Difference between revisions of "OpenEMR Certification Stage II Meaningful Use"

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Revision as of 19:22, 24 September 2015

Overview

This is the project page for the OpenEMR Certification Stage II Meaningful Use project. Modular Certification was obtained on December 24,2014 (for OpenEMR 4.2.x which was released on 12/28/14). The goal is to have Full Certification as soon as possible. There are 45 Certification Criteria, which are organized into 7 different topics (Clinical, Care Coordination, Clinical Quality Measures, Privacy and Security, Patient Engagement, Public Health, and Utilization).
Here are some useful links:
  • Ongoing MU2 work by ZH Healthcare, which will be included in OpenEMR:


Fund Raising

This barometer will track the approximate funds available via the OEMR 501c3 that are dedicated to this goal
Not Funded Certification Test Funds Development Funds Expended Funds

Required to Pay for Testing and Certification

$1000 $5000 $10,000 $15,000 $20,000 $25,000

GOAL ACHIEVED! --Tony McCormick 22:27, 29 January 2014 (UTC)

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



Matching Fund Drive for OpenEMR MU2 Certification

Care Management Solutions, Inc. will match up to $5,000 donated, from 06/14/15 thru 07/05/15. Please give today to help OpenEMR obtain Meaningful Use 2 Certification!!


DONATE HERE


$230 $500 $1000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 MATCHING GOAL $10,000


DONATE HERE


Completion Barometer

  • Modular Certification was obtained on December 24,2014 (for OpenEMR 4.2.x which was released on 12/28/14).
  • The goal is to have Full Certification as soon as possible
  • Last certification testing date was on 9/23/2015. Next certification testing date will be on 9/__/2015.
  • Testing restarted 9/21/15 --Tony McCormick 00:27, 24 September 2015 (UTC)
  • This barometer is tracking the progress of the Stage 2 MU project. See below Certification Criteria section for criteria titles.
a1 a2 a3 a4 a5 a6 a7 a8 a9 a10 a11 a12 a13 a14 a15 b1 b2 b3 b4 b5 b7 c1 c2 c3 d1 d2 d3 d4 d5 d6 d7 d8 d9 e1 e2 e3 f1 f2 f3 g1 g2 g3 g4
Not Ready Ready Certified and in Official Codebase


Legend Description:
  • Not Ready - Not ready for certification testing.
  • Ready - Ready for certification testing.
  • Failed Test - Issues found during certification testing.
  • Certification Pass - Passed certification and in official codebase.



Certification Criteria

Definitions for terms used in the below Criteria wiki pages:
  • Owner - This is the "current" person/group(s) that are working on this criteria and can be found in parenthesis next to the item.

Clinical (170.314(a))

a1. Computerized provider order entry (Finalized)
a2. Drug-drug, drug-allergy interaction checks (Finalized - MI-Squared/NewCrop)
a3. Demographics (Finalized - Jan Jajalla)
a4. Vital signs, body mass index, and growth charts (Finalized - Jan Jajalla)
a5. Problem list (Finalized - ZH Healthcare)
a6. Medication list (Finalized)
a7. Medication allergy list (Finalized)
a8. Clinical decision support (owner is EnSoftek)
a9. Electronic notes (Finalized - ZH Healthcare)
a10. Drug-formulary checks (Finalized - MI-Squared/ZH Healthcare Via NewCrop)
a11. Smoking status (Finalized - Brady Miller and Ensoftek)
a12. Image results (Finalized - Ensoftek)
a13. Family health history (Finalized - Ensoftek)
a14. Patient list creation (Finalized - Ensoftek)
a15. Patient-specific education resources (Finalized - Sunset Systems)

Care Coordination (170.314(b))

b1. Transitions of care – receive, display, and incorporate transition of care/referral summaries Finalized - ZH Healthcare)
b2. Transitions of care – create and transmit transition of care/referral summaries (Finalized - ZH Healthcare)
b3. Electronic prescribing (Finalized - MI-Squared/Ensoftek)
b4. Clinical information reconciliation (owner is ZH Healthcare in Care Coordination Module)
b5. Incorporate lab tests and values/results (owner is Ensoftek)
b7. Data portability (Finalized - ZH Healthcare)

Clinical Quality Measures (170.314(c))

c1. Clinical quality measures - capture and export ((Finalized - Ensoftek)
c2. Clinical quality measures - import and calculate (Finalized - Ensoftek)
c3. Clinical quality measures - electronic submission (Finalized - Ensoftek)

Privacy and Security (170.314(d))

d1. Authentication, access control, and authorization (Finalized)
d2. Auditable events and tamper-resistance (Finalized - Ensoftek)
d3. Audit report(s) (Finalized - Ensoftek)
d4. Amendments (Finalized - Ensoftek)
d5. Automatic log-off (Finalized)
d6. Emergency access (Finalized)
d7. End-user device encryption (Finalized)
d8. Integrity (Finalized)
d9. Accounting of disclosures (Finalized - Ensoftek)

