REAL WORLD TESTING RESULTS REPORT 2023
GENERAL INFORMATION
Plan Report ID Number: 20221209emp
Developer Name
eMedPractice, LLC
Product Name(s)
eMedicalPractice
Version Number(s)
2.0
Certified Health IT
2015 Edition
Product List (CHPL) ID(s)
15.02.05.2898.EMED.01.01.1.220112
Developer Real World Testing Page URL
CHANGES TO ORIGINAL PLAN
| Summary of Change | Reason | Impact |
|---|---|---|
| 170.315(f)(2) was not measured. | No adoption by any customer. | No impact. |
| 170.315(f)(4) was not measured. | No adoption by any customer. | No impact. |
| Changed Specialty from Infectious Diseases to Cardiology ambulatory facilities. | To cover more specialty customers. | No impact. |
STANDARDS UPDATES (INCLUDING STANDARDS VERSION ADVANCEMENT PROCESS (SVAP) AND UNITED STATES CORE DATA FOR INTEROPERABILITY (USCDI))
| Standard (and version) | N/A |
|---|---|
| Updated certification criteria and associated products | |
| Health IT Module CHPL ID | |
| Method used for standard update | |
| Date of ONC ACB notification | |
| Date of customer notification (SVAP only) | |
| Conformance measure | |
| USCDI updated certification criteria (and USCDI version) |
SUMMARY OF TESTING METHODS AND KEY FINDINGS
Test Plan: The test cases were included actions by varying user types to capture the required data and workflows. In some scenarios, real world patient data was used to confirm compliance with the things such as successful transmission statuses for some certification criteria requirements. Compliance with Required standards were tested via manual inspection and/or with ONC-recommended test tools.
Test Methods: The following test methods were used to complete testing of conformance with the certification criteria requirements.
- Entry of simulation data
- Analysis of log data & log files
- Testing with ONC-approved testing tools
- Real time patient centric scenarios in production environment
Lessons learned: It is always a challenge to deal with real data, most of the time we have discovered data formatting issues. Overall the tools that were used by the customers were really functioning.
Associated Certification Criteria
The following are the list of certification criteria associated with the measure and relied upon software.
| Measurement/Metric | Description | Justification | Relied Upon Software |
|---|---|---|---|
| 170.315(b)(1) Transitions of care |
Demonstration of creation of a C-CDA at the end of an ambulatory encounter with transmission to the referral provider of care via Direct Messaging. Verify receipt of C-CDA transmissions in the referral provider's environment from the referral inbound queue and save it to the EHR. |
This is to justify to creation of a C-CDA document from referral at the end of a patient visit with transmission to the referral provider of care via Direct Messaging. This is to demonstrate the ability to receive a C-CDA via Direct messaging into the email Inbound Documents Queue and process it as a clinical document and save it to the EHR. |
|
| 170.315(b)(2) Clinical information reconciliation and incorporation |
Demonstration of incorporating problem list, medication list and allergy medication list reconciliation from discrete problems, medications and medication allergies parsed from a C-CDA in referral providers environment. Verify the successful reconciliation of parsed discrete data in the referral provider's environment into the problem list, medication list and allergy list in the clinical summary. |
This is to demonstrate the ability to reconcile patient clinical data from referral in to discrete problems, medications, allergies, Lab data & notes parsed from a C-CDA into the EHR in a production environment. |
|
| 170.315(b)(3) Electronic Prescribing |
Demonstration of creation and transmission of an electronic prescription, cancel and refill flows on any selected practices. Verify the successfully transmitted electronic prescriptions in the practice eRx log and Surescripts log. |
This to justify providers sending real eRxs to pharmacies, receiving refills and rxchange requests from pharmacies in real world. | |
| 170.315(b)(6) Data export |
Demonstration of data export option by creating the patient-list to export of C-CDAs with the ability to save them to a local file system. |
This is to justify a practice can select a group of patients and download C-CCD documents. | |
| 170.315(c)(1) Clinical quality measures - record and export |
