MDVita Costs and Limitations Statement

MDVita version 25 is 2015 Edition compliant and has been certified by an ONC-ACTB in accordance with the applicable certification criteria adopted by the Secretary of the U.S. Department of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services.

MDVita version 25 was certified in the following criteria:

170.315 (a)(1): Computerized Provider Order Entry (CPOE) - Medications

170.315 (a)(2): CPOE - Laboratory

170.315 (a)(3): CPOE - Diagnostic Imaging                                                              

170.315 (a)(4): Drug-Drug, Drug-Allergy Interaction Checks for CPOE

170.315 (a)(5): Demographics

170.315 (a)(6): Problem List

170.315 (a)(7): Medication List

170.315 (a)(8): Medication Allergy List

170.315 (a)(9): Clinical Decision Support

170.315 (a)(11): Smoking Status

170.315 (a)(12): Family Health History

170.315 (a)(13): Patient-Specific Education Resources

170.315 (a)(14): Implantable Device List

170.315 (b)(1): Transitions of Care

170.315 (b)(2): Clinical Information Reconciliation and Incorporation

170.315 (b)(4): Common Clinical Data Set summary record – create

170.315 (b)(5): Common Clinical Data Set summary record – receive

170.315 (b)(6): Data Export

170.315 (c)(1): Clinical Quality Measures - Record and Export

170.315 (c)(2): Clinical Quality Measures - Import and Calculate

170.315 (c)(3): Clinical Quality Measures - Report

170.315 (d)(1): Authentication, Access Control, Authorization

170.315 (d)(2): Auditable Events and Tamper-Resistance

170.315 (d)(3): Audit Report(s)

170.315 (d)(4): Amendments

170.315 (d)(5): Automatic Access Time-out

170.315 (d)(6): Emergency Access

170.315 (d)(7): End-User Device Encryption

170.315 (d)(8): Integrity

170.315 (d)(9): Trusted Connection

170.315 (e)(1): View, Download, and Transmit to 3rd Party

170.315 (e)(2): Secure Messaging

170.315 (e)(3): Patient Health Information Capture

170.315 (f)(1): Transmission to Immunization Registries

170.315 (f)(2): Transmission to Public Health Agencies - Syndromic Surveillance

170.315 (g)(2): Automated Measure Calculation

170.315 (g)(3): Safety-Enhanced Design

170.315 (g)(4): Quality Management System

170.315 (g)(5): Accessibility-Centered Design

170.315 (g)(6): Consolidated CDA Creation

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

170.315 (h)(1): Direct Project

 

Costs and Limitations

 

Capability

Description of Capability

Costs or Fees

Types of costs or fees that a user may be required to pay to purchase, license, implement, maintain, upgrade, use, or otherwise enable and support the use of the implementation or use of the capability -OR- in connection with the data generated in the course using the capability

Contractual Limitations

Limitations of a contractual nature (including developer policies and other business practices) that a user may encounter in the implementation or use of the capability -OR- in the connection with the data generated in the course of using the capability

Technical or Practical Limitations

Limitations of a technical or practical nature that a user may encounter that could prevent or impair the successful implementation, configuration, maintenance, support or use of the capability -OR- prevent or limit the use, exchange or portability of any data generated in the course of using the capability

Cloud-based Solution Contract

A yearly contractual agreement per Provider/NPI with automatic renewal option

(a) One time implementation fee applies, that includes limited training,

(b) Monthly recurrent fee per Provider/NPI

(c) An additional onetime fee may apply for data import/migration procedures if client needs so

(d) An additional monthly fee may apply for document storage utilization above the limit set by contractual agreement

A contract agreement is required and acceptance of additional terms and conditions. Early contract cancellation fees may apply

All providers/NPI must have an active license.

AMA (American Medical Association) CPT codes

Adding support of CPT codes to MDVita functions

License for using AMA CPT procedure codes is needed. Provider is responsible for purchasing AMA CPT codes license.

https://www.ama-assn.org/

AMA contractual agreement, terms and condition apply

MDVita does not come with CPT codes loaded. Providers are responsible for purchasing codes from AMA and loading into MDVita

MDVita Internet Mailbox add-on

Adds secure Internet Email to the EHR

Monthly recurrent fee per mail box applies

May be added and cancelled at any time. Optional component

Limited storage space per mail box

MDVita Box File Repository add-on

Adds secure Web and SFTP access to a file repository used for data storage or secure data exchange with third parties

Monthly recurrent fee per storage account applies

May be added and cancelled at any time Optional component

Limited storage space per account

170.315 (a)(1): Computerized Provider Order Entry (CPOE) - Medications

Record, change, and access a patient’s medication orders

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (a)(2): CPOE - Laboratory

Record, change, and access a patient’s laboratory orders

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (a)(3): CPOE - Diagnostic Imaging

 

Record, change, and access a patient’s imaging orders

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (a)(4): Drug-Drug, Drug-Allergy Interaction Checks for CPOE

 

Drug-drug and drug-allergy interventions are automatically provided when ordering a medication during CPOE

No costs or fees

No contractual limitations

Medispan drugs data used for interactions. Database is updated once a month

170.315 (a)(5): Demographics

 

