Difference between revisions of "OpenEMR Certification"

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=CCHIT Certification=
=Meaningful Use Certification=
==Completion Barometer==
===Meaningful Use===
{| border = "1"
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|style="color:white; background-color:blue"|Requirements
|style="color:white; background-color:green"|Teams Identified
|style="color:white; background-color:green"|Development Started
|Submitted to CCHIT
|}
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* For numeric reference, see the [[Meaningful_Use_Focused_Action_Items_for_2011]]
[[OpenEMR 4.1 ONC Complete Ambulatory EHR Certification]]
{|
|Color Key:
|style="color:white; background-color:blue"|In Progress
|style="color:white; background-color:orange"|Coded
|style="color:white; background-color:green"|Completed
|}


===Full 'C' Certification===


This project follows successful Meaningful Use certification.
[[Certification Project Archive]]


{| border = "1"
=Dropped MU Items=
|Funding
As of 12/30/2009, the following MUs are no longer required:
|Requirements
|Teams Identified
|Development Started
|Submitted to CCHIT
|}


===Project Tracking===
# [[Advance Directives]] - Completed and included in 4.x release
* [[CCHIT_MU_2011_Project]] - Current meeting notes, target dates and SPRINT logs are located here as well as some team decisions about design choices.
# Progress Note - Already part of OpenEMR


===Summary===
==Links==
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.
* [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? '''


* http://www.cchit.org/get_certified/open_eligible_providers
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 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
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:
of Electronic Health Records. These criteria have divided into five very broad policies:
*[source: http://www.emrandehr.com/tag/ehr-product/]


# Improve quality, safety, efficiency, and reduce health disparities
:1. Go the ONC CHPL website: http://onc-chpl.force.com/ehrcert
# [[Engage Patients And Families|Engage Patients And Families.]]
: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.
# [[Improve Care Coordination|Improve Care Coordination.]]
: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.
# Improve population and public health
: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.
# Ensure adequate privacy and security protections for personal health information
: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.


==== Other References====
==Bradford-Scott Summary==
Ronald Leemhuis did some early testing of how OpenEMR stacks up against the 2008 criteria: [[Initial CCHIT Functionality Testing|Initial CCHIT Functionality Testing]]


This topic had been much discussed by the OpenEMR project at SourceForge:
By 2011:


* http://sourceforge.net/forum/forum.php?thread_id=2154323&forum_id=202506
    * use computerized physician order entry for all orders including medications;
* http://sourceforge.net/forum/forum.php?thread_id=2042768&forum_id=202504
    * 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.


===Organizational Meeting Notes===
By 2013:


We have had four organizational teleconferences and here are the transcripts: <br>
    * 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.


*  [[CCHIT Organizational Teleconference|CCHIT Organizational Teleconference #1 07/10/2009]]
By 2015:
*  [[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]]


===Criteria Breakdown Categories===
    * 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 Criteria are further subdivided into the large categories of Functionality, Interoperability, and Security:
==HHS Definition Summary==
* Feb 12, 2010


====Functionality====
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:


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:
Sec.  170.304  Specific certification criteria for Complete EHRs or EHR
Modules designed for an ambulatory setting.


*Organizing patient data<br>
The Secretary adopts the following certification criteria for
*Compiling lists<br>
Complete EHRs or EHR Modules designed to be used in an ambulatory
*Receiving and displaying information<br>
setting. Complete EHRs or EHR Modules must include the capability to
*Creating orders<br>
perform the following functions electronically and in accordance with
*Supporting decisions<br>
all applicable standards and implementation specifications adopted in
*Authorized sharing<br>
this part:
*Administrative and billing support<br>
<pre>
*Graphical reports<br>
    (a) Computerized provider order entry. Enable a user to
*Automatic alerts<br>
electronically record, store, retrieve, and manage, at a minimum, the
*Maintaining documents and guidelines<br>
following order types:
*Disease and drug management<br>
    (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).


====Interoperability====
[[Page 2047]]


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.  
    (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 required are:
</pre>
*Laboratory results<br>
== ONC Meaningful Use - Final Rules for 2011 ==
*Electronic medication prescribing<br>
*Exchange summary of documents<br>
* [[Improve Population Public Health|Improve Population and Public Health.]]


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


* Ensure adequate privacy and security protections for personal health information
ONC Initiatives
** The ability to maintain patient information safe and private. CCHIT requires ambulatory EHR products to provide state-of-the-art technical capabilities.  
* http://healthit.hhs.gov/portal/server.pt?open=512&objID=1497&parentname=CommunityPage&parentid=1&mode=2&in_hi_userid=10741&cached=true


The broad areas covered are:
NIST Test Scripts
* [[User Authentication|User Authentication.]]
* http://xw2k.nist.gov/healthcare/use_testing/index.html
* [[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.]]


[[OpenEMR CCHIT ToDo|CCHIT Security To Do List]] - Created by Visolve
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


===Exchange Clinical Information===
Archived Pages
* [[CCHIT Topics - Archived]]


* [[Requirements of Exchange Clinical Information|Requirements]]
[[Category:Certification]][[Category:Certification Stage I]]
* [[HIE User Interface|HIE User Interface]]
* [[Interoperability with openpixpdq and openxds]]
* [[Workflow Diagrams]]
 
===Provide Patient with Timely Electronic Access to Health Information===
 
* [[Requirements of Provide Patient with Timely Electronics Access|Requirements]]
 
===Provide Patient with Electronic copy of their Health Information upon Request===
 
* [[Requirements of Provide Patient Electronic Health Information|Requirements]]
 
===Capability to Submit Electronic Data to Immunization Registries===
 
* [[Capability to Submit Electronic Data to Immunization Registry|Requirements]]
 
===Capability to Provide Electronic Syndromic Surveillance Data to Public Health Agencies===
 
* [[Capability to Provide Electronic Syndromic Surveillance|Requirements]]
 
===Testing and QA for CCHIT Certification===
 
[[CCHIT_Project_QA_Testing_Page]]
 
=HHS Certification=
 
==Current Status==
 
Criteria Analysis
 
==Description==
 
At the end of December, 2009, Health and Human Services (HHS) released two important documents concerning EMR software:
 
* [http://www.federalregister.gov/OFRUpload/OFRData/2009-31216_PI.pdf Interim Final Rule (Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology)]
* [http://www.federalregister.gov/OFRUpload/OFRData/2009-31217_PI.pdf Notice of Proposed Rulemaking (Medicare and Medicaid Programs; Electronic Health Record Incentive Program)]
 
These documents outline the requirements that EMR software must meet, and what the medical practices and hospitals themselves must do in order to be eligible for the ARRA EHR incentive payments.
 
==Certification Criteria==
 
The certification criteria is currently being reviewed.
 
==Gap Analysis==
 
The gap analysis will be started once the certification criteria have been reviewed.
 
==Project Plan==
 
The project plan will completed following the gap analysis.
 
==Action Items & Backlog==
 
The outstanding items for HHS Certification process will be tracked 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

Retrieved from "https://www.open-emr.org/wiki/index.php?title=OpenEMR_Certification&oldid=18366"