Demonstration of the ability to export patient data recorded in the EHR for a given patient population and import that into the Cypress Test Tool for calculation of specified quality measures that will match the results obtained in the testing for 170.315(c)(2). |
This is to justify capturing all data points to calculate quality measures and export to QRDA I files. Same results should be calculated after importing to cypress tool. | |
| 170.315(c)(2) Clinical quality measures - import and calculate |
Demonstration of the ability to calculate quality measures for the patient data and measures specified in the demonstration for 170.315(c)(1) and match to the quality measure results obtained from the Cypress Test tool. |
This is to justify the calculation of quality measures final results with cypress tool. | |
| 170.315(c)(3) Clinical quality measures - report |
Demonstration of the ability to generate QRDA 1 and QRDA 3 files. |
This is to justify if a practice can generate QRDA files that can be submitted to CMS quality measurements. | |
| 170.315(e)(1) View, download, and transmit to 3rd party |
Login to the patient portal to view clinical summary, create and make a valid C-CDA available to download or transmit to 3rd party. |
This is to justify a patient can login the patient portal, view the clinical summary and download it. | WinRAR (Version 5) |
| 170.315(f)(1) Transmission to public health agencies-immunization registry |
Demonstration of the ability to add an immunization to a patient and generate a VXU message for an administered immunization and transmit it via HL7 2.5.1 to a public health agency successfully (FL SHOTS). Verify the immunization log of successful VXU message transmissions. |
This is to justify if a practice can report the information on administered immunizations to a public health agency. | |
| 170.315(f)(2) Transmission to public health agencies-syndromic surveillance |
Demonstration of the ability to generate a Syndromic Surveillance message for an Urgent care patient and transmit it via HL7 2.5.1 to a public health agency. |
This is to justify if any urgent care setup can submit information to a public health agency on patient health information. | |
| 170.315(f)(4) Transmission to cancer registries |
Demonstration of the ability to generate a message for an ambulatory care patient and transmit it via HL7 2.5.1 to a cancer registry. |
This is to justify if a practice can submit a message to a cancer registry. | |
| 170.315(g)(7) Application access - patient selection |
Demonstration of a patient's ability to make a data request through API for one or more data elements from the Common Clinical data Set. |
This is to justify that if a patient makes a request for a data category for one or more of the data elements in the Common Clinical data set from an API. | |
| 170.315(g)(9) Application access - all data request |
Demonstration of a patient's ability to make a data request through API for one or more data elements from the Common Clinical Data Set |
This is to justify that if a patient makes a request for complete data elements in the Common Clinical Data set from an API. | |
| 170.315(h)(1) Direct Project |
This measure will demonstrate the ability to send and receive direct project messages. |
This is to justify that a practice can send and receive referrals between the practices. |
Care Setting(s)
| Care Setting | Justification |
|---|---|
|
The selected specialty facility settings are representative of all of the settings that are currently using the eMedicalPractice. The test results are same for all specialties & facilities. |
|
|
Ambulatory Primary care |
Ambulatory Primary care PCPB Ambulatory Primary care GC Ambulatory Primary care PCP Ambulatory Primary care NMG |
|
Ambulatory Pulmonary |
Ambulatory Pulmonary PA |
|
Ambulatory Cardiology |
Ambulatory Cardiology HM Ambulatory Cardiology AZ |
Execution & Outcomes
| Measurement/Metric | Care Settings | Associated Criterion | Relied Upon Software | Execution Plan | Actual Outcomes | Results Evidence | Challenges Encountered | Time Frame for Key Milestones |
|---|---|---|---|---|---|---|---|---|
| 170.315(b)(1) Transitions of care |
Ambulatory Cardiology HM Ambulatory Primary care PCP Ambulatory Primary care PCPB Ambulatory Cardiology AZ |
Total number of successfully transmitted referrals along with attached CCDA via Direct messaging. Total number of failed transmissions based on receipt of message status. Total number of received email messages via inbound Direct messaging, to measure the volume of successful receipts of referrals via Direct Messaging. Error rates will be tracked and trended over time. |
