• Kyle Meadors

ONC Health IT Certification Program - Updated Test Procedures and Companion Guides - 22Jul16


For the week ending July 22, 2016, ONC updated the following test procedure, companion guides, test tools and other aspects related to their 2015 Edition testing program. Links to documents or relevant release emails are include below as appropriate. Summary and commentary on changes are included and impact measure with respect to developers as determined by Chart Lux staff is given.

TEST PROCEDURE

§ 170.315(f)(7): Transmission to Public Health Agencies – health care surveys

Summary of Change:

Updated the link to the underling standard used for healthcare surveys.

Impact and Commentary:

Very Minor. The location for the HL7 spec was changed and test procedure updated to reflect that.

COMPANION GUIDES

§ 170.315(d)(2): Auditable Events and Tamper-resistance

Summary of Change:

Clarified the intent of the recording of actions (additions, deletions, changes, queries, print, and copy). Notably, that the recording is to be done to assist user in reconstructing events. The added text on page 3 is: “Namely, the audit log should record actions in a way that assists the user in reconstructing events that occurred effecting health information. For example, a "change" action may be listed in the audit log as an "edit" event if that is the labeling the user is accustomed to using in the health IT Module for those kinds of actions.”

Impact and Commentary:

Minor. It is a clarification, but it can help developers understand a key use of the audit log which is for forensics and reconstructing events. Thus, the type of action listed in the log is more figurative than literal and done in a way to help people investigate Health IT system activity.

§ 170.315(e)(3): Patient Health Information Capture

Summary of Change:

Provided clarification on the criterion requirement about linking. Added 3 bullets.

  • The criterion does not define how and to what the health IT links (e.g., Dropbox, another health IT developer’s patient health record, a state advance directive repository, etc.). However, linking to an integrated portal would not suffice.

  • The requirement of this provision does not go beyond the specified functionality such as demonstrating the log-in/authentication process in connection with linking, via the internet, to an external site/source. [see also 80 FR 62662].

  • This requirement is separate and distinct from the criterion's requirement that health IT be able to demonstrate that it can access information directly and electronically shared by a patient (paragraph (i)).

Impact and Commentary:

Moderate. This is clarification and not changing anything. However, the linking aspect of this criterion is challenging to developers from a usability and value-add standpoint. This clarification should be given attention to by developers in satisfying a surprisingly difficult criterion.

§ 170.315(f)(7): Transmission to Public Health Agencies – health care surveys

Summary of Change:

Updated the link to the underling standard used for healthcare surveys.

Impact and Commentary:

Very Minor. The location for the HL7 spec was changed and test procedure updated to reflect that.

§ 170.315(h)(2): Direct Project, Edge Protocol, and XDR/XDM

Summary of Change:

Clarified how this criterion is for HISP doing transport-only, but HIT system certified to this criterion can still be interoperable with another HIT certified to 315.b.1 and also be part of meeting the Base EHR definition without getting a joint certification on b.1 and h.2 for a single HIT system certification.

Impact and Commentary:

Very Minor. Just restating in more explicit language what was in the 2015 Edition Final Rule.

TEST TOOLS

ePrescribing

Summary of Change:

No change to the official ONC test cases required for certification (ONC Certification Test Plan), but NIST did add two test plans out of scope for certification.

  1. Pharmacy Test Plan – This plan will allow pharmacies to test that they can receive the messages a certified EHR will send.

  2. The Structured and Codified SIG test plan – This plan will allow EHRs to test against 24 of the most common SIGs, and 19 complex SIGs. Developed by the NCPDP.

Impact and Commentary:

Negligible. However, the SIG Test Pan can be of value to EHR vendors as a best practice effort.

Syndromic Surveillance

Summary of Change:

Moved to version 1.5. Made changes on SS-ED-3_ED_ Visit_Patient_Admitted test case to allow patient admission from both inpatient and emergency department (previously only accepted “E” for emergency department). Also, relaxed some checking for SS-UC-1_UC_Visit_Influenza_Child test case in OBX.

Impact and Commentary:

Minor. Both changes essentially relaxed requirements on two test cases to be more flexible.

Edge Test Tool

Summary of Change:

Moved to version 1.0.20. Added some attachments for test cases SMTP MT 39, 40 and 41.

Impact and Commentary:

Minor. For these MDN test cases, added CCDA attachment options.

CQMs/Cypress

Summary of Change:

Released version 3.0.0RC1 which is very close to what will the official, initial release for 2015 Edition testing. New features listed on the email linked in previous sentence.

Impact and Commentary:

Moderate. Not yet official, but the tool is close to be ready for official testing.

#ONC #testprocedures #companionguides #2015Edition #updates #testtools

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