Real World Testing

Summary

This Real World Test (RWT) plan is intended to verify the adoption of WebHIS certified functionality.

The RWT plan will focus on certification criteria, represented as individual user stories for Ambulatory only care settings, Inpatient only care settings as well as user stories that are the same regardless of the care setting.

General Information

Background

The following elements are addressed for each User Story (listed above). Inpatient is the care settings where:

• Testing methodology:
  • demonstrate real-world interoperability and conformance to the criterion requirements
  • include scenario and use case-focused testing
• Description:
  • of how the test is performed
  • of how conformance is demonstrated
• Schedule:
  • of key Real World Testing milestones;
• Expected Outcomes:
  • based on feature adoption in the current year
• Measurement/ metric:
  • all measures used to validate criteria
• Justification for the Health IT Developer's Real World Testing approach
  • description of how the measurements/metrics selected reflect the adoption rate of each required Real World Testing element

Introduction

The EHR analyzed in this Real World Test is WebHIS EHR designed to present medical information to healthcare providers in Ambulatory and Inpatient healthcare settings. The workflows in WebHIS help users with Transitions of Care, Electronic prescribing, public health initiatives and patient engagement.

The purpose of this testing is to validate the adoption of the current user interface and EHR capabilities and to provide evidence of usability within WebHIS. To this end, measures of real world utilization of interoperability features and functionality are captured during the testing.

Table of Content

• § 170.315(b)(1) Transitions of care
• § 170.315(b)(2) Clinical information reconciliation and incorporation
• § 170.315(b)(6) Data export

Key Milestones Summary

170.315 (b)(1) (b)(2)

Measure Description:

Send and receive Transition of Care (TOC) messages with other providers to close the referral loop. The patient's ePHI will be exchanged using a C-CDA 2.1 Care Referral or Referral Note and DIRECT secure messaging for data transport. Patient data from incoming TOCs will be reconciled with existing data in the EHR including, at minimum, the patient's problems, medications, and medication allergies.

Justification:

We chose to concentrate on the aspects of this criterion that would:

1. Showcase WebHIS's streamlined approach to provider-to-provider patient referrals and transitions of care with the ultimate goal being higher quality patient care.
2. Eliminate as much risk of data entry errors as possible by transmitting patient data securely and electronically rather than relying on manual data entry for referrals.
3. Reduce the overall time burden of manual data entry.
4. Ensure private and secure transmission of patients' PHI.
5. Result in increased interoperability between disparate HIT systems.

Metric Description:

1. Over 80 percent of outbound TOC's successfully received by Third Party.
2. Average C-CDA grade from scorecard for C-CDAs generated from WebHIS is a "C" or better.
3. Over 75 percent of trading partner's TOC C-CDAs successfully received by WebHIS.
4. Over 90 percent of patients' problems, medications, and medication allergies from incoming TOCs are reconciled into the EHR.

Standards Implemented: (SVAP)

N/A

Care Setting:

Inpatient

Developer Info:

Holy Name Medical Center
718 Teaneck Road
Teaneck, NJ 07666
(201) 833-3000

Product Info:

Product Name: WebHIS

Product Version: 1.2

CHPL ID

15.07.09.1632.WE01.01.02.1.230127

Methods Use to Demonstrate Interoperability:

HISP via Direct Protocol (SMTP)

Relied Upon Software:

DataMotion (Version 6.4)

* Attestation

170.315 (b)(1) (b)(2)

Measure Description:

Send and receive Transition of Care (TOC) messages with other providers to close the referral loop. The patient's ePHI will be exchanged using a C-CDA 2.1 Care Referral or Referral Note and DIRECT secure messaging for data transport. Patient data from incoming TOCs will be reconciled with existing data in the EHR including, at minimum, the patient's problems, medications, and medication allergies.

Justification:

We chose to concentrate on the aspects of this criterion that would:

1. Showcase WebHIS's streamlined approach to provider-to-provider patient referrals and transitions of care with the ultimate goal being higher quality patient care.
2. Eliminate as much risk of data entry errors as possible by transmitting patient data securely and electronically rather than relying on manual data entry for referrals.
3. Reduce the overall time burden of manual data entry.
4. Ensure private and secure transmission of patients' PHI.
5. Result in increased interoperability between disparate HIT systems.

Metric Description:

1. Over 80 percent of outbound TOC's successfully received by Third Party.
2. Average C-CDA grade from scorecard for C-CDAs generated from WebHIS is a "C" or better.
3. Over 75 percent of trading partner's TOC C-CDAs successfully received by WebHIS.
4. Over 90 percent of patients' problems, medications, and medication allergies from incoming TOCs are reconciled into the EHR.

Standards Implemented: (SVAP)

N/A

Care Setting:

Inpatient

Developer Info:

Holy Name Medical Center
718 Teaneck Road
Teaneck, NJ 07666
(201) 833-3000

Product Info:

Product Name: WebHIS

Product Version: 1.2

CHPL ID

15.07.09.1632.WE01.01.02.1.230127

Methods Use to Demonstrate Interoperability:

HISP via Direct Protocol (SMTP)

Relied Upon Software:

DataMotion (Version 6.4)

* Attestation

170.315 (b)(6)

Measure Description:

Export all available data elements from the Common Clinical Dataset (CCDS) for a population of patients for use in a different health information technology product or a third party system. This export can be used for many purposes, including data portability when a physician practice switches to a new EHR platform.

Justification:

We chose to concentrate on the aspects of this criterion that would:

1. Demonstrate WebHIS's ability to export batches of patient data in a straightforward fashion.
2. Facilitate interoperability by providing the exported data in the form of valid CCD files that conform to the HL7 standards as described in the HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm).

Metric Description:

1. Over 90 Percent of Exports ran at the correct time.
2. C-CDA count matches actual patient count for requested date range.
3. Spot-check C-CDAs for conformance and errors.

Standards Implemented: (SVAP)

N/A

Care Setting:

Inpatient

Developer Info:

Holy Name Medical Center
718 Teaneck Road
Teaneck, NJ 07666
(201) 833-3000

Product Info:

Product Name: WebHIS

Product Version: 1.2

CHPL ID

15.07.09.1632.WE01.01.02.1.230127

Methods Use to Demonstrate Interoperability:

1. Ensure endpoint receives correct number of CCDs

170.315 (b)(6)

Measure Description:

Export all available data elements from the Common Clinical Dataset (CCDS) for a population of patients for use in a different health information technology product or a third party system. This export can be used for many purposes, including data portability when a physician practice switches to a new EHR platform.

Justification:

We chose to concentrate on the aspects of this criterion that would:

1. Demonstrate WebHIS's ability to export batches of patient data in a straightforward fashion.
2. Facilitate interoperability by providing the exported data in the form of valid CCD files that conform to the HL7 standards as described in the HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm).

Metric Description:

1. Over 90 Percent of Exports ran at the correct time.
2. C-CDA count matches actual patient count for requested date range.
3. Spot-check C-CDAs for conformance and errors.

Standards Implemented: (SVAP)

N/A

Care Setting:

Inpatient

Developer Info:

Holy Name Medical Center
718 Teaneck Road
Teaneck, NJ 07666
(201) 833-3000

Product Info:

Product Name: WebHIS

Product Version: 1.2

CHPL ID

15.07.09.1632.WE01.01.02.1.230127

Methods Use to Demonstrate Interoperability:

1. Ensure endpoint receives correct number of CCDs