1) Sent 3 direct referral messages from Ambulatory Primary care PCPB to Ambulatory Cardiology AZ. 2) Received 3 email messages via inbound direct messaging to Ambulatory Cardiology AZ, to measure the volume of successful receipts of referrals via direct messaging. 3)Received 3 email messages via inbound direct messaging to Ambulatory Cardiology HM from 3rd party. 4)Received clinical messages via inbound direct messaging to Ambulatory Primary care PCP. |
3 out of 3 messages | MDN Ack messages & Clinical MSGs in inbox | Data formatting issues | 3rd & 4th Quarters | |
| 170.315(b)(2) Clinical information reconciliation and incorporation |
Ambulatory Cardiology HM Ambulatory Primary care PCP. Ambulatory Primary care PCPB Ambulatory Cardiology AZ |
Total number of problem list reconciled total number of medication list reconciled total number of medication allergy list reconciled Total number with all 3 domains reconciled. Error rates will be tracked and trended over time. | Messages received via inbound direct messaging, to the practices and processed those CCDA documents. | 10 out of 10 messages | Messages are in inbox & patient data after reconciliation | Data formatting issues | 4th Quarters | |
| 170.315(b)(3) Electronic Prescribing |
Ambulatory Primary care PCPB Ambulatory Cardiology AZ Ambulatory Cardiology HM |
Log data will be verified in prescription log. Total number of new electronic prescriptions successfully transmitted Total number of changed electronic prescriptions successfully transmitted Total number of canceled electronic prescriptions successfully transmitted Total number of refill prescriptions successfully transmitted Total number of medication history requests sent electronically. Error rates will be tracked and trended over time. | Reviewed the production logs every months, all transactions are successful | 100 out of 100 | Log messages | None | 1st, 2nd, 3rd & 4th | |
| 170.315(b)(6) Data export | Ambulatory Primary care NMG | Total number of patients added to the export list based on the selected criteria. Total data exports performed. Data errors/accuracy will be tracked over the time and trended over the time. | Practices downloaded daily encounter signed notes | 100% | Files downloaded to sFTP folder | Data formatting issues | 1st, 2nd, 3rd & 4th Quarters | |
| 170.315(c)(1) Clinical quality measures - record and export |
Ambulatory Pulmonary PA Ambulatory Primary care PCPB Ambulatory Cardiology AZ |
Total number of measures selected by provider. Total number of defects identified and resolved. Total number of successful submissions to CMS or exported by provider. Data errors/accuracy will be tracked over the time and trended over the time. |
Number of Measures Selected:8 Number of Measures Selected :5 |
100% | Measures are captured | Data formatting issues | 3rd & 4th Quarters | |
| 170.315(c)(2) Clinical quality measures - import and calculate |
Ambulatory Pulmonary PA Ambulatory Primary care PCPB Ambulatory Cardiology AZ |
Total number of measures selected by provider & imported. Total number of defects identified and resolved. Total number of successful submissions to CMS or exported by provider. Data errors/accuracy will be tracked over the time and trended over the time. |
Number of Measures Selected:8 Number of Measures Selected :5 |
100% | Dashboard with numerator & denominator | 3rd & 4th Quarters | ||
| 170.315(c)(3) Clinical quality measures - report |
Ambulatory Primary care PCPB Ambulatory Pulmonary PA Ambulatory Cardiology HM |
Total number of measures selected by provider. Total number of defects identified and resolved to calculate the population dashboard. Total number of successful submissions QRDA III files to CMS or exported by provider. Data errors/accuracy will be tracked over the time and trended over the time. |
Number of Measures Selected:8 Number of Measures Selected :5 |
100% | QRDA-III files are downloaded without errors | 3rd & 4th Quarters | ||
| 170.315(e)(1) View, download, and transmit to 3rd party |
Ambulatory Primary care PCPB Ambulatory Primary care GC |
Total number of patient registered for patient portal. Total number of CCDA documents made available to patients via a patient portal. Error rates will be tracked and trended over time. | WinRAR (Version 5) | Patient successful registration for patient portal | 10 out of 10 | Verified on the report for successful patient registration. Viewed link to download CCDA | 1st, 2nd, 3rd, & 4th | |
