OpenEMR Certification Stage III Meaningful Use

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Overview

Goal completion is by 4/1/2022
Testing body is SLI.
Links:

Forums and Discussion


Funding and Sponsors

Barometer

Required to Pay for Testing and Certification - $15,625

$5,000 $8,000 $10,000 $15,625
$0


Required to support development efforts and timely delivery - $90,000

$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $65,709.50 $68,209.50 $70,000 $80,000 $82,600 $85,000 $90,000
$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $65,709.50 $68,209.50


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

Please help OpenEMR obtain 2015 Edition CEHRT


DONATE HERE


Major sponsors

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)
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): 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)
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
  • 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, Application access – patient selection, Application access – data category request, Standardized API for patient and population services
  • Stephen Waite*
  • Thuyet Tran - Demographics
  • Vishnu Yarmaneni - FHIR
  • Yash Raj Bothra - FHIR
*MU3 Project Managers


Testing Servers

MU3 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)

  • 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
  • a12, e3, c2, c3, (g1 or g2)
  • Items that can drop:
  • b10
  • Items that need to add:
  • e3