Real World Test Plan

GeeseMed

For Criteria

170.315 (b)(1), §170.315 (b)(2), §170.315 (b)(3), §170.315 (b)(6), §170.315 (e)(1), §170.315 (f)(1), §170.315 (f)(2), §170.315 (g)(7), §170.315 (g)(8), and §170.315 (g)(9)

General Information

Plan Report ID Number: MDOfficeManager_GeeseMed_RWTPlan_2021_V001

Developer Name: MDOfficeManager

Product Name(s): GeeseMed

Version Number(s): 7.0

Certified Health IT: 15.04.04.3013.Gees.07.001.180201

Product List (CHPL) ID(s): 15.04.04.3013.Gees.07.001.180201

Developer Real World Testing Page URL: MDofficeManager.com/GeeseMedRWT

Justification For Real World Testing Approach

Currently the Certified Health IT module, GeeseMed is sold by MDOfficeManager as an Ambulatory Care Electronic Health Record (EHR) Software application. It is uses in Ambulatory and Outpatient Surgery Centers of all sizes throughout the US. The applicable 2015 Edition criteria that we will include in our Real World Test plan are:

These criteria were tested individually during the ONC certification process. However, in the real world, these certified modules provide one seamless approach to accomplish the clinical and administrative documentation requirements and incorporate the features and functions of all of the criteria mentioned in Table 1. To that end, the Real World Test plan will be designed to demonstrate how these combined certified criteria perform in the production environment. Since this certified product is deployed in multiple settings and specialties within the marketplace, we will design our Real World Test plan to reinforce the capabilities that we encounter in these production environments. The GeeseMed application does allow providers to fully satisfy their reporting requirements for the MIPS program.

Standards Updates (Including Standards Version Advancement Process (SWAP) And United States Core Data For Interoperability (USCDII)

Measures Used In Overall Approach

Description Of Measurement/Metric

Describe the measure(s) that will be used to support the overall approach to Real World Testing.
The Measure/Metrics and the Descriptions listed below will apply to the simultaneous and seamless use of the functionality of the applicable certified measures mentioned in Table 1. The RWT will be witnessed via a Webex session with the participants (current customers) using a mirrored production environment and real patient data. Upon completion we will observe and report the successful conformance of our customers using the certified technology as it was designed, to be able to complete the applicable 2015 Edition Certified criteria listed in Table 1 above.
The Measure/Metrics and Descriptions for Measures 1 -6 listed below will apply to multiple criteria simultaneously to demonstrate the functionality of these certified measures: § 170.315(b) (1) Transitions of care (Receive), § 170.315(b) (2) Clinical Information Reconciliation and Incorporation, § 170.315(b) (3) Electronic Prescribing, § 170.315(b) (1) Transitions of care (Send), § 170.315 (e) (1) View, Download and Transmit to 3rd party, §170.315(g)(7,8,9) API. The Measure/Metrics and Descriptions for Measures 7 – 9 will apply to § 170.315(b) (6) Data export. The Measure/Metrics and Descriptions for Measures 10 and 11 will apply to § 170.315(f)(1) Transmission to Immunization Registries and Measure 12 will apply to the § 170.315(f)(2) Transmission to Public Health Agencies – Syndromic Surveillance.

Measurement/Metric

Description

Measure 1: Clinician logs into GeeseMed and receives a C-CDA from a referring provider via Direct Protocol with no Tech Support and no errors. C-CDA has demographic information adjusted so PHI is not visible. Successful receipt of C-CDA is achieved and observed.

Clinician begins a new patient encounter in the GeeseMed certified software with a patient referred by another clinician. With a Direct Address and unique EMRDirect PhiMail credentials, the clinician is able to have a seamless login and secure receipt of C-CDA from the referring clinician using the Direct Protocol. The Common Clinical Data Set standard will be demonstrated in these transactions through screenshots collected. Log files are also captured. These will all show the successful receipt of the     C-CDA with all fields completed and arranged per provider preference. This will meet § 170.315(b)(1) (Receive).

Measure 2: The C-CDA is validated, and Clinical Information Reconciliation is performed. No errors are expected.

After successful receipt of the C-CDA, the clinician validates the C-CDA within GeeseMed. Clinical information reconciliation for medication, medication allergy, and current problem list is performed using GeeseMed software. Common Clinical Data Set standard will be demonstrated in these transactions through screenshots collected. Log files demonstrate the reconciliation. This will meet § 170.315(b)(2).

