MU2 Progress

Archived OEMR Non Profit Organization
121

bradymiller wrote on Friday, November 13, 2015:

f(2) is included in ZH’s immunization module, which is already in the main codebase.
-brady

122

bradymiller wrote on Friday, November 13, 2015:

The AMC code should just require some re-factoring where the ZH solutions are being used instead of the Ensoftek solutions(since the AMC rules were written based on the Ensoftek solutions).

I don’t think the CQM code will require any refactoring(I haven’t looked at these in detail, though).

-brady

123

bradymiller wrote on Friday, November 13, 2015:

Hi,

The hurdle with a(8) was explained to me by Ensoftek as:

STARTQUOTE
For 170.314(a)(8), there are too many alerts(especially for Laboratory tests and values/results) that are being asked for MU2. In our case, we were asked to alert on all of the following:
Lab Result: Whether Abnormal
Lab Result: Result Code
Lab Result: Specimen Condition
Lab Result: Specimen Reject Reason
ENDQUOTE

This seems really odd since the testing manual only needs one lab rule (of which there is already a rule in OpenEMR that checks for existance of an INR when a patient is on coumadin/warfarin; and if there is no INR in this situation, then a reminder is triggered).

I can find no where in the testing manual that states that multiple types of lab rules are required:

Is there a way we can get clarification on this, so can then figure out how to get the CDR engine do what is needed here?

thanks,
-brady
OpenEMR

124

bradymiller wrote on Friday, November 13, 2015:

Also,

Are there any specifics on what is holding b(5) back from passing?

thanks,
-brady
OpenEMR

125

tmccormi wrote on Friday, November 13, 2015:

I have asked for a clarification from Kyle on the CDR

B(5)A just needs to be done. I don’t think Ensoftek (or MI2) knows exaclty how to get a lab result imported into openemr. We have interfaces to commericial labs so the process is quite different, OpenEMR base lab stuff is Rod’s baby. I think Vamsi constructed an HL7 file for this test, but I’m not sure.

126

sunsetsystems wrote on Friday, November 13, 2015:

Given an HL7 file, I’m happy to consult on getting it imported.

Rod
http://www.sunsetsystems.com/

127

tmccormi wrote on Friday, November 13, 2015:

from Kyle at INFOGARD

You just have to demonstrate that a CDS rule will trigger automatically based on a lab result or value, and we only need to show one example of this for Labs. Here is the only example I could find in the ONC test procedures:

See Image attached

Here is another page that gives an example of what kinds of CDS triggers can be used for Labs:

https://healthit.ahrq.gov/ahrq-funded-projects/clinical-decision-support-initiative/chapter-1-approaching-clinical-decision/section-4-types-cds-interventions

But we are only testing one example of a lab CDS trigger. I am curious where Ensoftek received the information you mention. Do the above examples help?

128

tmccormi wrote on Friday, November 13, 2015:

I knew you would be :slight_smile:

129

aethelwulffe wrote on Saturday, November 14, 2015:

Do we have a collection of HL7 lab files? Can anyone dealing with a DICOM server dump us some?

130

teryhill wrote on Saturday, November 14, 2015:

Not a DICOM file but orders

MSH|^~&|FFlexConnect|FFI|CHARGES|billing|20140417142218||DFT^P03|041714221801|P|2.3.1|||NE|NE
EVN|P03|20140417142218
PID|1|175323624TA|1823ATEST||TESTER^PATIENTER^G^^||19361022|F|||300 Fake Ave NE Unit B21^ANYWHERE^KEY^FL^33441^||^^^^^717^8186706|^^^^^717^8186706|||||175323624||||||||||
PV1|1|O|ARA^^^ARA^^^^||||2655^DANIEL, M.D.^RODNEY^^^^^L||||||||||2655^DANIEL, M.D.^RODNEY^^^^^L||V226377|T||||||||||||||||||||||||201403311358|
FT1|1||1|201403311357||CG|CRP^C-REACTIVE PROTEIN^True|||1||||||LAB^^^LAB|||714.0||2655^DOCTOR, M.D.^RODNEY^^^^^L||189998||CRP^C-REACTIVE PROTEIN^True|
FT1|2||1|201403311357||CG|CMP^COMP METABOLIC PROFILE^True|||1||||||LAB^^^LAB|||714.0||2655^DOCTOR, M.D.^RODNEY^^^^^L||189998||CMP^COMP METABOLIC PROFILE^True|
GT1|1||TEST^PATIENT^G^^||300 Fake Ave NE Unit B21^ANYWHERE^KEY^FL^33441^||||||5|
IN1|1|||MEDICARE PART B.|P.O. BOX 117^^JACKSONVILLE^FL^32231-4117^||^^^^^866^4549007||||||||MC|TEST^PATIENT^G^^|1||^^^^^||||||||||||N|||||1TESTIT
IN1|2|||United HealthCare|P.O. Box 800^^Atlanta^GA^30374-0800^|||31111|||||||C1|TEST^PATIENT^G^^|5||^^^^^||||||||||||N|||||973TTTEST

Terry

131

bradymiller wrote on Saturday, November 14, 2015:

Hi,

OpenEMR for a(8) then already supports the lab triggers twofold:

  1. When a user enters a medication called coumadin/warfarin, then a user is prompted to get an INR lab (and is reminded to do so every 4 weeks). If an INR lab has been completed within 4 weeks, then the prompt does not show up.
  2. When a lab is abnormal, it is bolded when viewed in Procedure->“Lab Overview”.

