TechCare 5.0 API

CY 2023 Real World Test (RWT) Plan for TechCare® Electronic Medical Records System

 

Executive Summary – RWT Overview

This is the CY 2023 Real World Test Plan for NaphCare, Inc.’s TechCare Electronic Medical Records System, a certified EMR solution. We will be testing functionality built into TechCare’s core business layer which supports all versions of the application deployed to our user community.

This Real World Test (RWT) is intended to verify the capabilities of TechCare certified functionality. This plan outlines our process for conducting and measuring observations of interoperability and data exchange.

The RWT plan will focus on certification criteria, represented as use cases in a correctional healthcare setting below. The purpose of this test is to validate the adoption of the underlying interfaces and EHR capabilities and to provide evidence of TechCare’s usability within the correctional healthcare environment. To accomplish this, measures of real world utilization of interoperability features and data exchange are captured during the test.

This RWT Plan has been updated from the 2022 version previously posted to include updates to testing approaches, technologies utilized and testing timelines.

Click the hyperlinked Use Case Name below to navigate directly to the specific Use Case.

 

Use Case 1: Care Coordination and Electronic Exchange

·         § 170.315(b)(1) Transitions of care

·         § 170.315(h)(1) Direct Project

 

Use Case 2: Data Export

·         § 170.315(b)(6) Data export

 

Use Case 3: Clinical Quality Measures (CQM)

·         § 170.315(c)(1) record and export

 

Use Case 4: Application Programming Interfaces (API)

·         § 170.315(g)(7) Application access— patient selection

·         § 170.315(g)(8) Application access— data category request

·         § 170.315(g)(9) Application access— all data request

General Information

Developer Name

NaphCare, Inc.

Product Name(s)

TechCare EHR

Version Number(s)

5.0

Certified Health IT

2015 Edition

Product List (CHPL) ID(s)

15.04.04.2813.Tech.05.00.0.191208

Developer RWT Page URL

https://devportal.techcareehr.com/RWTP

 

Pre-Test Information

Each Use Case addressed in this RWT includes the elements below. TechCare EHR is deployed to Correctional Healthcare Settings within county, state, and federal correctional facilities which are the only care settings where TechCare v.5.0 is used.

 

Testing Methodology

TechCare’s Reporting/Logging features will be used to examine functionality performed in the system and the success/failure with the tested measures within each use case.

·         Demonstrate real world interoperability and conformance to criterion requirements

·         Include patient care scenario and use case focused testing

 

Description

·         How the test is performed.

·         How conformance is demonstrated.

 

Schedule

·         Key Real-World Testing Milestones

 

Measurement/Metric

·         All measures used to validate criteria.

 

Justification for the Health IT Developer’s Real Worl Testing Approach

·         Description of how the measurement/metric selected reflect the adoption of each required Real World Testing element.

 

Expected Outcome

·         Based on feature adoption during current time.

 

 

TechCare Overview

TechCare is a comprehensive, integrated software solution comprising all key components necessary for a fully functional, corrections-specific EHR, alleviating the need to manage multiple software products. TechCare tracks the healthcare activities of each patient upon incarceration, creating standardized treatment processes (with the appropriate documentation) from intake through discharge. It identifies patients’ critical medical needs and ensures timely intervention with appropriate care. TechCare EHR includes the following functionality:

·         Electronic Health Records

·         Customizable Forms and Reports

·         Receiving and Intake/Discharge

·         Offsite Medical Scheduling / Offsite Medical Services Tracking

·         CIWA-Ar Detoxification Tool

·         Chronic Care Management

·         Grievance Tracking

·         Quality Assurance

·         Screening Tools (Intake, TB, Mental Health)

·         Specialty Care: Dental, OB, Optical, etc.

·         Mental Health (Screening, Evaluation, Suicide Alerts)

·         Pharmacy (Electronic Drug Orders, Electronic Medication Administration Records)

 

·         Discharge/Re-Entry Support and Documentation

·         Transfer Support and Documentation for inmates

·         Interface Connections (JMS, Pharmacy, X-Ray, Laboratory, etc.)

·         Medication Administration Record/Electronic Medication Administration Record

·         Sick Call

·         Flags & Alerts

·         Queues/Dashboards (Doctor, Nurse, Pharmacy)

·         Infectious Disease Control

·         Detailed, Compliance Supporting, Logging

 

Timelines and Milestones for Real World Testing CY 2023

·         4th Quarter 2022 – During the 4th Quarter of 2022, the CY 2023 Real World Test Plan will be completed according to ONC and ONC-ACB requirements. The test plan will be prepared for submission by November 2023. We plan on implementing USCDI v1 in our C-CDAs and API support during CY 2023.