Measure 3: The ability to review and approve a prescription refill requests and to create and transmit a new e-Prescriptions. No errors are expected.

The clinician easily completes the review and renewal of a refill request and to create and transmit a new prescription electronically within appropriate location in the GeeseMed software to meet 170.315(b)(3) by completing the appropriate fields in GeeseMed software.

Measure 4: Updated C-CDA is sent back to referring partner. Successful sending of CCDA is achieved and observed.

Clinician sends updated C-CDA with minimal delay back to referring clinician via Direct Protocol. Updated C-CDA is also sent to the patient portal. Confirmation of sent C-CDA is captured along with log files. This will meet § 170.315(b)(1) (Send).

Measure 5: Access via patient portal – Observation of the View, Download & Transmit functions are performed. This will demonstrate the portal as a key tool for the clinician to share the patient’s most current health information with the patient.

Real-time patient data will be adjusted to protect PHI before Measure 5 is completed. A patient will have access to patient portal to view encounter summaries of their choice as human readable C-CDAs and download the C-CDA without assistance. Transmission of patient data will be sent to a provider (Edge Protocol) and a standard email address. This will meet § 170.315 (e)(1).

Measure 6: Additionally, the patient will have the ability to access (by authentication) either partial or full encounter summaries by way of an API call from a 3rd-party application running on a patient-owned device to the API of the EHR.

This same patient will be enabled to present their authenticated credentials to use a 3rd-party application running on a patient-owned device to access either partial encounter summary data or a full encounter summary. They will have the ability to view and or transmit their information as they see fit. This will meet § 170.315 (g)(7,8,9).

Measure 7: A selected practice staff member is observed successfully exporting bulk patient data files on demand.

Authorized office practice staff member will perform an export of data from the production server in real-time (on demand) with a specific start & end date immediately. This will be done without delay and sent to a specific file location decided by the staff member. This will be accomplished efficiently and with no error and the file will be inspected when received to ensure it is the file requested. Real world data will be used but demographic information will be changed to protect patient health information. This measure allows the capture of report data selected by and on demand without assistance from development staff. The ability to independently create reports is vital to office practices and integral to a certified EHR. MDofficeManager staff will verify the reports have been created successfully with requested data and sent to specific location through screenshots.

Measure 8: a selected practice staff member is successfully exporting a file at a single delayed time – with a specific start and end date in the future.

An authorized office staff member will perform data export data in the future – 5 minutes from current time – from the production server with a scheduled specific start & end date -such as November 1 – November 2, 2021.This will be accomplished efficiently and with no error and the file will be inspected when received to ensure it is the file requested. This measure allows the staff member to select a time in the future without assistance from development staff. The ability to independently create reports is vital to office practices and integral to a certified EHR. MDofficeManager staff will verify the reports have been created successfully and sent to a specific file location with requested data through screenshots.

Measure 9: A selected practice staff member sets an export for a delayed future time during hours after the practice is closed and is able to run successfully. This scheduled event will repeat as scheduled.

An authorized staff member sets up a specific data export to run after the practice is closed. This measure allows the capture of report data selected by and on demand without assistance from development staff. The ability to independently create reports is vital to office practices and integral to a certified EHR. MDofficeManager staff will verify the reports have been created successfully with requested data and sent to specific location with screenshots that capture the activity. At the finish of Measure 9 § 170.315(b)(6) Data export will be satisfied.

Measure 10: The practice staff will demonstrate the ability to create immunization messages that can be transmitted to the Immunization Registry and properly respond to the Immunization Registries return messages.

An office staff member will be able to enter in the typical immunization administration data into the patient’s record and generates HL7 v2.5.1 Z22 VXU immunization information messages to an onboarded Immunization Registry, with the proper response of acceptance.

Measure 11: The practice staff will query Immunization Registry to demonstrate the ability to support receipt of immunization messages from an onboarded Immunization Registry and properly receives the patient’s Immunization history and forecasted dates.

An office staff member can receive the patient’s immunization history and forecast response in accordance with the standard at §170.205(e)(4) HL7 v2.5.1 Immunization Guide. The staff visualizes the display of the history and forecast information.

Measure 12: The practice staff demonstrates the ability to create and report Syndromic Surveillance messages that can be transmitted to a public health system (compliant to the Urgent Care setting).

An office staff member will aggregate the required information and generates the syndromic surveillance messages for a patient for the Urgent Care setting type. They will generate the messages to an onboarded public health entity.

