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GENERAL INFORMATION
Developer Name: ChartLogic, a Division of Medsphere Systems Corporation
Plan Report ID Number: 20221116chl
Product Name(s):
Version Number(s):
Product List (CHPL) ID(s):
ONC-ACB Certification ID:
Developer Real World Testing Page URL: https://www.medsphere.com/certifications/RealWorldTesting/ChartLogic/
JUSTIFICATION FOR REAL WORLD TESTING APPROACH
At this time, ChartLogic is only utilized within Ambulatory Practices. Therefore, the Real World Testing plan will apply to this care setting. We feel it is best to test functionality as a whole workflow rather than by individual measure as this is how it is utilized in the real world. Our Real World Testing approach will consist of three main components, Electronic exchange of information for Care Coordination and Patient Engagement, Population Health, and Application Programming Interfaces.
Electronic exchange of information for Care Coordination and Patient Engagement
ChartLogic has developed functionality and created a best practice workflow around sending, receiving, reconciling, and exporting electronic health information. This workflow will allow us to test several certification criteria simultaneously. All criteria involving the Consolidated Clinical Documentation Architecture (C-CDA) documents will be tested, including 170.315(b)(1) Transitions of Care, 170.315(b)(2) Clinical Information Reconciliation and Incorporation, 170.315(b)(6), Data Export and 170.315(h)(1) Direct Project.
Population Health
As the product is targeted for ambulatory practices in which a wide variety of patient ailments are seen and across multiple populations, we find it important to be able to communicate to public health registries as well as immunization registries.
Being able to efficiently transmit certain clinical information to external specialized registries is foundational to population health. This plan will also incorporate the testing of 170.315(f)(1) Transmission to immunization registries, and 170.315(f)(2) Transmission to public health agencies – syndromic surveillance.
Application Programming Interfaces
ChartLogic has also developed Application Programming Interfaces to enable ways for our providers to communicate and transfer data to external systems. ChartLogic also will test multiple measures simultaneously around the criteria involving Application programming interfaces, including 170.315(g)(7) Application access- patient selection, and 170.315(g)(9) Application access – all data request.
STANDARDS UPDATES (INCLUDING STANDARDS VERSION ADVANCEMENT PROCESS (SVAP) AND UNITED STATES CORE DATA FOR INTEROPERABILITY (USCDI))
This product utilizes all standards associated with the 2015 certification methods.
| Standard (and version) | Not applicable |
| Date of ONC-ACB notification | Not applicable |
| Date of customer notification (SVAP only) | Not applicable |
| USCDI-updated certification criteria (and USCDI version) | None |
MEASURES USED IN OVERALL APPROACH
The following outlines our measures that have been identified to best demonstrate how our product is in and maintains conformance to multiple certification criteria.
Electronic exchange of information for Care Coordination and Patient Engagement
Measure 1 (Care Coordination Exchange Thresholds and Mechanisms)
As part of the Real World Testing requirements for 170.315(b)(1) Transitions of Care, 170.315(b)(2) Clinical Information Reconciliation and Incorporation, and 170.315(h)(1) Direct Project, this measure will assess the sending and receiving of CCD-A documents, reconciling information received through the CCD-A, the methods of transmission for information shared between providers.
Metric 1 – This metric will determine the thresholds of the types of transport mechanism used to share transitions of care documents and EHI, as well as the success rate of transmission.
Associated certification criteria for the electronic exchange of information for Care Coordination and Patient Engagement in the ambulatory care setting include:
| Certification Criteria | Associated Criteria | Relied Upon Software |
| 170.315(b)(1) Transitions of Care | Send Transition of care/referral summaries | Surescripts Clinical Direct Messaging |
| Receive transition of care/referral summaries | ||
| 170.315(b)(2) Clinical Information Reconciliation and incorporation | Reconcile transition of care summary | N/A |
| 170.315(h)(1) Direct Project | Transmit summary using one of the methods of direct exchange | Surescripts Clinical Direct Messaging |
| 170.315(e)(1) View, download and transmit (ChartLogic V1 only) | Download ambulatory summary or inpatient summary using CCD Template | N/A |
| Download of transition of care/referral summaries | ||
| Transmit to third party |
Rationale: The system includes three functionalities of interest transmitting, receiving and reconciling electronic health information. These transitions of care documents can be shared using various transmission methods such as XDM processing, direct, SMTP, while other documents can be shared through the patient portal either encrypted or unencrypted. This metric will provide ChartLogic with information on the types of transmissions that are used and the frequency of the individual usages. We feel that these findings could help us determine which methods are the most advantageous to our target base and also help us identify those best practices that we can target those providers with low thresholds in order to reach out to them and provide them logic as to how to increase utilization. For ChartLogic V 1 only, we also feel that the metrics captured in test approach 2 will help us identify the usage of download and transmit functions by patients.
Test Approach 1: De-identifiable data from system logs, will be extracted in order to produce analytic reports that will be reviewed to determine thresholds of transmission used by the providers for transmitting and receiving transitions of care.
