Difference between revisions of "OpenEMR Certification Stage III Meaningful Use"
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Revision as of 22:35, 27 February 2022
Overview
- Goal completion is by 4/1/2022
- Testing body is SLI.
- Links:
- https://www.healthit.gov/topic/certification-ehrs/2015-edition
- https://qpp.cms.gov/mips/overview
- https://build.fhir.org/ig/HL7/US-Core/general-guidance.html
- https://www.healthit.gov/isa/sites/isa/files/2020-07/USCDI-Version-1-July-2020-Errata-Final.pdf
- https://build.fhir.org/ig/HL7/US-Core-R4/general-guidance.html#us-core-data-for-interoperability-and-2015-edition-common-clinical-data-set
- https://www.healthit.gov/sites/default/files/topiclanding/2018-04/2015Ed_CCG_CCDS.pdf
- https://inferno.healthit.gov/inferno
- https://inferno.healthit.gov/inferno/f3X6ykpeyzv/test_sets/test_procedure/
Forums and Discussion
Funding and Sponsors
Barometer
Required to Pay for Testing and Certification - $16,125
$5,000 | $8,000 | $10,000 | $15,625 |
$0 |
Required to support development efforts and timely delivery - $100,000
$10,000 | $20,000 | $30,000 | $40,000 | $50,000 | $60,000 | $68,709.50 | $70,000 | $80,000 | $90,000 | $95,209 | $97,600 | $100,000 |
$10,000 | $20,000 | $30,000 | $40,000 | $50,000 | $60,000 | $68,709.50 | $70,000 | $80,000 | $90,000 | $95,209 |
- 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 OpenEMR 2015 Certification
- Help OpenEMR obtain 2015 Edition CEHRT by donating here.
For lower processing fees please email hello@open-emr.org for wire transfer instructions.
Major sponsors
- Comlink, http://www.comlinkinc.com, Amit Panjwani, CEO
- Dr. Niru Jani
- Dr. Sushma Jani
- Brent Boecking, https://procaremedcenter.com/
- Michael J. Blaho, http://www.synergyinfoconnect.com/
- Community Behavioral Health, http://www.communitybehavioralhealth.net
- Care Management Solutions, http://cmsvt.org
Completion Barometer
- This barometer is tracking the progress of the 2015 ONC Ambulatory EHR 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 2015 certification with CEHRT (although note CEHRT is dependent on CMS) and CURES.
a1*F | a2*F | a5*F | a9* | a12*F | a14*F | b1 | c1 | c2 | c3 | d1*F | d2*F | d3*F | d4*F | d5*F | d6*F | d7*F | d8*F | d9*F | d12*F | d13*F | 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 (Jerry Padgett, Ken Chapple)
- 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): (estimated work to complete: low) (Brady Miller)
- 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
- 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):
- b11. Electronic prescribing (forum | wiki):
- 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 (estimated work to complete: high) (Jerry Padgett, Ken Chapple)
- c2. CQMs – import and calculate (forum | wiki): CQM (estimated work to complete: high) (Jerry Padgett, Ken Chapple)
- c3. CQMs – report criterion (forum | wiki): CQM (estimated work to complete: high) (Jerry Padgett, Ken Chapple)
- 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): (estimated work to complete: low) (Brady Miller)
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): (estimated work to complete: moderate/high) (Stephen Nielson)
- g3. Safety-enhanced design (forum | wiki): (estimated work to complete: moderate/high) (Columbia HIT, Brady Miller)
- g4. Quality management system (forum | wiki): (estimated work to complete: low/moderate) (Brady Miller)
- g5. Accessibility-centered design (forum | wiki): (estimated work to complete: low/moderate) (Brady Miller)
- g6. Consolidated CDA creation performance (forum | wiki): CCDA (estimated work to complete: low/moderate)
- g7. Application access – patient selection (forum | wiki): API FHIR (API documentation pending) (Brady Miller)
- g8. Application access – data category request (forum | wiki):
- g9. Application access – all data request (forum | wiki): API CCDA (detailed analysis after test CCDA, FHIR, and API) (Brady Miller)
- g10. Standardized API for patient and population services (forum | wiki): OAuth SMART FHIR (API documentation pending) (Brady Miller)
- 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) (Stephen Nielson)
- 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 2015.
- Required global settings
- Administration->Globals->Security->Hash Algorithm for Authentication->SHA512 (ONC 2015)
- Administration->Globals->Security->Hash Algorithm for Token->SHA512 (ONC 2015)
- Administration->Globals->Logging->Enable Audit Log Encryption->On
- To ensure optimal security, users need to run their OpenEMR client web browser on a end-user device that encrypts entire drive(s) with AES based encryption algorithm.
- To ensure accurate time, server will need 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 2015, 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
- 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, Safety-enhanced design
- Columbia HIT (plan to include all names, if give permission, of everybody involved in the safety-enhanced design project and testing) - Safety-enhanced design
- 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
- Ken Chapple - CQM, Clinical quality measures (CQMs) – record and export, CQMs – import and calculate, CQMs – report criterion
- Rachel Ellison - Implantable device list
- Stephen Nielson - SMART, FHIR, API, OAuth, Automated measure calculation, Application access – patient selection, Application access – data category request, Standardized API for patient and population services, Direct Project
- Stephen Waite*
- Thuyet Tran - Demographics
- Vishnu Yarmaneni - FHIR
- Yash Raj Bothra - FHIR
- *MU3 Project Managers
Testing Servers
Notes
- Below is how we derived the items to include in the main barometer:
- Based on analysis incorporating finalized proposed changes and Cures: 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
- Cures specific items are: a1, a2 or a3, a5, a9, a14, b1(standard or cures(cures is mandatory after 5/2/22)), c1, g7, g8 or g10(g10 is mandatory after 5/2/22), g9(standard or cures(cures is mandatory after 5/2/22)), h1 or h2
- New distilled list including cures stuff that is mandatory after 5/22/22: a1, a2 or a3, a5, a9, a12, a14, b1(cures version), b6, c1, c2, c3, e3, g1 or g2, g7, g9(cures version), g10(cures), 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(cures 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(cures version), g10(cures), 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(cures 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(cures version), g10(cures), h1 or h2(will do h1)
- Since doing CURES.
- 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 CURES): a12, b10, c2, c3, g2
Redo analysis from scratch (to ensure on right path)
- Base EHR definition for 2015 Edition Cures Update (https://www.healthit.gov/topic/certification-ehrs/2015-edition-test-method/2015-edition-cures-update-base-electronic-health-record-definition)
- 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
- Note above items are determined by ONC for Base EHR. Also need to ensure get CEHRT status which is determined by CMS and appears more confusing to sort out (analysis ongoing): https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Certification
- Additional items required for CEHRT (ongoing analysis):
- Per https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-495/subpart-A/section-495.4 need:
- 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),