Associated Certification Criteria.

Justification For Selected Measurement/Metric

Measurement/Metric

Justification

Measure 1: Clinician logs into GeeseMed and receives a C-CDA from a referring provider via Direct Protocol with no Tech Support and no errors. C-CDA has demographic information adjusted so PHI is not visible. Successful receipt of C-CDA is achieved and observed.

The ability to electronically receive a C-CDA, without developer assistance, from another provider and or point of service by using the Edge Protocol is integral to the exchange of data and interoperability and inherent in a certified EHR. The C-CDA will use the Common Clinical Data Set standard.

Measure 2: The C-CDA is validated, and Clinical Information Reconciliation is performed. No errors are expected.

A clinician must be able to perform clinical information reconciliation and incorporation for medication, medication allergy and the problems effectively, without developer assistance. As a result, a revised C-CDA using the Common Clinical Data Set standard will be created which can then be shared with additional clinicians and be sent to the patient portal for patient access. The ability to do this as part of the test plan will show how clinicians can complete this task efficiently and without error. The most current information will be available to both clinicians and the patient as required by a certified EHR.

Measure 3: The ability to review and approve prescription refill requests and to create and transmit a new e-Prescriptions. No errors are expected.

An important part of certified EHR technology is the ability to review, create and electronically send patient prescriptions. Included in this functionality are the ability to refill prescriptions, review drug formularies, receive drug-drug and drug-allergy alerts as well and to easily send the prescriptions to the pharmacy of the patient’s choice.

Measure 4: Updated C-CDA is sent back to referring provider. Successful sending of the C-CDA is achieved and observed.

To complete the ability to bi-directionally participate in the interoperability of patient information the certified EHR technology must be able to allow providers to send a C-CDA using the Edge Protocol, and the Common Clinical Data Set standard.

Measure 5: Access via patient portal – Observation of the View, Download & Transmit functions is performed. This will demonstrate the portal as a key tool for the clinician to share the patient’s most current health information with the patient. The amount of time should be no more than 3 minutes total for 3 tasks and there should be no errors. Additionally, the ability to access (authenticate) either partial or full encounter summaries by way of an API call from a 3rd-party application running on a patient-owned device to the API of the EHR.

The patient portal is vital to all patients. Patients will be able to login at any time and view their most current information as well as share it with any other clinicians they might choose to visit. This allows the exchange of information by the patients themselves which is key to giving control of their health information. This is an essential part of certified EHR technology.

Measure 6: Additionally, the patient will have the ability to access (by authentication) either partial or full encounter summaries by way of an API call from a 3rd-party application running on a patient-owned device to the API of the EHR.

The certified EHR technology must provide the patient with an additional ability to obtain their medical information via a request from an application of their own, outside of the domain of an EHR. This functionality will supplement the capabilities that are achieved with a patient portal.

Measure 7: Practice staff member is observed successfully exporting data files on demand.

Exporting data on demand is an essential requirement for a clinical practice with a certified EHR. A selective member of the office staff needs the capability of doing this immediately and successfully without developer assistance.

Measure 8: Practice staff member is successfully exporting a file at a delayed time – with a specific start and end date.

Exporting data at a relative time is a requirement for a clinical practice with a certified EHR. A selective member of the office staff needs the capability of doing this successfully without developer assistance.

Measure 9: Practice staff member sets an export for a delayed time during hours after the practice is closed and is able to run successfully.

Exporting a specific report with large amount of data after hours is an essential requirement for a clinical practice with a certified EHR. A selective member of the office staff needs the capability of doing this successfully without developer assistance. The certified EHR requires this capability to avoid placing undue load on the technology during regular business hours and allows the staff member to place the files in a location of their choice.

Measure 10: The practice staff will demonstrate the ability to create immunization messages that can be transmitted to the Immunization Registry and properly respond to the Immunization Registries return messages.

The creation of immunization information for electronic transmission to an appropriate Registry is an important part of the information sharing of the patient’s immunization status. The EHR must use HL7 immunization messages that can be transmitted to an Immunization Registry. The full range of immunizations that can be administered is supported.

Measure 11: The practice staff will query Immunization Registry to demonstrate the ability to support receipt of immunization messages from an onboarded Immunization Registry and properly receives the patient’s Immunization history and forecasted dates.

The certified EHR technology needs to complete the immunization process by providing a message response and displaying a patient’s evaluated immunization history and immunization forecast from an immunization registry.