Expected Outcome(s): It is anticipated that providers and patients will be able to share their electronic health information with no limitations and in compliance with the certification criteria, including the technical standards and vocabulary code sets.
Transmission errors will be tracked and trended over time and trended to determine utilization rates.
Test Approach 2: Information of actions of download and transmit will be extracted from system logs to determine the success rate of patients downloading and transmitting documents.
Expected Outcome: It is expected that patients will be able to share their information using the transmission methods provided with no limitations. The success/failure of the events will be logged and reviewed over time.
Measure 2 (Data Export Trends)
(Care Coordination Exchange Thresholds and Mechanisms)
As part of the Real World Testing requirements for 170.315(b)(6), Data Export, this measure will capture the success/failure events related to exporting EHI for an individual patient as well as a batch of patients in real time and for a scheduled time. The associated certification criterion is:
| Certification Criteria | Associated Criteria | Relied Upon Software |
| 170.315(b)(6) Data Export | Create an export file (real time) single and batch | Internet browser: Chrome, Firefox, Safari, or Edge |
| Create an export file (scheduled) single and batch |
Rationale: The export of EHI is another function that enables a way to share information with external organizations. The export is typically used when a particular patient requests for their medical records or to send a batch of CCD-A for patients seen during a specific time frame to an external source such as the patient portal.
Test Approach 1: System logs reviewed to trend error rates. We will also analyze the data to validate the proper utilization and determine if there are certain timeframes which cause system performance issues when scheduling them to run in batch. This will help us identify best practices related to this functionality.
Expected Outcome: It is expected that authorized users will be able to export data without limitations and in compliance with the certification criteria, including the technical standards and vocabulary code sets. Error rates and system performances will be tracked and trended over time.
Measure 3 (Transmission of HL7 messages)
This measure will capture the error rates of HL7 messages being transmitted. Specifically, we will extract the VXU message types to analyze error rates related to Immunization registries and extract ADT messages to analyze error rates for public health agencies.
| Certification Criteria | Associated Criteria | Relied Upon Software |
| 170.315(f)(1) Transmission to Immunization Registries | Transmit VXU message to external entity | Notepad++ |
| 170.315(f)(2) Transmission to Public Health Agencies – Syndromic Surveillance | Transmit ADT message to public health agency. | N/A |
Rationale: ChartLogic allows clinicians the ability to transmit certain information to external entities using HL7 standards. These message types are transmitted through an HL7 engine and logged in the system. When immunization data or communicable disease data is captured within the system, these data elements are parsed into an HL7 message and transmitted to the respective external entity. This will provide an analytical view of the success rates of transmission.
Test Approach 1: System logs will be used to extract certain message types related to immunization and syndromic surveillance activities. Success rates of VXU message types being delivered to immunization registries as well as ADT messages being delivered to public health agencies will be reviewed and trended.
Expected Outcome(s): It is expected that clients will be able to transmit HL7 messages without limitations and in compliance with the certification criteria, including the technical standards and vocabulary code sets. We do anticipate some clients will experience some delay on first attempt due to network connectivity so we anticipate that 90% of messages will be successfully transmitted and the 10% error rate accounts for issues with network.
Measure 4 (API Requests)
This measure will capture the volume of API transactions across the measurement period.
| Certification Criteria | Associated Criteria | Relied Upon Software |
| 170.315(g)(7) Application Access- patient selection Immunization Registries | API query for patient | N/A |
| 170.315(g)(9) Application Access – all data request | API query for all data related to patient | N/A |
Rationale: ChartLogic has developed API’s that can be used by external entities. These API’s can be used to ping the system in order to retrieve certain information based on a query for a single patient, requesting specific data categories for that patient or requesting all data for the selected patient.
Test Approach 1: (in the event we have an external system using the API’s)System logs will be used to capture the success rate of API transactions over time.
Expected Outcome(s): It is expected that external entities will be able to connect to the ChartLogic system without error using these API’s without limitation and in compliance with the certification criteria, including the technical standards and vocabulary code sets. These successful transaction thresholds will be used to demonstrate the utilization of the API in the real world over the testing year.
Test Approach 2: (in the event we do not have any external system using the API’s). Quarterly tests will be done in a test environment to ensure the API’s are functionable. This will be done by using a test system to ping the host application for each level of access and the success/failure of the ping will be captured. This test will be done quarterly.
Expected Outcome(s): It is expected that the test system will be able to connect to the ChartLogic system without error using these API’s without limitation and in compliance with the certification criteria, including the technical standards and vocabulary code sets. We anticipate that the test system will be able to perform patient/data requests successfully during each quarter. At the end of the testing year, we anticipate to have 4 successful events for each of the request types.
Care Setting(s)
ChartLogic is only marketed to the ambulatory practice setting, therefore, only ambulatory practices will be used for Real World Testing.
