ONC Health IT Certification Program Updates

ONC Health IT Certification Program Updates (08/06/2018)

Test Method Updates

Recently Updated Test Procedures (TPs)

2015 Edition Test Procedures (TPs)
Criterion Number	Criterion Title	Details
§ 170.315(b)(3)	Electronic prescribing	Updated hyperlinks to NCPDP hosted eRx testing tool and documentation

Transition of the eRx Test Method from NIST to NCPDP

On Monday, July 16, 2018, the National Council for Prescription Drug Programs (NCPDP) formally took over stewardship of the ONC-approved electronic prescribing (eRx) testing tool from the National Institute of Standards and Technology (NIST). This transitions aligns with ONC’s 5-year Goal to Transition the ONC Health IT Certification Program’s Testing Portfolio to expand our testing portfolio to include a diverse mix of testing tools that can help to optimize the testing experience. The NCPDP-hosted eRx tool and documentation is located on the NCPDP ePrescribing test suite webpage.

HIMSS Immunization Integration Program (HIMSS-IIP) Updates

The HIMSS Immunization Integration Program, the ONC – Approved Alternate Test Method for § 170.315(f)(1) - Transmission to immunization registries has recently been updated as follows:

• Test Tool Version 1.7.3
• Test Plan Version 6.1

ONC welcomes from any entity the submission of test procedures, test tools and associated test data for consideration for approval and use under the ONC Health IT Certification Program. To learn more about the ONC-Alternative Test Method including the application and evaluation processes, visit the ONC-Approved Alternative Test Method webpage.

Now Available: Cypress v4.0

Cypress v4.0 is now available to support 2015 Edition ONC certification testing for electronic clinical quality measures (eCQM). Cypress v4.0 supports testing the Eligible Hospital / Critical Access Hospital eCQMs and Eligible Professional / Eligible Clinicians eCQMs updated for calendar year 2019 reporting.  The new v4.0 release and release notes are available on the Cypress website.

Cypress v4.0 Features

• Support for § 170.315(c)(1), (c)(2), (c)(3), and (c)(4) certification criteria
• Support for the CMS QRDA I Implementation Guide for the Calendar Year 2019 Performance Period
• Health Level Seven International (HL7) Clinical Document Architecture (CDA®) R2 Implementation Guide: Quality Reporting Document Architecture (QRDA III), Release 1, STU Release 2.1 - US Realm
• Health Level Seven International (HL7) Clinical Document Architecture (CDA®) R2 Implementation Guide: Quality Reporting Document Architecture (QRDA I), Release 1, Standard for Trial Use (STU) Release 5 - US Realm
• Support for the eCQMs for electronic reporting for the 2019 Reporting Period
  • 56 Eligible Professional/Eligible Clinician eCQMs
    • Including new eCQMs CMS249v1 (Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture) and CMS359v1 (HIV Screening)
  • 16 Eligible Hospital/Critical Access Hospital eCQMs
• Support for eCQM Value Sets as of 5/4/2018.

Cypress v3.2.3 will remain available for ONC certification testing for eCQMs for calendar year 2018 reporting.

Since Cypress v4.0 only supports testing with eCQM logic expressed using the Clinical Quality Language, Cypress v3.2.3 will remain available for testing with eCQM logic expressed using the Quality Data Model (i.e., eCQMs for the 2018 reporting and earlier).  Cypress v3.2.3 is anticipated to be supported through spring 2019.

Now Available: FHIR Population API Example Code

Now available on the ONC Standards Implementation and Testing Environment: demonstration and example code for FHIR Population Level Application Programming Interfaces. There is a section for beginners who want to see a FHIR "bulk data" API query in action, and inspect the request and response communications in an easy, click-through workflow. For more experienced health IT developers, example code for the Bulk Data API server and client is provided, along with test data and a testing client for your own API implementation.

This FHIR Bulk Data API from ONC is another example of how the emerging API ecosystem frees data to move seamlessly, promoting interoperability. The API is built to a draft specification that is working its way through the HL7 FHIR standard balloting process. The specification is designed to support sharing large data sets represented in FHIR. For example, providers and organizations accountable for managing the health of populations may need to access large volumes of information on a cohort. Or, an EHR may want to access claims data to close gaps in care. This population level data movement can now be accomplished using the FHIR Population API. For more information, please contact: SITTeam@hhs.govor visit www.healthit.gov/SITE

Required Use of 2015 Edition Certification Criteria for 2019 Hospital IQR Program

Finalized in the 2019 Inpatient Prospective Payment System final rule, CMS is requiring eligible hospitals and critical access hospitals to use only the 2015 Edition certification criteria to meet the requirements of the Certified EHR Technology (CEHRT) definition starting in 2019. The 2015 Edition offers functionalities and updated standards not available in the 2014 Edition that will promote interoperability and the flow of information between providers and patients. CMS has stated that the 2014 Edition certification criteria are out of date and insufficient for provider needs in the evolving health IT industry. Some of the benefits of the 2015 Edition include:

• Certification for application programming interface (API) criteria that can improve electronic health information access for patients and providers
• Improvements in the functionality and quality of electronic clinical quality measure data
• Updated standards supporting structured data capture.

As indicated in an ONC infographic on 2015 Edition Market Readiness for Hospitals and Clinicians, an estimated 9 in 10 hospitals and 4 in 5 clinicians have 2015 Edition certified technology available from their most recently reported EHR developer.

Note that CMS has also proposed to require eligible professionals and eligible clinicians use solely the 2015 Edition certification criteria for CEHRT starting in 2019 in the 2019 Physician Fee Schedule proposed rule.

For additional information on the ONC health IT testing and certification requirements, please visit the program webpage. Questions may be directed to the ONC Health IT Certification Program via email at: ONC.Certification@hhs.gov.