Measure 12: The practice staff demonstrates the ability to create and report Syndromic Surveillance messages that can be transmitted to a public health system (compliant to the Urgent Care setting).

The certified EHR technology must demonstrate the ability to create syndromic surveillance messages that can be transmitted to a public health system. The minimum method will correspond to the within the Urgent Care point of service. This group of tests is for the creation of syndromic surveillance information for electronic transmission.

Care Setting(S)

Care Setting

Justification

Facilities:

  1. Ambulatory
  2. Outpatient Surgery Centers

Specialties:

  1. Internal Medicine
    1. Cardiology
    2. Neurology
  2. Behavioral Health
  3. Pain management

The GeeseMed is currently used by providers in multiple points of service and multiple specialties. This test plan will demonstrate that the overall functionality is the same regardless of the facility or specialty. We will get feedback from Internal Medicine, Cardiology, Behavioral Health, and Dermatology. Additionally, we will document that the EHR performs the same in different facilities. The overall process will be the same in all specialties. However, we will confirm that the EHR accommodates the specific workflow of each specialty.

We will be conducted the Real World Testing with clinicians from the listed care settings with between 1-5 clinicians, these are the MDofficeManager’s target audience.

Real patient data will be deidentified and the testing will be using a mirrored production environment.

The ability to complete all measures successfully with these practices will be documented through observation of the completed tasks. Deviations from the designed process, if any, will be noted and addressed.

Expected Outcomes

Schedule Of Key Milestones

Key Milestone

Care Setting

Date/Timeframe

 

Prepare the GreeseMed application for use in collecting data to support the RWT plan.

Facilities:

  1. Ambulatory
  2. Outpatient Surgery Centers

Specialties:

  1. Internal Medicine
    1. Cardiology
    2. Neurology
  2. Behavioral Health
  3. Pain Management

 

December 2021

 

 

Identify the user practices the will participate in the test plan

Facilities:

  1. Ambulatory
  2. Outpatient Surgery Centers

Specialties:

  1. Internal Medicine
    1. Cardiology
    2. Neurology
  2. Behavioral Health
  3. Pain Management

 

December 2021 & January 2022

 

Confirm that the Real World Test Plan participants are able to log into their accounts and are ready to start the RWT plan documentation

Facilities:

  1. Ambulatory
  2. Outpatient Surgery Centers

Specialties:

  1. Internal Medicine
    1. Cardiology
    2. Neurology
  2. Behavioral Health
  3. Pain Management

 

January 2022

 

Conduct the series of Real World Testing with the participants on a regular basis (minimum, once a quarter) to obtain feedback on their progress and or if there are any issues to address.

Facilities:

  1. Ambulatory
  2. Outpatient Surgery Centers

Specialties:

  1. Internal Medicine
    1. Cardiology
    2. Neurology
  2. Behavioral Health
  3. Pain management

 

Quarterly 2022

 

 

End the Real World Test to coincide with the end of the Year.

Facilities:

  1. Ambulatory
  2. Outpatient Surgery Centers

Specialties:

  1. Internal Medicine
    1. Cardiology
    2. Neurology
  2. Behavioral Health
  3. Pain management

 

 

December 2022

 

 

Real World Test analysis and generation of the report

Facilities:

  1. Ambulatory
  2. Outpatient Surgery Centers

Specialties:

  1. Internal Medicine
    1. Cardiology
    2. Neurology
  2. Behavioral Health
  3. Pain management

 

January 2023

 

 

Submit Real World Test Report to ACB before established deadline

Facilities:

  1. Ambulatory
  2. Outpatient Surgery Centers

Specialties:

  1. Internal Medicine
    1. Cardiology
    2. Neurology
  2. Behavioral Health
  3. Pain management

 

February 2023

Attestation

The Real World Testing plan must include the following attestation signed by the health IT developer authorized representative.

Note: The plan must be approved by a health IT developer authorized representative capable of binding the health IT developer for execution of the plan and include the representative’s contact information.

This Real World Testing plan is complete with all required elements, including measures that address all certification criteria and care settings. All information in this plan is up to date and fully addresses the health IT developer’s Real World Testing requirements.

Authorized Representative Name: Suhas Gandhi

Authorized Representative Email: suhas@mdofficemanager.com

Authorized Representative Phone: 812-248-9206

Authorized Representative Signature: Suhas Gandhi

Date: 11/11/2021