ONC Health IT Certification Program Updates (12/15/2017)

Program Guidance

ONC recently published Program Guidance #17-04 which summarizes the process for implementing the modified ONC-Approved test procedures for thirty of the 2015 Edition certification criteria1 in which the testing approach is now constrained to health IT developer self-declaration.  ONC also published Program Guidance #17-05 which provides guidelines for Product Identification & Versioning with accompanying CHPL Product Versioning FAQs.

Test Method Updates

Recently Updated Certification Companion Guides (CCGs)

2015 Edition Certification Companion Guides (CCGs)
Criterion Number	Criterion Title	Details
§ 170.315(f)(1)	Transmission to immunization registries	Revised to include an ONC approved alternative test tool offered by Healthcare Information Management Systems and Society (HIMSS): Immunization Integration Program
§ 170.315(h)(2)	Direct project, Edge protocol, and XDR/XDM	Revised the location of the Edge Testing Tool training videos in the section “applies to entire criterion.” Clarified that Direct, the Edge protocols (SMTP & XDR) and XDM processing are required by this criterion, consistent with interpretative guidance provided in the 2015 Edition final rule in the section “applies to entire criterion.”

Recently Updated Test Procedures (TPs)

2015 Edition Certification Test Procedures (TPs)
Criterion Number	Criterion Title	Details
§ 170.315(f)(1)	Transmission to immunization registries	Revised to include an ONC approved alternative test tool offered by Healthcare Information Management Systems and Society (HIMSS): HIMSS Immunization Integration Program; Note added advising that this ONC-developed Test Procedure and associated Normative Test Process Document is for the NIST-developed tool only.

For additional information on the 2015 Edition requirements, please visit the ONC Standards and Certification Regulation webpage.

ONC-Approved Alternative Test Method

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. The HIMSS Immunization Integration Project was recently approved for the testing of § 170.315(f)(1)  Transmission to immunization registries, joining The National Committee for Quality Assurance (NCQA) electronic quality measures testing method which was approved in May 2017 for the testing of eCQMs § 170.315(c)(2)-(c)(4).  To learn more about the ONC-Alternative Test Method including the application and evaluation processes, visit the ONC-Approved Alternative Test Method webpage.

Use of Cypress v3 for 2014 Edition Testing

Cypress v3 can now be configured for use with 2014 Edition CQM testing for § 170.314(c)(1)-(c)(3). Instructions for configuring Cypress v3 for 2014 Edition CQM testing can be found here. The configuration changes were integrated into the Cypress v3.2.3 patch, released December 14, 2017. 

CMS Announces Transition of Electronic Clinical Quality Measures to Clinical Quality Language for the CY2019 Reporting/Performance Periods

The Centers for Medicare & Medicaid Services (CMS) announced on October 31, 2017 that CMS quality program electronic clinical quality measures (eCQMs) will be transitioned to use the HL7 Clinical Quality Language (CQL) standard (CQL Release 1, Standard for Trial Use (STU) 2) for logic expression. CQL unifies the logic expression for eCQMs and Clinical Decision Support (CDS), and provides the ability to better express logic defining measure populations to improve the accuracy and clarity of eCQMs.

The transition to reporting CQL-based measures will begin with the calendar year (CY) 2019 reporting period for Eligible Hospitals and Critical Access Hospitals (CAHs), and CY 2019 performance period for Eligible Professionals (EPs) and Eligible Clinicians.

See the full announcement on the eCQI Resource Center here.

ONC strongly recommends that developers install and self-test using Cypress or the Pre-Submission Validation Application (PSVA) in preparation for reporting CQL-based measures beginning with the calendar year (CY) 2019 reporting period for Eligible Hospitals and Critical Access Hospitals (CAHs) and CY 2019 performance period for Eligible Professionals (EPs) and Eligible Clinicians. To support the transition, CMS will publish CQL-based eCQMs in Spring 2018. The beta release of Cypress v4 with support for CQL-based eCQMs will be made available in spring 2018 with a full release in summer 2018.

Cypress is an open source certification testing tool for evaluating the accuracy of clinical quality measure calculations in electronic health records (EHRs) systems and EHR modules. Cypress enables testing of an EHR’s ability to accurately calculate eCQMs. Cypress serves as the official eCQM testing tool for the 2015 EHR Certification program by the Office of the National Coordinator for Health IT (ONC). 

PSVA is a downloadable tool that operates on a user's system which allows submitters to catch and correct errors prior to data submission to CMS.  The application provides validation feedback within the submitter's system and allows valid files to be separated and submitted while invalid files are identified for error correction. Users must login to the QualityNet Secure Portal with valid user credentials to download the PSVA tool. After the initial PSVA tool download, the user will install the PSVA tool in their client environment.

New Health IT Resource: Application Programming Interfaces (API) Education Module

ONC has launched a new API education module which offers an interactive way to learn how APIs work and how they can be used to help improve access to information.   Learn more: https://www.healthit.gov/api-education-module/story_html5.html

Questions may be directed to the ONC Health IT Certification Program via email at: ONC.Certification@hhs.gov