 

·         1st Quarter 2023 – Communicate with NaphCare clients to secure support and participation in real world testing. The goal is to have partner facilities committed for real world testing by end of 1st Quarter 2023.

 

·         2nd Quarter 2023 - Complete Attestation to Conditions of certification.

 

·         2nd Quarter – 3rd Quarter 2023 – During the 2nd and 3rd quarter of 2023, the real-world testing with partner facilities will be scheduled and confirmed. NaphCare will work with designated client representatives to prepare for testing activities. Results will be documented in the test results section of the test methods and used to build the test report. If any non-conformances are observed, we will notify ONC-ACB of the findings and make the necessary changes required.

 

·         4th Quarter 2023 - During the 4th Quarter of 2023, the CY 2023 Real World Test Plan will be executed according to ONC and ONC-ACB requirements.  We will also complete the CY 2024 Real World Test Plan.

 

Standards Version Advancement Process (SVAP) Updates

For CY 2023, we are not planning to make any version updates on approved standards through the SVAP process.

 

Standard (and version)

None

Updated certification criteria and associated product

N/A

Health IT Module CHPL ID

N/A

Method used for standard update

N/A

Date of ONC-ACB notification

N/A

Date of customer notification (SVAP only)

N/A

Conformance measure

N/A

USCDI-updated certification criteria (and USCDI version)

N/A

 

Changes in Technology (FHIR® API)

In CY 2022 NaphCare implemented use of the FHIR API to support conformance with the § 170.315(g)(10) Standard.  This technology has applicability to a subset of the Testing Use Cases below.

 

Real World Testing Use Cases

Please note that Use Case # 1 and Use Case # 4 include testing for multiple criteria.

 

Use Case #1: Care Coordination and Direct Project

Criteria Covered

·         § 170.315(b)(1) Transitions of care

·         § 170.315(h)(1) Direct Project

 

Testing Methodology

Validate the adoption of certified EHR functionality that contributes to a patient’s care coordination and electronic exchange of information with other facilities.

Goal: Measure the user adoption rate of

·         Transitions of Care Workflow

·         Direct Project

 

Scenario/Use Case – A patient is transferred from a correctional facility to an offsite hospital facility. TechCare user will generate C-CDA documents including all required data elements. The C-CDA will be sent to the offsite hospital facility using Direct Edge messaging using POP3 Edge Protocol. Users identified by permitted roles will generate C-CDA based on time period required by the receiving facility.

 

Measurement Description

This use case is associated with two different criteria and tracking two different metrics.  It will be used to track and count how many C-CDAs are created successfully and then sent and received via Direct Project connecting to a HISP for successful transmission.

·         Test Performed 1:

o    Capture the total number of offsite patient visits created during the test period.

o    Capture total number of C-CDAs created for patients sent for offsite visits during the test period.

·         Test Performed 2:

o    Capture the total number of C-CDAs

o    Compare with total C-CDAs shared with offsite hospital facility electronically via Direct Edge Protocol Transmission

·         Test Performed 3:

o    Capture the total number of offsite visits during the test period.

o    Capture the total of C-CDA received from offsite hospital upon patient’s return to the facility.

 

Schedule

·         Februrary 15, 2023 – Run query to gather all required numerator and denominator values

·         > April 1, 2023 – Complete adoption rate analysis.

 

Meausurements/Metric

Test 1

·         Numerator – All offsite visits scheduled between 1/15/2023 and 4/15/2023

Denominator – All patient files saves with Type = CCD between 1/15/2023 and 4/15/2023

 

Test 2

·         Numerator - Total number of C-CDAs for offsite visits between 1/15/2023 and 4/15/2023

·         Denominator - Total C-CDAs shared with offsite hospital facility electronically via Direct Edge Protocol Transmission between 1/15/2023 and 4/15/2023

 

Test 3

·         Numerator - The total number of offsite visits during the test period between 1/15/2023 and 4/15/2023

·         Denominator - The total of C-CDA received from offsite hospital upon patient’s return to the facility between 1/15/2023 and 4/15/2023

 

Justification

·         Capture the total Transition of Care documents completed, compared with total summaries provided to offsite hospital facility via Direct Message

·         Capture the total number C-CDAs received from offsite hospital upon patient’s return to the facility.

 

Expected Outcome

·         80% of patients transferred to offsite hospital facility had C-CDA created.

·         50% of C-CDAs created are sent electronically to offsite hospital electronically.

