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Implementation Workgroup: Current Activities and Next Steps

Implementation Workgroup: Current Activities and Next Steps. Member List. Elizabeth Johnson, Co-Chair, Tenet Healthcare Corp . Cris Ross, Co-Chair, Mayo Clinic Robert Anthony, Centers for Medicare & Medicaid Robert Barker, NextGen Healthcare Kevin Brady, NIST

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Implementation Workgroup: Current Activities and Next Steps

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  1. Implementation Workgroup:Current Activities and Next Steps

  2. Member List • Elizabeth Johnson, Co-Chair, Tenet Healthcare Corp. • Cris Ross, Co-Chair, Mayo Clinic • Robert Anthony, Centers for Medicare & Medicaid • Robert Barker, NextGen Healthcare • Kevin Brady, NIST • Anne Castro, BlueCross BlueShield of South Carolina • Simon P. Cohn, Kaiser Permanente • Tim Cromwell,Veterans Affairs • John Derr, Golden Living, LLC • Carol Diamond, Markle Foundation • Timothy Gutshall, Iowa HIT Regional Extension Center • Joseph Heyman, Whittier IPA • David Kates, NAVINET • Tim Morris, Emory University • Nancy Orvis, Department of Defense • Steven Palmer, Texas Health/Human Services Commission • Wes Rishel, Gartner, Inc. • Kenneth Tarkoff, RelayHealth • John Travis, Cerner • MickyTripathi, MA eHealth Collaborative • Ex-Officio Aneesh Chopra, Chief Technology

  3. Overview • Test Scenario Development • 2014 Test Methods Timeline • 2014 Test Methods: Public Review and Comment • IWG Next Steps

  4. Development Methodology:Unit Based Testing Unit Based Test Procedures • Current Test Procedures employ a unit based testing module where each criteria is tested individually. • Testing data nor results are forwarded onto any other tests for that product

  5. Development Methodology:Scenario Based Testing Development Methodology Scenario Based Test Procedures • Proposed Test Procedures will employ scenario based testing where results and data is forwarded onto test for that product

  6. Development Methodology:ScenarioBased Testing Development Methodology Scenario Based Test Procedures • Scenario Based Test Procedures will be modularly developed so that individual tests can be skipped for products which do not have that capability

  7. Test Scenario Development • Development Approach • Reflects a typical clinical workflow in multiple care settings • Allows persistence of data elements • Provides a model for data threading between different certification criterion and various destinations within an EHR • Maintains testing flexibility (e.g. add/remove “unit test”) • Types • Medication Management – Outpatient • Emergency Department – Inpatient

  8. Test Scenario Development • Process • Develop clinically plausible workflow • Current Testing Scenarios based on 2011 Edition Certification Criteria • Reevaluate against 2014 Edition Certification Criteria

  9. Test Scenario Example • PDF of Medication Management Test Scenario Review

  10. Findings • Scenario-based testing can be used to test EHRs • Complexities in specific individual tests and testing data will yield difficulty in scenario testing • Complexity, and cost-benefit will be evaluated further to determine next steps

  11. 2014 Test Method Timeline OCT NOV SEPT DEC AUG 2014 Test Method Timeline JAN LRI W3 W1 W5 W4 W2 A1 Workshop 10/17 10/31 9/14 9/7 10/5 • 12/14/2012 9/28 9/21 8/23/2012 Public Comment Period 9/7 11/15 DRAFT W1 9/7 9/21 A1 A2 W3 9/21 10/5 10/31 10/5 10/19 12/1 W4 Technical Workshop (public) Technical Workshop (ATL/ACB) 10/12 9/28 11/13/12 – 11/15/12 10/2/12 – 10/4/12 LRI W5 11/14 10/31 10/31 10/17 Test Procedures Revised National Coordinator Approval 9/21 12/3 11/30 12/7 W2 2014 Certification Begins 2014 Scope Expansion for ACBs and ATLs 9/28 9/14 12/7 12/14 2014 Test Procedures Posted 12/14/2012 1/2/201 Test Scenarios Reviewed/revised On-going 12/7

  12. 2014 Test Method (TPs, TD, TTs)Public Comment: Wave 1 • Release Date: 9/7/2012 (Comment Period: 9/7/12 – 9/21/12) • 170.314(a)(1) Computerized provider order entry • 170.314(a)(4) Vital signs, body mass index, and growth charts. • 170.314(a)(5) Problem List • 170.314(a)(6) Medication List • 170.314(a)(7) Medication allergy list • 170.314(a)(10) Drug formulary checks • 170.314(a)(11) Smoking status • 170.314(a)(15) Patient-specific education resources • 170.314(a)(17) Inpt setting only - advance directives • 170.314(d)(5) Automatic log-off • 170.314(d)(8) Integrity • 170.314(d)(9) Optional-accounting of disclosures • 170.314(f)(1) Immunization Information • 170.314(f)(2) Transmission to immunization registries • 170.314(f)(2) TOOL ONLY - Immunization Registry (IIS)

  13. 2014 Test Method (TPs, TD, TTs)Public Comment: Wave 2 • Release Date: 9/14/2012 (Comment Period: 9/14/12 – 9/28/12) • 170.314(a)(3) Demographics • 170.314(a)(9) Electronic notes • 170.314(a)(13) Family health history • 170.314(a)(14) Patient list creation • 170.314(d)(6) Emergency access • 170.314(f)(5) Ambsetting only—cancer case information • 170.314(f)(6) Ambsetting only—transmission to cancer registries • 170.314(f)(6) TOOL ONLY - CDA Validation (Cancer Registry)

  14. IWG Next Steps • Test Scenarios • Incorporate 2014 Certification Criteria • Review against 2014 Test Procedures • 2014 Test Procedures • Provide input on the draft Test Procedures

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