1. Vendor Orientation Meaningful Use Informatics Division

2. Agenda 1. OSDH 2. Registration of Intent 3. Onboarding Process 4. Acknowledgement 5. Resources / FAQs

3. Declaration The Oklahoma State Department of Health (OSDH) has been participating with Meaningful Use since July 1, 2012 and will continue for Stage 2. OSDH has the capacity to accepts immunization data, reportable lab results and cancer case information. Stages 1 and 2 OSDH does not currently accept syndromic surveillance data. OSDH requires PHINMS for message transport. Stage 2 OSDH is not accepting specialized disease registry data. To meet Stage 2 meaningful Use requirements, Eligible Providers/Hospitals must submit data for at least 90 days during the first EHR reporting period.

4. Public Health Agency Requirements Registration Register Providers that plan to test for MU1 objectives and/or submit public health data for MU2 objectives On-Boarding Test and validate on-going submissions from Providers Acknowledgement Provide written communication to Providers that have achieved ongoing submission of data relevant to public health for MU2 objectives

5. Immunization Registries Stage 1 vs. Stage 2 Eligible Professionals (EPs) Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) ObjectiveMeasure Stage 1 Capability to submit electronic data to immunization registries immunization information systems and actual submission according to applicable law and practice. Successful ongoing submission of electronic immunization data from CEHRT to an immunization registry or immunization information system for the entire EHR reporting period Stage 2 Capability to submit electronic data to immunization registries immunization information systems and actual submission according to applicable law and practice. Successful ongoing submission of electronic immunization data from Certified EHR Technology to an immunization registry or immunization information system for the entire EHR reporting period

6. Laboratory Reporting Stage 1 vs. Stage 2 Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) ObjectiveMeasure Stage 1 Capability to submit electronic reportable laboratory results to public health agencies, except where prohibited, and in accordance with applicable law and practice. Performed at least one test of certified EHR technologys capacity to provide electronic submission of reportable lab results to public health agencies and follow-up submission if the test is successful Stage 2 Capability to submit electronic reportable laboratory results to public health agencies, except where prohibited, and in accordance with applicable law and practice. Successful ongoing submission of electronic reportable laboratory results from Certified EHR Technology to public health agencies for the entire EHR reporting period as authorized, and in accordance with applicable State law and practice

7. Cancer Case Reporting Stage 1 vs. Stage 2 Eligible Professionals (EPs) MeasureObjective Stage 1 New Stage 2 Capability to identify and report cancer cases to a State cancer registry, except where prohibited, and in accordance with applicable law and practice Successful ongoing submission of cancer case information from Certified EHR Technology to a cancer registry for the entire EHR reporting period

8. REGISTRATION OF INTENT

9. Pre-Registration Prior to registration with OSDH, providers EHR must be 2014 Certified EHR Technology (CEHRT) All Electronic Health Records (EHRs) must be 2014 Certified EHR Technology (CEHRT) certified by FY/CY 2014. Information about obtaining certification is available on the Office of the National Coordinator (ONC) website at http://www.healthit.gov/policy-researchers- implementers/about-certification. http://www.healthit.gov/policy-researchers- implementers/about-certification

10. www.health.ok.gov

11. Registering with OSDH Immunization Laboratory Results Cancer Cases Providers need to register through the OSDH website Registration forms are specific to the provider type, eligible professional or eligible hospital Once submitted; confirmation email will be sent and provider will wait in a queue pending an invitation from OSDH to attend Webinar for On-Boarding

12. ON-BOARDING OSDH will send an invitation to register and attend the On-Boarding Webinar Various dates/times will be provided; Choose and register to attend Vendor, Provider, On-site IT, will be required to attend. Additional staff who are involved with the meaningful use effort are encouraged to attend.

13. Post Webinar After attending the On-Boarding Webinar and prior to testing, next steps should be: NIST Validation Set up PHINMS connection Register OIDs Facility OIDs EPs address should match the registered Facility OID they are using Application OIDs

14. MESSAGING Requirements Structure Validation Connectivity Content Validation

15. Message Requirements OSDH only accepts HL7 v2.5.1 messaging for the Meaningful Use attestation. Immunization Messaging HL7 v2.5.1 Immunization Implementation Guide Release 1.4 Errata information for IG Release 1.4 Laboratory Messaging HL7 v2.5.1 ORU message specification ELR 2.5.1 Clarification Document for EHR Technology Certification v1.2 Cancer Case Messaging Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries, HL7 Clinical Document Architecture (CDA) LOINC and SNOMED code can be found at: http://phinvads.cdc.gov/http://phinvads.cdc.gov/

