2023 EHR RWT Results
Professional Imaging, LLC PI EMR v2
2023 Real World Testing Results
CHPL Product Number: 15.07.05.2835.PROI.01.01.1.231027 (current), 15.07.07.2835.PI01.01.00.1.190712 (previous)
Developer RWT Plan/Results Page URL: https://www.proimagetx.com/ehr-real-world-testing-plan
Care Setting: Ambulatory Interaction with Nursing Facilities
PI EMR is a Self-Developed EHR
Summary of Testing Methods and Key Findings
Care Coordination
The following outlines testing methods and findings regarding criteria concerning Care Coordination (170.315(b)(1) and 170.315(b)(2).
The b1 criteria was tested by generating both a Continuity of Care and a Referral Note CCDA R2.1 document using a representative synthetic patient. Both CCDA xml files generated were successfully validated using the 2023 ONC Cures Update R2.1 and USCDI v1 Validator Tool at https://ett.healthit.gov/ett/#/validators/ccdar3#ccdaValdReport.
The b2 criteria was tested using a representative synthetic patient. First, we imported an initial patient record (CCDA R2.1 xml) file. Then we imported an updated patient record for the same patient containing new medications, problems and alerts and reconciled (merged) it with the medications, problems and alerts in the initial patient record. To simulate a referral from another practice, we generated the initial and updated patient records (CCDA R2.1 files) at a practice at one location and then transmitted the CCDA files to a 2nd practice at a different location using a secure messaging system. Importing, reconciliation and incorporation of the initial and updated CCDA files was then performed at the 2nd practice. The resulting patient record was exported in CCDA R2.1 format and validated using the 2023 ONC Cures Update R2.1 and USCDI v1 Validator Tool (at https://ett.healthit.gov/ett/#/validators/ccdar3#ccdaValdReport).
This test resulted in the data being successfully imported and applied to the target patient with no errors.
Clinical Quality Measures
The following outlines testing methods and findings regarding criteria concerning Clinical Quality Measures (170.315(c)(1),170.315(c)(2) and 170.315(c)(3).
As we were required to submit CQM data to CMS in 2023, the test methodology was as follows. We conducted an analysis of use logs associated with transmission of CQM data to CMS for MIPS.Those logs confirm that every transmission was accepted without error.
For QRDA category I data, we were unable to find a way to validate our QRDA I files using CMS tools. Instead, we used Cypress to validate a representative sample of our QRDA category I data for reporting year 2023. First, QRDA I files were exported for a representative sample of patients, one batch for each measure uploaded to CMS. These files were then redacted to ensure no live patient data was uploaded to Cypress. The QRDA I files for each measure were then put in a zip file and imported into Cypress as “Vendor Patients”. This test was used to validate our exported QRDA I data. All exported QRDA I files were imported into Cypress without error. To ensure our EHR was able to import QRDA I files, the Vendor Patient files imported to Cypress were also imported into our EHR into a test database, also without error or loss of data.
Patient Engagement
The following outlines testing methods and results for the certification criteria concerning Patient Engagement (170.315(e)(1).
We used analysis of the usage logs from our patient portals to provide total counts of documents viewed and downloaded from our patient portal. At our practice's request the option to transmit patient records has not been enabled. To test the transmission of patient records we transmitted a representative sample of synthetic patient records in CCDA R2.1 format from our EHR to our HISP provider. A representative sample of downloaded and transmitted CCDA R2.1 files were successfully validated using the 2023 ONC Cures Update R2.1 and USCDI v1 Validator Tool at https://ett.healthit.gov/ett/#/validators/ccdar3#ccdaValdReport.
Public Health
The following outlines the test methods and results for the certification criteria concerning Transmission to Public Health Agencies (170.315(f)(2) and 170.315(f)(7).
For f2 we generated NIST HL7v2 Syndromic Surveillance xml files for a representative sample of synthetic patient data based on our actual patient cases. This process produced two synthetic patient files. We confirmed the accuracy and completion of these test files then used the NIST HL7v2 Syndromic Surveillance validation website for validation.
For f7, we generated a NHCS xml survey file for a representative sample of synthetic patient data based on our actual patient cases. This process produced two synthetic patient files. We confirmed the accuracy and completion of these test files, then used the NHCS validation website to validate the generated xml test files.
Application Programming Interfaces
The following outlines the testing methods and results for the certification criteria concerning APIs (170.315(g)(7) and 170.315(g)(9).
We used an in-house developed application named PI_EHR_API_Test that demonstrates use of our certified EHR API. This is because since its implementation, we have received no requests for information through our API.
For g7, we successfully generated an encrypted api key that allows access to a specific representative synthetic patient (name RWT_PT PATIENT_01, DOB 1960-05-01).
Testing of g9 was performed by downloading a CCDA R2.1 document for the aforementioned synthetic patient. This file was validated using the 2023 ONC Cures Update R2.1 and USCDI v1 Validator Tool at https://ett.healthit.gov/ett/#/validators/ccdar3#ccdaValdReport and no errors were found.
Electronic Exchange
The following outlines the testing methods and results for the certification criteria concerning Electronic Exchange (170.315(h)(1)).
Using our EHR, we sent a Direct message to a test Direct addresscontaining a zip file attachment. This attachment was downloaded from the inbox at the HISP provider’s website, renamed and sent back in a reply to our EHR to ensure the zip file contents remain unchanged.
The test zip file was generated by looking up a synthetic test patient then exporting it in CCDA R2 xml format and then zipping the file along with a separate file containing a 256 SHA-2 hash digest. Also, the CCDA R2 xml file in the zip file attachment was successfully validated using the ONC C-CDA R2.1 Validator Tool at https://ett.healthit.gov/ett/#/validators/ccdar3#ccdaValdReport.
Withdrawn Products
Product Name – PI EMR
Version Number – 2
CHPL ID and Date Withdrawn -
· 15.07.07.2835.PI01.01.00.1.190712 – Dec 9 2022
· 15.07.07.2835.PI01.01.01.1.221209 – Jan 30 2023
· 15.07.05.2835.PROI.01.00.1.230127 – Oct 31, 2023
Data captured in the results reported was under CHPL ID 15.07.05.2835.PROI.01.00.1.230127
Relied Upon Software
· MaxMD for b1, b2, g9, and h1
· MaxMD, Meinberg NTP, and WebSupergooABCpdf for c3 and e1
Key Milestones
Communication with our affiliate practice to schedule participation was conducted as necessary via phone conversation throughout the first 3 quarters of 2023.
Dates testing was performed were as follows:
· (b)(1) and (b)(2) –August 21, 2023
· (c)(1), (c)(2) and (c)(3) – August 23/24, 2023
· (e)(1) – August 21/24, 2023
· (f)(2) and (f)(7) – August 21/22, 2023
· (g)(7) and (g)(9) – August 21, 2023
· (h)(1) – August 22/24, 2023
Our CY 2024 real-world test plan was completed and submitted to our ONC-ACB on October 13, 2023
All test documents associated with this report are available upon request.
Overall Summary
The testing methods employed, and necessary changes made from those planned are specified in the report sections for each category of functionality tested. The reported results of this testing effectively verify that the certified functionality tested complies with the criteria requirements as no errors were encountered.
Standards Updates
There were no updates to the certified criteria during the period in which testing was conducted.
Authorized Representative Signature:
Date: February 4th, 2024