Patient Engagement (170.314(e))

e1. View, download, and transmit to 3rd party (Finalized - ZH Healthcare)
e2. Clinical summaries (Finalized - ZH Healthcare)
e3. Secure messaging (Finalized - ZH Healthcare)

Public Health (170.314(f))

f1. Immunization information (Finalized - Jan Jajalla)
f2. Transmission to immunization registries (Finalized - ZH Healthcare)
f3. Transmission to public health agencies – syndromic surveillance (Finalized - There are two solutions. ZH Healthcare solution is certified and in codebase. Ensoftek solution is in codebase but not yet certified.)
f5. Cancer case information (Optional and not needed for certification) (owner is ZH Healthcare)
f6. Transmission to cancer registries (Optional and not needed for certification)

Utilization (170.314(g))

g1. Automated numerator recording (Finalized - Ensoftek)
g2. Automated measure calculation (Finalized - Ensoftek)
g3. Safety-enhanced design (Finalized - Columbia University Health IT Certificate Program)
g4. Quality management system (Finalized)


Features that Are Needed (ie. "Building Blocks")

  • Prescriptions/meds/allergies need to have a RxNorm association option. (Rod added support for this in 4.2.0)
  • Production and real incorporation of fully-featured CCD and CCD(a)s. (ZH is working on this)
  • Be able to connect to DIRECT. Here is home page of Direct: http://www.healthit.gov/policy-researchers-implementers/direct-project (EMR Direct provided a solution for this which was committed into OpenEMR 4.1.2: Direct)
  • Medical problems need to have a SNOMED association option (Already supported since 4.1.1 version)
  • Need to support import of US SNOMED extension package in addition to the currently supported base international package (ie. need to be able to install/update both simultaneously). (This feature was committed to OpenEMR 4.1.2)

Estimates

  • Here is a estimate by Visolve of the time to complete each certification criteria above. The estimate is approximately 80 work weeks of effort.

Notes

Some Analysis of Proposed Guidelines (Outdated)

Difference(s) from Stage 1
Improving quality, safety, efficiency, and reducing health disparities
Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter licensed healthcare professional who can enter orders into the medical record per State, local and professional guidelines to create the first record of the order.
More than 60 percent of medication, laboratory, and radiology orders created by the EP or authorized providers of the eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23) during the EHR reporting period are recorded using CPOE.
  • Adds laboratory & radiology
  • Increased from 30% to 60%
  • Requirement is based on number of orders, not number of patients.
Generate and transmit permissible prescriptions electronically (eRx)
More than 65 percent of all permissible prescriptions written by the EP are compared to at least one drug formulary and transmitted electronically using Certified EHR Technology.
  • Increased from 40% to 65%.
  • Includes formulary check which formerly was part of menu set
Record the following demographics
  • Preferred language
  • Gender
  • Race
  • Ethnicity
  • Date of birth
More than 80 percent of all unique patients seen by the EP have demographics recorded as structured data
  • Increased from 50% to 80%.


Record and chart changes in vital signs:
  • Height/length
  • Weight
  • Blood pressure (age 3 and over)
  • Calculate and display BMI
  • Plot and display growth charts for patients 0-20 years, including BMI
More than 80 percent of all unique patients seen by the EP have blood pressure (for patients age 3 and over only) and height/length and weight (for all ages) recorded as structured data
  • Increased from 50% to 80%.
  • Changed from age 2 and over to age 3 and over.


Record smoking status for patients 13 years old or older More than 80% of all unique patients 13 years old or older seen by the have smoking status recorded as structured data
  • Increased from 50% to 80%.
Use clinical decision support to improve performance on high-priority health conditions
  1. Implement 5 clinical decision support interventions related to 5 or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period.
  2. The EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entre EHR reporting period.
  • Increased from implementing one rule to five.
  • Must be related to five quality measures for entire reporting period.
  • Incorporates drug-drug/drug-allergy checks (formerly standalone requirement).


Incorporate clinical lab-test results into Certified EHR Technology as structured data
More than 55 percent of all clinical lab tests results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in Certified EHR Technology as structured data
  • Formerly menu set item.
  • Increased from 40% to 55%.


Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach
Generate at least one report listing patients of the EP, eligible hospital or CAH with a specific condition.
  • Formerly menu set item.


Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care
More than 10 percent of all unique patients who have had an office visit with the EP within the 24 months prior to the beginning of the EHR reporting period were sent a reminder, per patient preference
  • Formerly menu set item.
  • Eliminated age parameters; changed to “unique patients who have had an office visit”
Engage patients and families in their health care
Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP.
  1. More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely (within 4 business days after the information is available to the EP) online access to their health information subject to the EP's discretion to withhold certain information
  2. More than 10 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download , or transmit to a third party their health information
  • Formerly menu set item.
  • More specific
  • Increased from 10% to 50%
  • Added requirement for patients to “view, download or transmit” information.