Record patient demographic data

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (a)(6): Problem List

 

Record, change, and access a patient’s active problem list

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (a)(7): Medication List

 

Record, change, and access a patient’s medication list

No costs or fees

No contractual limitations

Medispan drugs data used for monograph information, NDC and RXNORM identifications. Data updated monthly

170.315 (a)(8): Medication Allergy List

 

Record, change, and access a patient’s medication allergy list

No costs or fees

No contractual limitations

Medispan drugs data used for allergen identifications and Drugs active components interactions. Medispan data updated monthly

170.315 (a)(9): Clinical Decision Support

 

CDS Intervention Interaction, CDS Configuration, Evidence-based Decision Support Intervention. Linked Referential CDS (Diagnostic and Therapeutic Reference Resources) using HL7 “Infobutton” Standard.

Interventions and reference resources are available for the elements and their combinations: Problem List, Medication List, Medication allergy list, patient’s demographics (date of birth and gender), Laboratory test results, and Vital signs.

No costs or fees

No contractual limitations

Medline Plus is used as the reference resources source. Availability depend on the https://Medlineplus.gov site to be online.

There are 7 core interventions built-in in the EHR. The user may create new customized interventions using the Risk Category interaction module.

170.315 (a)(11): Smoking Status

 

Record, change, and access a patient’s smoking status

No costs or fees

No contractual limitations

Smoking Status entries are restricted to the list of standard SNOMED CT entries/codes

170.315 (a)(12): Family Health History

 

Record, change, and access family health history for first-degree family members as structured data

No costs or fees

No contractual limitations

Uses SNOMED concepts at a minimum September 2017 release

170.315 (a)(13): Patient-Specific Education Resources

 

Identify patient-specific education resources based on data included in the patient’s problem list and medication list using HL7 “Infobutton” Standard

No costs or fees

No contractual limitations

Medline Plus is used as the source of Patient educational materials. Availability depend on the https://Medlineplus.gov site to be online.

Educational material may be provided in patient’s preferred language other than English when available at MedlinePlus.

170.315 (a)(14): Implantable Device List

 

Record, parse, and access unique device identifier (UDI) attributes. Enable users to change the status of the UDI

No costs or fees

No contractual limitations

Access GUDID web online service is used to retrieve device registration data. Availability of the feature is limited to the third party site to be online

170.315 (b)(1): Transitions of Care

 

Send and receive transitions of care via edge protocol, validate and display CCDAs, and create transition of care summaries for referrals

A Direct mailbox yearly fee applies per NPI/Provider

EMRDIRECT terms and conditions apply

EMRDIRECT service provider is used to send and receive emails using the Edge protocol

170.315 (b)(2): Clinical Information Reconciliation and Incorporation

User matches to correct patient in health IT module and reconciles clinical information (medications, medication allergies, and problem list) based upon the receipt of C-CDA 1.1, and C-CDA 2.1

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (b)(4): Common Clinical Data Set summary record – create

User generates C-CDA 2.1 documents based on patient clinical data

No costs or fees

No contractual limitations

Procedure codes use the standard §170.207 (a)(4) – SNOMED CT, US Edition at least September 2017 edition

Medication NDC codes are translated to closest RXNORM available. Map may not be exist and manual determination may be needed

170.315 (b)(5): Common Clinical Data Set summary record – receive

User imports/receive all required Continuity of Care Document clinical data elements

No costs or fees

No contractual limitations

Procedure codes are incorporated in their original SNOMED codes, no CPT translation done.

Medication RXNORM codes are translated to NDC codes using Medispan mappings. Manual intervention may be needed when mapping is not found

170.315 (b)(6): Data Export

User can configure an export clinical summary of patients any time the user chooses

No costs or fees

No contractual limitations

The user is limited to a maximum of 4 recurrent instances of a schedule.

170.315 (c)(1,2,3): Clinical Quality Measures - Record and Export, Import and Calculate, and Report

User records data into patient charts, including exclusions and exceptions, which is necessary to calculating each CQM. User exports valid QRDA Category I files on-demand based without needing developer assistance.

Health IT module can electronically:

-          Import HL7 QRDA Category I files for all data needed to calculate each of the certified CQMs

-          Calculate each and every CQM

User generates data files formatted to the HL7 QRDA Category I and HL7 QRDA Category III

No costs or fees

No contractual limitations

EHR uses a certified popHealth instance (at least version 5.1) for measure calculations.

Two years of measure versions are loaded at any given time

170.315 (d)(1): Authentication, Access Control, Authorization

Authenticate user and establish permitted user access

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (d)(2): Auditable Events and Tamper-Resistance

Record actions related to electronic health information. Audit log records the audit log status and/or the encryption status.

For all permissible actions, the audit log function records the following data: Date and Time, Patient Identification, User Identification, Type of Action , and identification of patient data accessed

No costs or fees

No contractual limitations

User cannot disable Audit recordings

170.315 (d)(3): Audit Reports

User generates audit report for a specific time period and sorts audit log entries

No costs or fees

No contractual limitations

User needs to place a work order to obtain details of data elements changed and/or forensic historical research of a record

170.315 (d)(4): Amendments

Ability to append an accepted amendment and a denied amendment request, along with denial, within patient record or add a link indicating location of amendment(s).

