Clinical decision support (MU2)

MU Requirements

Per ONC

Taken from ONC Final Rule:File:2014 Edition Cert Federal Register.pdf

(8) Clinical decision support. (i) Evidence-based decision support interventions. Enable a limited
set of identified users to select (i.e., activate) one or more electronic clinical decision support
interventions (in addition to drug-drug and drug-allergy contraindication checking) based on
each one and at least one combination of the following data:
(A) Problem list;
(B) Medication list;
(C) Medication allergy list;
(D) Demographics;
(E) Laboratory tests and values/results; and
(F) Vital signs.
(ii) Linked referential clinical decision support. (A) EHR technology must be able to:
(1) Electronically identify for a user diagnostic and therapeutic reference information; or
(2) Electronically identify for a user diagnostic and therapeutic reference information in
accordance with the standard specified at § 170.204(b) and the implementation
specifications at § 170.204 (b)(1) or (2).
(B) For paragraph (a)(8)(ii)(A) of this section, EHR technology must be able to
electronically identify for a user diagnostic or therapeutic reference information based on
each one and at least one combination of the following data referenced in paragraphs
(a)(8)(i)(A) through (F) of this section:
(iii) Clinical decision support configuration. (A) Enable interventions and reference
resources specified in paragraphs (a)(8)(i) and (ii) of this section to be configured by a
limited set of identified users (e.g., system administrator) based on a user’s role.
(B) EHR technology must enable interventions to be electronically triggered:
(1) Based on the data referenced in paragraphs (a)(8)(i)(A) through (F) of this section.
(2) When a patient’s medications, medication allergies, and problems are incorporated
from a transition of care/referral summary received pursuant to paragraph (b)(1)(iii) of
this section.
(3) Ambulatory setting only. When a patient’s laboratory tests and values/results are
incorporated pursuant to paragraph (b)(5)(i)(A)(1) of this section.
(iv) Automatically and electronically interact. Interventions triggered in accordance with
paragraphs (a)(8)(i) through (iii) of this section must automatically and electronically occur when
a user is interacting with EHR technology.
(v) Source attributes. Enable a user to review the attributes as indicated for all clinical decision
support resources:
(A) For evidence-based decision support interventions under paragraph (a)(8)(i) of this
section:
(1) Bibliographic citation of the intervention (clinical research/guideline);
(2) Developer of the intervention (translation from clinical research/guideline);
(3) Funding source of the intervention development technical implementation; and
(4) Release and, if applicable, revision date(s) of the intervention or reference source.
(B) For linked referential clinical decision support in paragraph (a)(8)(ii) of this section and
drug-drug, drug-allergy interaction checks in paragraph(a)(2) of this section, the developer
of the intervention, and where clinically indicated, the bibliographic citation of the
intervention (clinical research/guideline).

Per ONC/NIST Final Test Methods

See here: http://www.healthit.gov/policy-researchers-implementers/2014-edition-final-test-method

Proposal

Based on Visolve's Estimation document no new development needs to be done. However, we will need to validate that this is acceptable using the Test scripts published by NIST.

Owner

EnSoftek/MI2

Links

• OpenEMR Certification Stage II Meaningful Use Main Project Page
• Clinical Decision Rules wiki page for stage I certification
• All the wiki pages related to the Clinical Decision Rules (CDR) engine