·         50% of C-CDAs received from offsite hospital received electronically upon patient’s return to the facility.

 

Use Case #2: Data Export

Criteria Covered

·         § 170.315(b)(6) Data export

 

Testing Methodoligy

Goal: Validate the adoption of certified EHR functionality that contributes to the export of Release Summaries/C-CDAS are exported as patients are released from the facility.

Goal: Measure the user adoption rate of

·         Data Export

 

Scenario/Use Case – When patients are released, they leave the facility at a designated time. The Release Summaries/C-CDAs should be exported as patients are released from the facility.

 

Measurement Description

This use case is tracking the number of times a batch export should be done and comparing the number to how many times the facility exported the C-CDAs using the EHR export functionality.

·         Test Performed 1:

o    Capture total number of days more than 1 inmate is released

o    Capture total number of days batch C-CDAs are exported

Schedule

·         yellow'>May 1, 2023 – Run query to gather all required numerator and denominator values

·         > August 1, 2023 – Complete adoption rate analysis.

 

Meausurements/Metric

Test 1

·         Numerator – Total number of days where more than 1 inmate is released 5/1/2023 and 8/1/2023

·         Denominator – Total number of days a batch export is generated 5/1/2023 and 8/1/2023

 

Justification

·         Capture the total number of days more than 1 inmate was released from the facility and compare it to the total number of days a batch export is generated

 

Expected Outcome

·         100% batch C-CDAs are exported on every day more than 1 inmate is released

 

Use Case # 3: CQM

Criteria Covered

·         § 170.315(c)(1) record and export

 

Testing Methodoligy

Goal: Validate the adoption of certified EHR functionality to capture clinical quality measure data

 

Scenario/Use Case

Required health data for CQM will be collected and stored in the EHR database.  Data for the requested time period will be exported.  

 

Measurement Description

This use case tracks the number of CQM data that is exported compared to how the number of data elements the users enters.  This test focus is primarily on whether the user is correcting entering the required data.  Test results not meeting the expected outcome will indicate user training is required

·         Test Performed 1:

o    Total number of CQM data exported

o    Total number of required data elements collected

 

Schedule

·         August 15, 2023 – Run query to gather all required numerator and denominator values

·         > November 1, 2023 – Complete adoption rate analysis.

 

Meausurements/Metric

·         Numerator – Total number of CQM data exported between 8/15/2022 and 11/1/2022

·         Denominator – Total number of required data elements collected between 8/15/2022 and 11/1/2022

 

Justification

·         Capture the total number of exported CQM’s compared with the total number of required data elements

 

Expected Outcome

·         30% of exported CQM exported will contain the required data elements

 

Use Case #4: Application Programming Intefaces (APIs)

Criteria Covered

·         § 170.315(g)(7) Application access— patient selection

·         § 170.315(g)(8) Application access— data category request

·         § 170.315(g)(9) Application access— all data request

 

Testing Methodology

Goal: Validate the adoption of certified EHR functionality to provide patient health data through application interfaces

 

Scenario/Use Case

Request received from external source to access patient health data via API.  External source is validated and granted access to API. C-CDA will be created based upon requested data.

 

Measurement Description

This use case tracks the number of API request and how many are successful. Due to the inability of the EHR to control number of systems requesting access, the focus of the test will be on the success of the systems retrieving the C-CDAs

·         Test Performed 1:

o    Capture the total number of requests for API access

o    Capture total number of successful API validations 

·         Test Performed 2:

o    Capture total number of successful API validations

o    Capture total number of C-CDA’s created

 

Schedule

·         October 15, 2023 – Run query to gather all required numerator and denominator values

·         December 1, 2023 – Complete adoption rate analysis.

 

Meausurements/Metric

Test 1

·         Numerator – All requested API access between 10/15/2023 and 12/1/2023

·         Denominator – All successful API validations 10/15/2023 and 12/1/2023

 

Test 2

·         Numerator – All successful API validations between 10/15/2023 and 12/1/2023

·         Denominator – All C-CDAs created 10/15/2023 and 12/1/2023

 

Justification

·         Capture the total number of requests for API access compared with total number of successful validations

·         Capture the total number successful API validations compared with total number of CDA’s created

 

Expected Outcome

·         50% of request for API access are successful

·         80% of successful API connections successfully create C-CDA

 

Developer 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: Mr. Jason Douglas, Chief Development Officer

Authorized Representative Email: jason.douglas@naphcare.com

Authorized Representative Phone: 205-536-8445

Authorized Representative Signature: Jason Douglas

Date: 10-26-22