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (d)(5): Automatic Access Time-out

Authorized user configures a defined period of inactivity for automatic access time-out

No costs or fees

No contractual limitations

Cloud deployment is set to 30 minutes and an EHR user cannot change the setting

170.315 (d)(6): Emergency Access

Enable emergency access for identified user that can access health information during an emergency

Emergency access authorizations are limited to a set of identified users

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (d)(7): End-User Device Encryption

Electronic health information locally stored on end-user device is encrypted after use of technology on the device stops

No costs or fees

No contractual limitations

Electronic health information is NOT locally stored on end-user device after use of technology on the device stops

170.315 (d)(8): Integrity

Health IT product can generate a hash over a message containing health information.

Health IT product can receives electronically exchanged health information and validate message digest

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (d)(9): Trusted Connection

 

Health IT product implements Transport-Level security: Establishing a trusted connection in accordance with the standards specified at §170.210(a)(2) and §170.210(c)(2)

No costs or fees

No contractual limitations

Cloud servers control the minimum set of cypher algorithms allowed to establish a connection by the client using SSL TLS 1.2, SHA2 or higher and  FIPS140-2

170.315 (e)(1): View, Download, and Transmit to 3rd Party

 

Patient (and their authorized representatives) use internet-based technology to view, download and transmit the patient’s health information

Two options available:

(a) MDVita offers a certified Patient Portal for a cost to the provider

(b) A non-certified Microsoft HealthVault portal is available at no cost

(a) MDVita Patient Portal terms and conditions apply

(b) Microsoft HealthVault terms and conditions apply

Microsoft HealtVault is not a MU2-2015 certified product and does not meet (e)(1) criteria

170.315 (e)(2): Secure Messaging

 

Authenticated user sends/receives secure message to/from an authenticated patient

Two options available:

(a) MDVita offers a certified Patient Portal for a cost to the provider. (e)(2) Secure Messaging is included at no cost.

(b) A non-certified Microsoft HealthVault portal is available at no cost and (e)(2) Secure messaging requires obtaining a DIRECT mail box from EMRDIRECT at a cost to the provider

(a) MDVita Patient Portal terms and conditions apply

(b) Microsoft HealthVault terms and conditions apply

The HealthVault option is subject to Microsoft availability

170.315 (e)(3): Patient Health Information Capture

 

Enable a user to identify, record, and access information directly and electronically shared by a patient (or authorized representative)

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (f)(1): Transmission to Immunization Registries

 

Create immunization information for electronic transmission.

Record immunization content and generate the HL7 v2.5.1 Z22 VXU immunization information messages

 

No costs or fees

State terms and condition apply

State registration is needed by the provider

170.315 (f)(2): Transmission to Public Health Agencies - Syndromic Surveillance

 

Implement standards for Syndromic Surveillance content

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (g)(2): Automated Measure Calculation

 

IT module electronically records the numerator and denominator and resulting percentage for each meaningful use/Advancing Care Information (ACI) objective with a percentage-based measure and create a report that includes the numerator, denominator and resulting percentage

No costs or fees

No contractual limitations

Health IT supports EHR Incentive Programs: Modified Stage 2, Stage 3, ACI-Transition, and ACI.

Measure calculations are automatically refreshed overnight, but the user may re-calculate on demand.

 

170.315 (g)(3): Safety-Enhanced Design

 

User-Centered Design process is applied during the design and development of all product capabilities

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (g)(4): Quality Management System

 

The use of a Quality Management System (QMS) must be identified in the development, testing, implementation, and maintenance for each capability

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (g)(5): Accessibility-Centered Design

 

Identify accessibility-centered design as applied to each capability of the product

No costs or fees

No contractual limitations

MDVita does not use any health IT accessibility-centered design

170.315 (g)(6): Consolidated CDA Creation

 

User generates C-CDA R2.1 documents

No costs or fees

No contractual limitations

No technical or practical limitations

170.315 (g)(7,8,9): Application Access - Patient Selection, Data Category Request, and All Data Request

 

Receives API request for a patient with enough data to identify the patient (e.g. Demographics),

User makes an API call (using a Patient ID or other token) to get data according to each CCDS category,

User makes an API request for a C-CDA R2.1 Continuity of Care Document for a Patient using a Patient ID or other token based upon: a specific date request; and a date range

It requires enrollment and there is a recurrent yearly fee for using the feature

EHRDIRECT terms and condition apply

Requires the use of EHRDIRECT phiQuery services and subject to EHRDIRECT availability and implementation limitations

170.315 (h)(1): Direct Project

 

Ability to send health information in accordance with the standards specified in §170.202(a)(2), including formatted only as a “wrapped” message

 

It requires enrollment and there is a recurrent yearly fee for using the feature

EHRDIRECT terms and condition apply

Requires the use of EHRDIRECT phiMail services and subject to EHRDIRECT availability and implementation limitations.

Emails are received in 50 minutes intervals