problem list,
medication list, medication allergy list, immunizations, and procedures
in accordance with:
(i) One of the standards specified in Sec. 170.205(a)(1);
(ii) The standard specified in Sec. 170.205(a)(2)(i)(A), or, at a
minimum, the version of the standard specified in Sec.
170.205(a)(2)(i)(B);
(iii) One of the standards specified in Sec. 170.205(a)(2)(ii);
(iv) At a minimum, the version of the standard specified in Sec.
170.205(a)(2)(iii); and
(v) The standard specified in Sec. 170.205(a)(2)(iv).
ONC Meaningful Use - Final Rules for 2011
Health and Human Services - Standards & Certification
ONC Initiatives
NIST Test Scripts
14 organizations have applied to become ONC-ATCB so CCHIT will definitely not be the only one.
Archived Pages