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We have had three organizational teleconferences and here are the transcripts: <br>
=Meaningful Use Certification=
*  [[CCHIT Organizational Teleconference|CCHIT Organizational Teleconference #1 07/10/2009]]
*  [[CCHIT Organizational Teleconference 2|CCHIT Organizational Teleconference  #2 07/14/2009]]
*  [[CCHIT Organizational Teleconference 3|CCHIT Organizational Teleconference #3 08/24/2009]]
*  [[CCHIT Organizational Teleconference 4|CCHIT Organizational Teleconference #4 10/24/2009]]


[[OpenEMR 4.1 ONC Complete Ambulatory EHR Certification]]


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.


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
[[Certification Project Archive]]
of Electronic Health Records.  These criteria have divided into five very broad policies:


1. Improve quality, safety, efficiency, and reduce health disparities<br>
=Dropped MU Items=
2. Engage patients and families<br>
As of 12/30/2009, the following MUs are no longer required:
3. Improve care coordination<br>
4. Improve population and public health<br>
5. Ensure adequate privacy and security protections for personal health information


<hr>
# [[Advance Directives]] - Completed and included in 4.x release
# Progress Note - Already part of OpenEMR


==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://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://en.wikipedia.org/wiki/American_Recovery_and_Reinvestment_Act_of_2009 Wikipedia ARRA]
== How to Register / Attest for Certified EHR use ==
'''How do I obtain a CMS EHR Certification ID? '''


From there the Criteria are further subdivided into the large categories of Functionality, Interoperability, and Security:
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.


'''Functionality'''
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:
*[source: http://www.emrandehr.com/tag/ehr-product/]


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:
: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.


*Organizing patient data<br>
==Bradford-Scott Summary==
*Compiling lists<br>
*Receiving and displaying information<br>
*Creating orders<br>
*Supporting decisions<br>
*Authorized sharing<br>
*Administrative and billing support<br>
*Graphical reports<br>
*Automatic alerts<br>
*Maintaining documents and guidelines<br>
*Disease and drug management<br>


By 2011:


'''2011 Objectives'''
    * 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.


* [[Engage Patients And Families|Engage Patients And Families.]]
By 2013:


* [[Improve Care Coordination|Improve Care Coordination.]]
    * 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:


'''Interoperability'''
    * 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.


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.
==HHS Definition Summary==
* Feb 12, 2010


The broad areas required are:
The Secretary adopts the following certification criteria for
*Laboratory results<br>
Complete EHRs or EHR Modules designed to be used in an ambulatory
*Electronic medication prescribing<br>
setting. Complete EHRs or EHR Modules must include the capability to
*Exchange summary of documents<br>
perform the following functions electronically and in accordance with
all applicable standards and implementation specifications adopted in
this part:


* [[Improve Population Public Health|Improve Population and Public Health.]]
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:
<pre>
    (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).


'''5. Ensure adequate privacy and security protections for personal health information (Security)'''
[[Page 2047]]


The ability to maintain patient information safe and private. CCHIT requires ambulatory EHR products to provide state-of-the-art technical capabilities.  
    (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).


The broad areas covered are:
</pre>
* [[User Authentication|User Authentication.]]
== ONC Meaningful Use - Final Rules for 2011 ==
* [[Controlling Access|Controlling Access.]]
* [[Auditing Changes|Audit Control.]]
* [[Encryption Transmission|Encryption During Transmission.]]
* [[Protection Ephi|Protection at Rest.]]
* [[Encounter Integrity|Practitioner Data Integrity.]]
* [[Backup Scripts|Backup Strategies.]]
* [[Patient Information Access|Individual Patient Access.]]


Health and Human Services - Standards & Certification
* http://healthit.hhs.gov/portal/server.pt?open=512&objID=1153&mode=2


ONC Initiatives
* http://healthit.hhs.gov/portal/server.pt?open=512&objID=1497&parentname=CommunityPage&parentid=1&mode=2&in_hi_userid=10741&cached=true


Dear Ronald Leemhuis did some early testing of how OpenEMR stacks up against the 2008 criteria: InitialFunctionalityTesting
NIST Test Scripts
* http://xw2k.nist.gov/healthcare/use_testing/index.html


This topic had been much discussed by the OpenEMR project at SourceForge:<br>
14 organizations have applied to become ONC-ATCB so CCHIT will definitely not be the only one.
* http://community.advanceweb.com/blogs/nurses_17/archive/2010/06/23/onc-establishes-temporary-certification-program-for-ehrs.aspx


* http://sourceforge.net/forum/forum.php?thread_id=2154323&forum_id=202506<br>
Archived Pages
* http://sourceforge.net/forum/forum.php?thread_id=2042768&forum_id=202504<br>
* [[CCHIT Topics - Archived]]


 
[[Category:Certification]][[Category:Certification Stage I]]
[[OpenEMR CCHIT ToDo|CCHIT To Do List]]: What we Need to do and who has volunteered to work on it can be found here.

Latest revision as of 17:34, 11 November 2014

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:

  1. Advance Directives - Completed and included in 4.x release
  2. 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

  • Feb 12, 2010

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