SCHEDULE OF KEY MILESTONES
| Key Milestone | Date/Timeframe |
| Begin collection of data laid out by plan | March 2023 |
| Data Collection and Review | Quarterly |
| Certification 170.315(b)(10) | Q3-Q4 |
| End of Real World Testing for all measures. | December, 2023 |
| Final data review and analytics, create results report | January 2024 |
| Submit Real World Testing Results Report to ACB | January 2024 |
ATTESTATION
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: | Nicki Anderson, Director, Compliance |
| Authorized Representative Email: | nicki.anderson@medsphere.com |
| Authorized Representative Phone: | 760.979.6531 |
| Authorized Representative Signature: | Nicki Anderson |
| Date: | November 4, 2022 |
GENERAL INFORMATION
Developer Name: ChartLogic, a Division of Medsphere Systems Corporation
Plan Report ID Number: RWTP-0000567
Product Name(s): ChartLogic Patient Portal
Version Number(s): ChartLogic Patient Portal v. 9
Product List (CHPL) ID(s): ChartLogic Patient Portal – 15.04.04.1223.Char.09.00.1.170814
ONC-ACB Certification ID: ChartLogic Patient Portal – 15.04.04.1223.Char.09.0.1.170814
Developer Real World Testing Page URL: https://www.medsphere.com/certifications/RealWorldTesting/chartlogicpatientportal
JUSTIFICATION FOR REAL WORLD TESTING APPROACH
At this time, ChartLogic Patient Portal is only utilized within Ambulatory Practices using ChartLogic. Therefore, the Real World Testing plan will apply to this care setting.
Electronic exchange of information for Patient Engagement
ChartLogic Patient Portal has developed functionality to enable patients to view, download and transmit electronic health information. The best practice workflow will allow us to test the utilization of this feature as well as the how the patients are transmitting the data. This plan addresses the criteria involving the Consolidated Clinical Documentation Architecture (C-CDA) 170.315e(1) View, download, and transmit to 3rd party,
STANDARDS UPDATES (INCLUDING STANDARDS VERSION ADVANCEMENT PROCESS (SVAP) AND UNITED STATES CORE DATA FOR INTEROPERABILITY (USCDI))
This product utilizes all standards associated with the 2015 certification methods.
| Standard (and version) | Not applicable |
| Date of ONC-ACB notification | Not applicable |
| Date of customer notification (SVAP only) | Not applicable |
| USCDI-updated certification criteria (and USCDI version) | None |
MEASURES USED IN OVERALL APPROACH
The following outlines our measures that have been identified to best demonstrate how our product is in and maintains conformance to for 170.315e(1) View, download, and transmit to 3rd party.
Electronic exchange of information for Patient Engagement
Measure 1 (Care Coordination Exchange Thresholds and Mechanisms)
As part of the Real World Testing requirements for 170.315e(1) View, download, and transmit to 3rd party, this measure will assess the utilization of downloading and transmitting CCD-A documents.
| Certification Criteria | Associated Criteria | Relied Upon Software |
| 170.315(e)(1) View, download and transmit | Download ambulatory summary or inpatient summary using CCD Template | Surescripts Clinical Direct Messagin |
| Transmit to third party |
Rationale: The system gives the patient the ability to view, download and transmit their CCD-A document. Once the patient views and downloads, the system offers the ability to transmit the document either encrypted or unencrypted. We feel that reviewing the transmission methods used as well as the frequency of utilization will best represent utilization of these features. By producing analytics on these results, we feel it will also help us identify those providers with low thresholds to reach out to them and provide them logic as to how to increase utilization.
Test Approach 1: De-identifiable data from system logs, will be extracted to produce analytic reports that will be reviewed to determine thresholds and methods of transmission used by the patients for transmitting CCD-A documents.
Expected Outcome(s): It is anticipated that patients will be able to share their electronic health information using the various transmission methods provided with no limitations and in compliance with the certification criteria, including the technical standards and vocabulary code sets.
Test Approach 2: Information of actions of download and transmit will be extracted from system logs to determine the success rate of patients downloading and transmitting documents. Transmission errors will be tracked and trended over time.
Expected Outcome: It is expected that patients will be able to share their information using the transmission methods provided with no limitations. The success/failure of the events will be logged and reviewed over time.
Care Setting(s)
ChartLogic Patient Portal is only marketed to the ambulatory practices using ChartLogic, therefore, only ambulatory practices will be used for Real World Testing.
SCHEDULE OF KEY MILESTONES
| Key Milestone | Date/Timeframe |
| Begin collection of data laid out by plan | March 2023 |
| Data Collection and Review | Quarterly |
| End of Real World Testing for all measures. | December, 2023 |
| Final data review and analytics, create results report | January 2024 |
| Submit Real World Testing Results Report to ACB | January 2024 |
ATTESTATION
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 | Nicki Anderson, Director, Compliance |
| Authorized Representative Email: | Nicki.Anderson@Medsphere.com |
| Authorized Representative Phone: | 760-979-6531 |
| Authorized Representative Signature: | Nicki Anderson |
| Date: | October 26, 2022 |
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