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  #11  
Old 05-06-2013, 05:16 AM
wit-man wit-man is offline
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Provider attesting for MU. We are a hospital with multiple physician practices. We have two different EHRs, one for the hospital side and one for the practice side. We use Mirth independently of any of our systems and send information from our hospital EHR to the practice EHR.

Sometimes we have to change the message that is sent and that is where we have been told it has to be certified. If it was just passing the data along, no issue, but once you manipulate it, that additional component has to be certified. This is what we were told by our attorney.

Since you are a vendor and included Mirth in your certification, I believe you should be fine because it was included as a component in your certification. However, that is not our case. Our two EHR vendors never had anything to do with Mirth so it is a separate entity.
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  #12  
Old 05-06-2013, 05:39 AM
ironbridge ironbridge is offline
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So what MU objectives will you be using mirth to attest with for both the eligible professional and eligible hospital?
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  #13  
Old 05-06-2013, 05:42 AM
wit-man wit-man is offline
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Transmission of data to other entities. For example, transmission of immunization data.
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  #14  
Old 05-06-2013, 05:49 AM
rwilson@ClaimTrak.com rwilson@ClaimTrak.com is offline
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wit-man, I would spend some time in the testing procedures and rules from the links that I posted.

Here are a few points to think about.

What are the changes that you are making to the messages from one system to another?
Do these changes affect the Results of a message or outcomes?
Is your usage of Mirth Connect contained within your company network?

There is only one case where I could see a potential issue and that would be if you are manipulating Direct Messages prior to endpoint delivery.

Outside of that I do not see anything in the requirements related to HL7 or CDA messaging that would preclude you from altering a message prior to final delivery that would affect the status MU Certification testing. The EHR that you have would still function as tested with the data provided.

There is nothing in the requirements that provides for endpoint to endpoint validation for HL7 or CDA messaging.

It sounds like you are using Mirth Connect of the exact purpose that the interoperability rule was intended for. You receive a message at the Hospital for lab results and you match the PCP for the patient and forward the message to the practice EHR. Neither of these actions would alter the functionality of the MU requirements at either EHR in my opinion.
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Old 05-06-2013, 05:57 AM
wit-man wit-man is offline
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We use this both to send to internal systems and external systems (health information exchange).

I looked at several of the destinations and as an example, in at least two of them to an HIE we move or manipulate several of the fields, including OBX and OBR fields.
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  #16  
Old 05-06-2013, 06:04 AM
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narupley narupley is online now
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I'm not a lawyer either, but I used to work at an HIE where (among other things) we would facilitate MU attestation/certification for a variety of clients. Of course we also had legal council that helped to guide us on the right track, but never once did we have to certify the integration engine the client used (whether it was Mirth Connect, Cerner Open Engine, Cloverleaf, etc.). At least, not to my knowledge.
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  #17  
Old 05-06-2013, 06:10 AM
wit-man wit-man is offline
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OK, well once again, I am back to my original predicament. On one hand, I have my lawyer telling me that I must certify my interface engine.

On the other hand, I have others saying no I don't. Excuse me for about 10 minutes while I tear my hair out.

Narupley, were you just passing the information through or were you making any changes?
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  #18  
Old 05-06-2013, 06:32 AM
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Quote:
Originally Posted by wit-man View Post
OK, well once again, I am back to my original predicament. On one hand, I have my lawyer telling me that I must certify my interface engine.

On the other hand, I have others saying no I don't. Excuse me for about 10 minutes while I tear my hair out.

Narupley, were you just passing the information through or were you making any changes?
In most cases we were making changes to the data being passed through the engine. In some cases the client also used their own integration engine, and likely made plenty more changes then too.
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Always include what Mirth Connect version you're working with. Also include (if applicable) the code you're using and full stacktraces for errors (use CODE tags). Posting your entire channel is helpful as well; make sure to scrub any PHI/passwords first.


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- You just bar.
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  #19  
Old 05-06-2013, 07:45 AM
rwilson@ClaimTrak.com rwilson@ClaimTrak.com is offline
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The rule that is being cited by your legal council would be of great insight to everyone I think.

I review the product that you referenced in your link and it appears to be a canned solution that provides very specific results and that would appear to be the interest in MU Certification then just the usage of the product or the manipulation of a message or sending out a message.
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  #20  
Old 05-07-2013, 04:55 AM
wit-man wit-man is offline
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I am getting more information that seems to support everyone's claim that it doesn't have to be certified. Might be time to have another chat with our attorney. I will post anything I find out. Thanks.
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