OpenEMR Certification Stage III Meaningful Use

Overview

Links:

• https://www.healthit.gov/topic/certification-ehrs/2015-edition
• https://qpp.cms.gov/mips/overview

Forums and Discussion

• https://community.open-emr.org/t/2015-edition-certification-fka-meaningful-use-3/11528
• https://community.open-emr.org/tags/2015-onc-cert

Funding Barometer

Not Funded

Certification Test Funds

Development Funds

Expended Funds

Required to Pay for Testing and Certification

$1000

$5000

$10,000

$13,000

Required to support development efforts and timely delivery

$2,500

$5,000

$10,000

$12,500

$15,000

$20,000

$25,000

$30,000

$35,000

$40,000

$45,000

$50,000

$55,000

$60,000

$65,000

$70,000

$75,000

Legend Description:

• Not Funded - Unfunded Goal.
• Certification Test Cost - Funds available to pay for Certification Testing
• Development - Funds available for development work
• Expended Funds - Funds that have been spent.

Fund Drive for OpenEMR 2015 Certification

Please help OpenEMR obtain 2015 Edition CEHRT

DONATE HERE

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.

a1*

a2*

a5*

a9*

a12*

a14*

b1

b6

b10

c1

c2

c3

d1*

d2*

d3*

d4*

d5*

d6*

d7*

d8*

d9*

d12*

d13*

g2

g3

g4

g5

g6

g7*

g8

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.
• Failed Test - Issues found during certification testing.
• Certification Pass - Passed certification and in official codebase.
• ^* - Self-declaratiion (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:

• CCDA (Jerry Padgett)
• FHIR (Jerry Padgett) (Vishnu Yarmaneni)
• API

• 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): (estimated work to complete: low) (Thuyet Tran) (Brady Miller) ongoing work here: https://github.com/openemr/openemr/pull/3266

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)

a10. Drug-formulary and preferred drug list checks (forum | wiki):

a11. Smoking status (forum | wiki):

a12. Family health history (forum | wiki): (estimated work to complete: low)

a13. Patient-specific education resources (forum | wiki):

a14. Implantable device list (forum | wiki): (estimated work to complete: moderate) (Rachel Ellison) (Brady Miller) plan discussed here: https://community.open-emr.org/t/implantable-device-list-2015-onc-mu3-a14/13418

a15. Social, psychological, and behavioral data (forum | wiki):

Care Coordination (170.315(b))

b1. Transitions of care (forum | wiki): CCDA (estimated work to complete: moderate)

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): CCDA (estimated work to complete: moderate)

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): CCDA FHIR (estimated work to complete: moderate)

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): (estimated work to complete: high) (Thuyet Tran)

c2. CQMs – import and calculate (forum | wiki): (estimated work to complete: high) (Thuyet Tran)

c3. CQMs – report criterion (forum | wiki): (estimated work to complete: high) (Thuyet Tran)

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) (BradyMiller)

d3. Audit report(s) (forum | wiki): (estimated work to complete: low/moderate) (BradyMiller)

d4. Amendments (forum | wiki):

d5. Automatic access time-out (forum | wiki):

d6. Emergency access (forum | wiki):

d7. End-user device encryption (forum | wiki): (estimated work to complete: low) (BradyMiller)

d8. Integrity (forum | wiki): FINALIZED

d9. Trusted connection (forum | wiki):

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):

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)

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)

g3. Safety-enhanced design (forum | wiki): (estimated work to complete: moderate/high)

g4. Quality management system (forum | wiki): (estimated work to complete: low/moderate)

g5. Accessibility-centered design (forum | wiki): (estimated work to complete: low/moderate)

g6. Consolidated CDA creation performance (forum | wiki): (g6 is considered completed when b1 and b6 is completed)

g7. Application access – patient selection (forum | wiki): API FHIR (estimated work to complete: low)

g8. Application access – data category request (forum | wiki): API FHIR (estimated work to complete: moderate/high)

g9. Application access – all data request (forum | wiki): API CCDA (estimated work to complete: moderate/high)

g10. Standardized API for patient and population services (forum | wiki): FHIR (estimated work to complete: moderate/high) (Jerry Padgett)

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)

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->Audit Logging SELECT Query->On
• Administration->Globals->Logging->Enable Audit Log Encryption->On
• Administration->Globals->Logging->Printing Log Option->Log entire document

Acknowledgment Tracking

Brady Miller - FHIR, Integrity, Encrypt authentication credentials certification criterion

Jerry Padgett - CCDA, FHIR, Standardized API for patient and population services

Rachel Ellison - Implantable device list

Thuyet Tran - Demographics

Vishnu Yarmaneni - FHIR

Yash Raj Bothra - FHIR

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)