General Information & Background
2025 Testing Period
Justification for Real World Testing Approach
Our EHR system includes the Electronic Health Information (EHI) export capability certified under 170.315(b)(10). Our implementation provides a JSON-structured export containing resident demographics, insurance information, admission/discharge data, contact details, and medical record notes.
Current Usage Analysis:
- The export capability is enabled across 100% of our LTC facilities
- Approximately 5% of facilities actively use this feature
- Usage primarily occurs during:
- Resident transfers to hospitals
- Corporate compliance audits
- State survey preparations
Given this minimal usage pattern, our testing approach emphasizes:
- Tracking all production exports (estimated 1-2 exports per month across all facilities)
- Supplementing limited production data with monthly synthetic validation
- Maintaining capability readiness for all facilities
- Validating JSON structure and completeness
This approach allows us to demonstrate ongoing compliance while acknowledging the low-usage reality in our LTC facilities.
Standards Version Advancement Process (SVAP) Updates
- Standard (and version): Not applicable
- Updated certification criteria: Not applicable
- CHPL ID: Not applicable
- Date of ONC-ACB notification: Not applicable
- Date of customer notification: Not applicable
Measures Used In Overall Approach
Measure 1: Production Export Analysis
Description of Measurement/Metric:
Comprehensive tracking and analysis of all real-world JSON exports across our customer base.
Associated Certification Criteria:
170.315(b)(10) Electronic health information export.
Justification for Selected Measurement/Metric:
With only 5% facility usage, each production export provides valuable validation data. We expect approximately 12-24 total exports annually across our customer base. Each export will be analyzed for:
- JSON structure validity
- Data completeness
- Export performance
- Error conditions
Care Setting
- Long Term Care Facilities
- Skilled Nursing Facilities
Expected Outcomes
1. Export Success Rate:
{
"metrics": {
"denominator": "Total number of export attempts",
"numerator": "Successfully completed exports",
"target_rate": ">= 95%",
"expected_volume": "1-2 exports per month"
}
}
2. Data Validation:
{
"validation_points": {
"json_structure": {
"required_fields": [
"_id", "mrn", "personal_information",
"insurance_information", "admission_and_discharge",
"contact_and_address", "responsible_party_information",
"medical_record_notes", "payer_information"
]
},
"data_accuracy": "Matches source records"
}
}
Measure 2: Capability Readiness Validation
Description of Measurement/Metric:
Monthly automated testing using synthetic data to ensure export capability remains functional.
Associated Certification Criteria:
170.315(b)(10) Electronic health information export.
Justification for Selected Measurement/Metric:
With 95% of facilities not regularly using the feature, we must verify ongoing readiness through proactive testing.
Expected Outcomes
1. Monthly Validation:
{
"test_scenarios": {
"single_resident": {
"complete_record": true,
"validation_frequency": "Monthly",
"expected_success_rate": "100%"
},
"multi_resident": {
"sample_size": "10 synthetic residents",
"validation_frequency": "Monthly",
"expected_success_rate": "100%"
}
}
}
2. System Performance:
{
"metrics": {
"export_completion_time": "< 5 minutes",
"system_resource_usage": "Within normal parameters",
"error_handling": "Proper error messages and logging"
}
}
Schedule Of Key Milestones
| Key Milestones | Date/Timeframe |
|---|---|
| Configure automated testing and synthetic data generation | December 15, 2024 |
| Begin production export tracking | January 1, 2025 |
| First quarter analysis (est. 3-6 exports) | March 31, 2025 |
| Review and adjust testing protocols if needed | April 15, 2025 |
| Mid-year review (est. 6-12 exports) | July 1, 2025 |
| Update synthetic test data | August 1, 2025 |
| Capability readiness assessment | September 1, 2025 |
| Begin preparation for results reporting | November 1, 2025 |
| Final data collection | December 15, 2025 |
| Data analysis and report creation | January 15, 2026 |
| Submit Real World Testing report to ONC-ACB | March 1, 2026 |
Test Methodology
Real-World Export Testing
1. Production Export Tracking:
{
"tracking_elements": {
"per_export": {
"facility_identifier": "Anonymized facility ID",
"export_timestamp": "YYYY-MM-DD HH:MM:SS",
"export_type": ["single_resident", "multi_resident"],
"completion_status": ["success", "failure"],
"error_details": "If applicable",
"performance_metrics": {
"start_time": "Timestamp",
"end_time": "Timestamp",
"file_size": "MB",
"record_count": "Number"
}
}
}
}
2. JSON Structure Validation:
{
"validation_checks": {
"schema_validation": "Check against defined JSON schema",
"required_fields": "Verify all mandatory fields present",
"data_types": "Validate correct data types",
"nested_objects": "Verify proper object nesting"
}
}
Synthetic Testing Protocol
1. Monthly Automated Testing:
- Generate synthetic resident data
- Execute test exports
- Validate JSON structure
- Verify data completeness
- Document results
2. System Monitoring:
- Export feature availability
- System performance metrics
- Error handling validation
- Access control verification
Attestation
This Real World Testing plan is complete with all required elements for the 2025 testing period, specifically addressing minimal usage scenarios while maintaining capability across all facilities. All information in this plan is up to date and fully addresses the health IT developer's Real World Testing requirements.
- Authorized Representative Name: Asim Ranjha
- Authorized Representative Email: asim.ranjha@docnow.ai
- Authorized Representative Phone: (425) 502-0865
- Authorized Representative Signature: Asim Ranjha
- Date: October 31, 2024
