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Certification / Adoption Workgroup. Larry Wolf. May 13th, 2014. Agenda. Update from May HITPC Meeting Update from Certification Hearing Proposed LTPAC Patient Assessment Recommendation Next Steps: LTPAC / BH Voluntary Certification Blog Listening Session – Thursday, 05/22/2014.

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Certification adoption workgroup

Certification / Adoption Workgroup

Larry Wolf

May 13th, 2014


  • Update from May HITPC Meeting

  • Update from Certification Hearing

  • Proposed LTPAC Patient Assessment Recommendation

  • Next Steps:

    • LTPAC / BH Voluntary Certification Blog

    • Listening Session – Thursday, 05/22/2014

Update from may hitpc
Update from May HITPC

  • TOC & Privacy Recommendations Approved by HITPC w/ the following clarifications:

    • Alignment with MU: TOC certification criteria and standards should align with ONC’s Meaningful Use criteria and standards to ensure interoperability across systems and to encourage exchange.

    • Updated with MU: Starting with the 2014 Edition of CEHRT, criteria and standards for other settings should be updated when MU criteria and standards are updated.

  • Data Segmentation/Consent Management

    • Provider Workflow: HITPC requested that the Privacy & Security Tiger Team (P&S TT) conduct additional outreach to stakeholders to determine the workflow impact of data segmentation and consent management of documents. The P&S TT will engage in this outreach in May

    • Definition of Disclosure: P&S TT also will work with SAMHSA to determine the definition of disclosure used for purposes of 42 CFR part 2

    • Report Back to HITPC: P&S TT anticipates reporting back to HITPC in June with updated recommendations

Update from may hitpc1
Update from May HITPC

HITPC Feedback on Draft Quality Measurement Recommendations for LTPAC / BH Voluntary Certification

  • Noted that the proposed behavioral health quality measures are process focused, and should be more focused on outcomes.

  • Consider how data already collected from LTPAC/BH providers (e.g., by CMS) could provide a foundation for quality measurement in the setting

  • Interested in additional vendor feedback on the proposed quality measure recommendations

  • Consider international examples of ways to integrate behavioral health, maternal health, social care programs, etc. to render a holistic view of the patient

    2015 NPRM Feedback

  • HITPC to provide ONC with 2015 NPRM discussion ‘sentiments’

    • Certification should be ‘lean and mean’

    • Balance between maturity of standards and infrastructure needed to support policy (e.g., Meaningful Use, Advanced Care Models)

Feedback from certification hearing
Feedback from Certification Hearing

  • The certification process is overwhelming for some (timeframes, complexity)

  • Certification of immature criteria/standards are concerning

  • The certification schedule involves tight timelines and cycles that vendors must work within

  • Certification regulations lack clarity

  • Feedback mechanisms beyond the NPRM process are needed

  • Certification can stifle innovation

Certification hearing outcomes
Certification Hearing Outcomes

Key Points:

  • ONC should organize a Certification Kaizen

    • Need for active collaboration with all stakeholders, including CMS

    • Kaizen process is more effective than responding to NPRMs

  • Certification efforts should focus on interoperability, privacy and security, and quality measures

Voluntary certification for ltpac and bh
Voluntary Certification for LTPAC and BH

Proposed LTPAC Setting Specific Recommendation

Ltpac patient assessments
LTPAC Patient Assessments

Policy Opportunity:  

  • Alignment among federal programs around data and standards

  • Patient assessments can be key drivers of interoperability

    • Previous standards mapping work has been done (e.g., mapping assessment content to vocabulary standards, CCDA)

  • Responsive to certification hearing concerns regarding the lack of interoperability

Ltpac setting specific recommendations
LTPAC Setting Specific Recommendations

Interoperability of LTPAC Patient Assessment Data

  • NEWSupport the ability to create, maintain, and transmit (in accordance with CMS requirements) assessment instruments and data sets for LTPAC in, for example, MDS 3.0 (Nursing Homes), OASIC-C (Home Health), IRF-PAI (Inpatient Rehabilitation Facility), CARE subset (for Long Term Care Hospital), and a Hospice Item Set.

  • NEW Support the use of accepted vocabulary standards to enable the reuse of assessment data for:

    • various clinical purposes; and

    • administrative purposes.

  • NEW Support the ability of the provider or a designated third party to create and exchange interoperable LTPAC Assessment Summary CDA documents.


  • Harmonization of federal content and format for patient assessments with ONC specified EHR standards (e.g. consistent standards on demographics).

  • Make the data element library publically available and link content to nationally accepted standards.