16. OIDs You need to register your OID (Unique Object Identifier) and use Sending Application OID for MSH-3 and Sending Facility OID for MSH-4 from HL7 OID Registry: http://www.hl7.org/oid/index.cfm. http://www.hl7.org/oid/index.cfm HL7 Implementation Guidance for creating and registering your OIDs can be found: http://www.hl7.org/implement/standards/produ ct_brief.cfm?product_id=210. http://www.hl7.org/implement/standards/produ ct_brief.cfm?product_id=210

17. Example MSH-3 |Name of Sending Application^Your Sending Application OID^ISO | MSH-4 |Name of Sending Facility^Your Sending Facility OID^ISO| MSH-5 and MSH-6 OSDH OIDs OSDH Receiving Application OID for MSH-5 is |OSDHMessaging^2.16.840.1.113883.3.1014.4^ISO| OSDH Receiving Facility OID for MSH-6 is |OSDH^2.16.840.1.113883.3.1014^ISO|.

18. Message Testing This will allow you to correct most mistakes: MQF Validation Tool: https://phinmqf.cdc.gov/default.aspxhttps://phinmqf.cdc.gov/default.aspx Validation by MQF: MSH-2 should be: MSH|^~\&| NIST Validation Tool: ** Do not use a message with real PHI data when using this tool online. This tool can be downloaded and used locally for real PHI data. ** Validation by NIST: MSH-2 should include the # sign as shown in this example: MSH|^~\&#| ELR (ORU): http://hl7v2-elr-testing.nist.gov/mu-elr/http://hl7v2-elr-testing.nist.gov/mu-elr/ There are 30 test cases for ELR. You will need to test your file by these Test Case Types. Immunization (VXU): http://hl7v2-iz-testing.nist.gov/mu-immunization/http://hl7v2-iz-testing.nist.gov/mu-immunization/ To find validation tables (or value set): http://www.hl7.org/special/committees/vocab/v26_appendix_a.pdf http://www.hl7.org/special/committees/vocab/v26_appendix_a.pdf

19. For Providers Resending Second Stage 1 Meaningful Use Test Message for Failure. The Oklahoma State Department of Health (OSDH) is encouraging all providers who have submitted a Meaningful Use (MU) Stage 1 test immunization or reportable disease laboratory result messages failing OSDH message validation to make the necessary system modifications and resubmit. With successful MU Stage 1 test message validation and secure messages transport capabilities, Oklahoma providers will be better prepared to meet attestation requirements for MU Stage 2. If system modifications are not possible following a failed Stage 1 test message submission, the OSDH understands, for the purpose of meeting MU Stage 1 attestation requirements, a second message failure will occur. In the event that a provider has submitted one failed test message, makes no modifications to their system, and intends to submit a second test message for MU Stage 1 that will also fail, there is no need to submit the second test message to OSDH for validation.

20. Connectivity/Transport o PHINMS (Public Health Information Network Messaging System) is the CDC-provided software that fulfills this critical need for public health. o PHINMS can securely send and receive any message type over the Internet, facilitating interoperability among myriad public health information systems. o PHINMS is available at no cost through CDC. You can request the software, download the technical and implementation guides by clicking here. clicking here o Technical Support is available through the CDC PHIN Help Desk at PHINTech@cdc.gov or calling 1-800-532-9929 option 2. PHINTech@cdc.gov

21. PHINMS 1.Get username and password to Download CDC provided PHINMS software 2.Install PHINMS software on Server with internet access 3.Purchase digital certificate 4.Install certificate and exchange with OSDH 5.Configure PHINMS 1. General configuration 2. Route(s) and Folder Polling 6.Exchange CPA file 7.Contact OSDH to establish service action pair 8.Validate PHINMS connection by sending test text message

22. Message Submission When you submit a HL7 v2.5.1 message by email or by PHINMS to OSDH indicate if it has passed the test on the validation tools, or if not, what the remaining issues are, and: For VXU: list the Sending Facilities for which you want attestation by email For ORU: list the Sending Facilities and the test case you are testing for by email For CDA: list the Sending Facilities and the test case you are testing for by email

23. Message Submission With test data: For validation should populate all the R (Required), RE (Required if it is known or available) fields and CE (Conditional Empty) fields. NO personal health information (PHI) can be sent by email for validation. With real PHI data: Should have all the R fields populated, RE fields populated if the data is available, and CE fields populated Do not send in an unsecured email. It should be only sent by PHINMS or secure email (encrypted).

24. Acknowledgement Acknowledgement is the official communication from OSDH that affirm a Provider has successfully submitted public health data for a MU2 public health objective. MU1- one single test message MU2- provide ongoing submission of actual patient data OSDH will provide a listing of EPs/CAHs/EHs acknowledgement via the OSDH website.

25. Contacts OSDH Public Health Informatics Division Meaningful Use Team (405)271-3751 Meaningfuluse@health.ok.gov