Still unclear then why this item specifically failed testing.

-brady
OpenEMR

132

tmccormi wrote on Tuesday, November 17, 2015:

This is the test process Ensoftek says we need to use -

Here is what I have for B(5) A. See attached word document for instructions on what you need to configure before the testing and go through this URL: http://hl7v2-lab-testing.nist.gov/mu-lab/ and import everything under LIS Context Based-Validation and Test Cases under GU section. Make sure all the HL7s are downloaded and imported into OpenEMR before the testing and verify if all the data is being pulled into the system. Once you make sure all the data is pulled-in delete all the lab results prior to the testing. Because they need to see a clean chart with no lab results prior to the testing. They will have you download the results from this site during the test. So anything that you have prior to the test does not work. In case you need to delete data from the database here use the truncate scripts to clean the tables (see attached).

133

bradymiller wrote on Wednesday, November 18, 2015:

Hi,

Is the next testing date scheduled?

Regarding the AMC rules item g(2), I am in process of doing a quick analysis to get an idea of how much work is still needed here:

-brady
OpenEMR

134

harleytuck wrote on Wednesday, November 18, 2015:

Hi Brady-
I hope to schedule b5a in a day or so.
As far as HL7 files go, the last page of the test packages is an HL7 Message which appears to contain the data for that test item.
Regards- Harley Tuck

135

sunsetsystems wrote on Wednesday, November 18, 2015:

Extracting the HL7 message from a PDF is a bit awkward. Copy-and-past will give you line breaks within segments where they don’t belong, and nonstandard delimiters between segments. Doesn’t seem right that that they would expect vendors to fix that at test time… could you inquire about it?

Rod
http://www.sunsetsystems.com/

136

tmccormi wrote on Wednesday, November 18, 2015:

There is lot’s the isn’t right, they won’t change any of that and asking doesn’t get you anywhere. The data is provided by the ONC / CMS and the testing agency has no control over how it’s provided.

137

harleytuck wrote on Wednesday, November 18, 2015:

well… I was just going to search/ replace \n with empty string but you’re
right- it doesn’t seem quite proper. Let’s see what Kyle says.

  • HT

On Wed, Nov 18, 2015 at 11:30 AM, Rod Roark sunsetsystems@users.sf.net
wrote:

Extracting the HL7 message from a PDF is a bit awkward. Copy-and-past will
give you line breaks within segments where they don’t belong, and
nonstandard delimiters between segments. Doesn’t seem right that that they
would expect vendors to fix that at test time… could you inquire about it?

Rod
http://www.sunsetsystems.com/

MU2 Progress
https://sourceforge.net/p/openemr/discussion/oemr_501c3/thread/e0c8ffd8/?limit=25&page=5#3714/65ab

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138

harleytuck wrote on Wednesday, November 18, 2015:

this back from Milton at Infogard:

Kyle no longer works with us but I happy to help address any questions.

B5A does have test data within the test testing. Please use the following
link to access the tool. Please use the “EHR Context-Base Validation” tab.

http://hl7v2-lab-testing.nist.gov/mu-lab/

Regards,

Milton Padilla

Program Manager

mpadilla@infogard.com

office 805.783.0810

On Wed, Nov 18, 2015 at 12:08 PM, Tony McCormick tmccormi@users.sf.net
wrote:

There is lot’s the isn’t right, they won’t change any of that and asking
doesn’t get you anywhere. The data is provided by the ONC / CMS and the
testing agency has no control over how it’s provided.

MU2 Progress
https://sourceforge.net/p/openemr/discussion/oemr_501c3/thread/e0c8ffd8/?limit=25&page=5#b045

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htuck [at] mi-squared: 713-574-6714

Please be aware that e-mail communication can be intercepted in
transmission or misdirected. Please consider communicating any sensitive
information by telephone. The information contained in this message may be
privileged and confidential. If you are NOT the intended recipient, please
notify the sender immediately with a copy to hipaa-security@mrsb-ltd.com and
destroy this message.

–
Please be aware that e-mail communication can be intercepted in
transmission or misdirected. Please consider communicating any sensitive
information by telephone. The information contained in this message may be
privileged and confidential. If you are NOT the intended recipient, please
notify the sender immediately with a copy to hipaa-security@mrsb-ltd.com and
destroy this message.

139

harleytuck wrote on Wednesday, November 18, 2015:

Sorry about the sig line(s); will post instead of email.

More from Milton:

I will be your main point of contact from this point forward.
Please following the following steps to view test files:

  1. Click “EHR Context-based Validation” tab in yellow text.
  2. Select either GU or NG drop down.
  3. Select test case drop down for example LRI_1.0_Sed_Rate
  4. Select/Click LRI-1.0-GU_Final
  5. Click on “Select” button on top right side of the window.
    HL7 test file will display in a couple seconds

It’s true, that shows the hl7; 1st attached pic.
Then I clicked on the ‘send’ button, thinking it might pertain to importing the hl7 files; 2nd pic.

  • HT
140

bradymiller wrote on Thursday, November 19, 2015:

Hi,

Here is the complete quick analysis for g(2) AMC rules item code :

Will begin to work on this on the following branch:

I set up a “up for grabs” demo here for this branch:
http://www.open-emr.org/wiki/index.php/Development_Demo#192.168.1.133

Here is the test data that will be used to certify this item:
http://healthit.gov/sites/default/files/170.314g12_2014_td_approved_v2.0.xlsx

It would be very helpful if folks begin testing this test data on the above demo.

-brady
OpenEMR