Preparing for 170.315 (b)(10) EHI Export:
Identifying FHIR resources outside of US Core
ConnectEHR was one of the first EHR modules certified for (b)(10) although our database is currently limited to USCDIv1 data., we are in the process of rolling out support for USCDlv2 and 3. Keep in mind that, (b)(10) ePHI data export will be more extensive for a true EHR.
DHIT can help EHR vendors comply with the 12/31/2023 expanded (b)(10) requirements. The first step would be for you to provide an inventory of all ePHI data elements.
Dynamic FHIR supports the FHIR R4 DocumentReference resource. This resource can be used with any document format with a recognized mime type. Currently, we support the CCD in the DocumentReference resource. We are preparing to expand beyond CCD to other listed mime types. https://www.hl7.org/fhir/documentreference.html
DocumentReference is metadata describing a document such as:
CDA documents in FHIR systems
FHIR documents stored elsewhere (i.e., registry/repository following the XDS model)
PDF documents, Scanned Paper, and digital records of faxes
Clinical Notes in various forms
Image files (e.g., JPEG, GIF, TIFF)
Non-Standard formats (e.g., WORD)
Other kinds of documents, such as records of prescriptions or immunizations
We recommend the FHIR DocumentReference resource as a container for your ePHI data that is outside the scope of USCDI. Note that Dynamic FHIR will be upgraded for USCDIv3 by Q2, 2023, so we will be able to support an even greater collection of your ePHI data.
ConnectEHR is certified to (b)(10) under the limited ePHI USCDIv1 definition. The ConnectEHR UI provides bulk data export downloads in C-CDA 2.1 XML format.
Dynamic FHIR API supports creating a single-patient FHIR resource DocumentReference and FHIR Bulk Data Export for patient populations.
ConnectEHR allows Administrators to export patient data to XML using the HL7 C-CDA 2.1 Standard.
Create Data Export Reports
Administrators are able to create instant or scheduled data export reports via the 'Administration' tab (Administration>Data Export). In order to create data export reports, the ConnectEHR Agent (located in Services) must be running and the AgentRun_Batch in tblConfiguration should be set to True.
On-demand data export reports allow the user to select all patients, a single patient, or a subset of patients at a specific practice.
Login to ConnectEHR and navigate to Administration>Data Export>>Data Export
Choose a Practice from the Practice List dropdown.
Click on Export specific patients and search for your patient(s)
Confirm your patients then Click Run Report
Navigate to Administration>Data Export>>Data Export Status to identify and download your batch.
After clicking 'Run Report', whether for an entire practice or subset of patients, you will see 'Data Queued to be Exported' across the top of the screen in a green banner
CQMsolution Electronic Health Information export
CQMsolution is a user-friendly web-browser-based application from Dynamic Health It, Inc. (DHIT) for calculating, displaying, and generating clinical quality measures. This application is certified for the 2015 Edition Cures Update of the ONC Health IT Certification Program:
170.315(c)(1) – Clinical Quality Measures – Capture and Export **
170.315(c)(2) – Clinical Quality Measures – Incorporate and Calculate
170.315(c)(3) – Clinical Quality Measures – Reporting
170.315(c)(4) – Clinical Quality Measures – Filter
CQMsolution’s user interface is accessed via web browser, where users can report quality measures, view patient-level results, examine underlying data, and filter on demographic variables.
Once CQMsolution has calculated the numerators, denominators, etc. for all of the measures, it outputs QRDA I and QRDA III files and a QRDA III XML file which is viewable in the GUI. The QRDA I files are computable XML files containing patient-level data.
The type of report output for QRDA I (and other) files will be determined by your CQMsolution license, user preferences, and the report type.
Any QRDA I program output satisfying 170.315(b)(10) EHI Export requirements. This includes HQR and Joint Commission output formats.
To determine the output on a given report, the following three considerations are made in the application:
1. Is the program available in the CQMsolution license? HQR PI, HQR IQR, MIPS, AOA MORE, PCF, and/or CCBHC must be activated by CQMsolution’s XML license. If the program is not specifically licensed, it cannot be assigned to a user, and the output will not be generated.
2. Is the program assigned to the user? For each program that is active in the license, a checkbox will appear on the user edit screen (see below). Depending on your practice’s “Reporting Type,” the programs available to users will be further limited by type (Ambulatory Individual, Ambulatory Group, or Inpatient). QRDA I and QRDA III output consistent with the latest Cypress validation will be generated by default for all users (only QRDA III can be turned off). An EP (EC) user will have some or all of these output types, depending on what has been licensed:
The QRDA I output XML contains all EHI stored in CQMsolution for each patient. After queueing a report, you can download QRDA I files from the Detail screen, shown below:
3. What type of report is being run?
For EP reports: Only QRDA I, QRDA III, MIPS, AOA MORE, PCF, and CCBHC outputs are possible.
For EH reports: Only QRDA I, QRDA III, HQR PI, HQR IQR, and HQR PI IQR outputs are possible.
An EH user will have some or all of these output types, depending on what has been licensed.
Note that QRDA I files are zipped and downloaded to the CQMsolution server, not your local PC. Consult your CQMsolution User Documentation for details.