Summary of Change

Reason

Impact

Use Case 2:  Testing performed using synthetic data in our staging environment which mirrors production.

In the correctional health care setting, bulk C-CDAs would only be generated in the case of a facility transferring EHR vendors.  During the testing period, no participating partners transferred to an EHR vendor. 

This prevented NaphCare from testing using a production environment, resulting in testing performed in the staging environment which mirrors production.

Use Case 3 & 4: The corrections-specific industry that is our care setting did not see direct correlation with this use case and we were unable to identify participating partners to complete this study. 

Although functionality exists for Record and Export, Application Access and is available in production environments, we were not able to find willing participants.

This prevented NaphCare from being able to document and measure the success of this measure in a real-world use case.  To meet testing requirements testing was performed in the staging environment which mirrors production.

Measurement/

Metric

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.

Expected

Outcome(s)

·         95% of patients seen for a Telehealth encounter by a specialty care provider had a C-CDA created.

·         66% of C-CDAs created are sent electronically to the Telehealth Care provider electronically.

·         66% of patients receive a C-CDAs from Telehealth Care provider electronically upon completion of the scheduled Telehealth event.

Outcomes

Test 1

Numerator –958,965 total number of C-CDAs created

Denominator – 985,699 total number of Telehealth visits scheduled

Results 97%

Test 2  The partnering facilities did not have access to specialty care facilities using Direct Messaging (via POP3 Edge Protocol).  Testing performed using synthetic data in our staging environment which mirrors production.
              Numerator –865,635 total number of C-CDAs sent electronically
              Denominator – 865,635 total number of C-CDAs created
              Results 100%

Test 3 The partnering facilities did not have access to specialty care facilities using Direct Messaging (via POP3 Edge Protocol).  Testing performed using synthetic data in our staging environment which mirrors our production environment.

        Numerator – 698,536 total number of C-CDAs received

        Denominator – 698,536 total number of scheduled Telehealth visits

        Results 100%

Challenges

Encountered (if Applicable)

Challenges experienced were caused by the lack of partnering facilities preventing testing from being performed in the production environment.

Measurement/

Metric

This use case is tracking a complete batch export comparing the number of actual patients with a health information record (within the EHR system) to the number of electronically exported C-CDAs created using the EHR export functionality.  The planned testing scenario was exporting patient C-CDAs from TechCare to another EHR vendor. 

Expected

Outcome(s)

100% of eligible C-CDAs are exported in bulk.

Outcomes

None of the testing partners transitioned to a new EHR vendor. Testing was performed using synthetic data in our staging environment which mirrors production.

           Numerator:  923,635 test patients with heath information recorded
           Denominator: 923,635 batch C-CDAs were exported

           Results: 100%

 Challenges

Encountered (if Applicable) 

The planned scenario was not applicable in any of our participating testing facilities, preventing testing from being performed in the production environment.

Measurement/

Metric 

This use case tracks the number of CQM data that is exported and compares it to the number of data elements the users enter.  This test focus is primarily to determine whether the user is correctly entering the required data.  Test results not meeting the expected outcome indicate that user training is required.

Expected

Outcome(s)

35% of exported CQM exported will contain the required data elements.

Outcomes

 Testing was performed using synthetic data in our staging environment which mirrors our production environment. 

           Numerator:  658,698 test CQM data exported
           Denominator:  923,635 7otal number of data elements collected

           Results 71%

Challenges

Encountered (if Applicable)

While the ability to enter the specific CQM data is available in the system and its ability to be exported is validated by Live Testing as a part of CEHRT processes, no customers opted to implement.  The application was able to record and display the required data but due to the lack of participating customers. No testing was performed in the production environment.

Measurement/

Metric

This use case captures the total number of validated API request that resulted in received (intake) or generated (discharge) C-CDA records, compared with total opportunities to ingest or send useful information from a neighboring system.

Expected

Outcome(s)

25% of the patients received into a new facility will have health history transferable via electronic C-CDA.

25% of the released from a facility will be rebooked into another facility and have records requested of them.

75%of the patients will either not have been booked before, or will not be released and rebooked within the reporting period in a neighboring facility.

Outcomes

None of our participating facilities had neighboring facilities with the functionality for sending or receiving C-CDAs. Testing was performed in our staging environment which mirrors production.

         Numerator: 1,235 test patients were used to request C-CDAs via API

         Denominator: 1,235 of the C-CDAs were successfully received
         Results: 100%

          Numerator: 1,300 test patients requested records via API

          Denominator: 1,300 of the C-CDAs were successfully sent

          Results:  100%

Challenges

Encountered (if Applicable)

Due to lack of request for patient data we were unable to test transferring C-CDAs in the production environment. 

Due to lack of technology from facilities patients booked into our facilities we were unable to test receiving C-CDA’s via API in our production environment.

Milestone

Care Setting

Date

Finalization of all Application Functionality/Modules including data collection mechanisms for Use Case 2, 3.

Correctional Healthcare (Jails, Prisons)

December 2024 (TechCare v5.0 2024/R6)

 Finalization of all Application Functionality/Modules including data collection mechanisms for Use Case 4.

Correctional Healthcare (Jails, Prisons)

December 2024 (TechCare v5.0 2024/R6)

 Finalization of all Application Functionality/Modules including data collection mechanisms for

Use Case 1.

Correctional Healthcare (Jails, Prisons)

April 2024 (TechCare v5.0 2024/R2)

Attempted engagement with partners across all Use Cases

Correctional Healthcare (Jails, Prisons)

February 2024 – December 2024