| 170.315(f)(1) Transmission to public health agencies-immunization registry |
Ambulatory Primary care PCPB Ambulatory Primary care PCP |
Total number of immunization registry HL7 messages transmitted of administered immunizations. Total number of response message transmissions occurred by querying immunization log. Data errors/accuracy will be tracked over the time and trended over the time. | Checked log for submitted HL7 files and viewed history on patient immunizations | 10 out of 10 | Logs msgs and pulled the immunization history from registry | 1st, 2nd, 3rd & 4th | ||
| 170.315(f)(2) Transmission to public health agencies-syndromic surveillance. | No facilities are using this feature | Total number of Syndromic Surveillance HL7 messages transmissions occured. Data errors/accuracy will be tracked over the time and trended over the time. | None of the customers are using this feature | Not measured | Not measured | |||
| 170.315(f)(4) Transmission to cancer registries | No facilities are using this feature | Total number of HL7 messages transmissions occured to Cancer registries. Data errors/accuracy will be tracked over the time and trended over the time. | None of the customers are using this feature | Not measured | Not measured | |||
| 170.315(g)(7) Application access - patient selection |
Ambulatory Pulmonary PA Ambulatory Primary care PCPB Ambulatory Primary care PCP |
Total number patient API authentication requests came in. Total number patient API requests completed by checking in log. Data errors/accuracy will be tracked over the time and trended over the time. | Tested this in stage environment | Measured as expected results | Other party able to receive the patient data and documents. Verified the logs. | 4th Qtr | ||
| 170.315(g)(9) Application access - all data request |
Ambulatory Primary care PCP Ambulatory Primary care PCPB |
Total number patient API authentication requests came in. Total number of patient API requests completed for all data by checking in log. Error rates will be tracked and trended over time. | Tested this in stage environment | Measured as expected results | Other party able to receive the patient data and documents. Verified the logs. | 4th Qtr | ||
| 170.315(h)(1) Direct Project |
Ambulatory Cardiology HM Ambulatory Primary care PCP Ambulatory Primary care PCP Ambulatory Cardiology AZ |
Expected to see messages successfully sent and received. Error rates will be tracked and trended over time. | Checked inbox and outbox message for b(1) & b(2) in direct email | 4 out 4 | MDNs Acks & mails in inbox | 2nd & 4th Quarters |
KEY MILESTONES
| Key Milestone | Care Setting | Date/Timeframe |
|---|---|---|
|
Identified various ambulatory care settings and start capturing the data & logs |
Ambulatory |
1st Quarter of 2023 |
|
with final data collection, datasets generated and analyzed during the current study. |
Ambulatory |
1st, 2nd, 3rd & 4th Quarter of 2023 |
|
Report the final data to ACB |
Ambulatory |
02/02/2024 |
Disclaimer
eMedicalPractice is committed to Real World Testing (RWT) plan as much as possible but execution of this plan is dependent on eMedicalPractice customer participation on the RWT activity throughout calendar year 2023, based on their availability, which is beyond eMedicalPractice’s control. eMedicalPractice strives to review the plan on an ongoing basis and may modify the RWT plan steps as and when necessary to fully meet the needs of RWT. There are a few criteria that needs mentioning owing to less adoption by the industry or by customer base.
Use of the following certified criteria has low usage among the customer base. Testing the following transactions for RWT might be difficult and eMedicalPractice reserves the right to test transactions using a simulated environment.
- 170.315(e)(1) View, download, and transmit to 3rd party-Use of download & transmit.
- 170.315(f)(2) Transmission to public health agencies-syndromic surveillance.
- 170.315(f)(4) Transmission to cancer registries.
ATTESTATION
This Real World Testing report is complete with all required elements, including measures that address all certification criteria and care settings. All information in this report is up to date and fully addresses the health IT developer’s Real World Testing & Reporting requirements.
Authorized Representative Name
Nandu Dhanekula
Authorized Representative Email
Nandu@emedpractice.com
Authorized Representative Phone
561-921-0978
Authorized Representative Signature
Date
02/02/2024
