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					                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                         Capability
DC.1.1.1     Record Management              Identify and Maintain a Patient Record      The system SHALL create a single logical          A single record is needed for legal
                                                                                        record for each patient.                          purposes, as well as to organize it
                                                                                                                                          unambiguously for the provider. Health
                                                                                                                                          information is captured and linked to the
                                                                                                                                          patient record. Static data elements as
                                                                                                                                          well as data elements that will change
                                                                                                                                          over time are maintained. The patient is
                                                                                                                                          uniquely identified, after which the
                                                                                                                                          record is tied to that patient. Combining
                                                                                                                                          information on the same patient, or
                                                                                                                                          separating information where it was
                                                                                                                                          inadvertently captured for the wrong
                                                                                                                                          patient, maintains health information for
                                                                                                                                          a single patient. In




                                                                                                                                          the process of creating a patient record, it
                                                                                                                                          is at times advantageous to replicate
                                                                                                                                          identical information across multiple
                                                                                                                                          records, so that such data does not have
                                                                                                                                          to be re-entered. For example, when a
                                                                                                                                          couple (i.e., husband and wife) are
                                                                                                                                          registered as new patients, the address,
                                                                                                                                          guarantor, and insurance data may be
                                                                                                                                          propagated from the record of one
                                                                                                                                          spouse to the other without having to re-
                                                                                                                                          enter the data.



DC.1.1.2     Record Management              Identify and Maintain a Patient Record      The system SHALL provide the ability to
                                                                                        create a record for a patient when the
                                                                                        identity of the patient is unknown.


DC.1.1.3     Record Management              Identify and Maintain a Patient Record      The system SHALL provide the ability to
                                                                                        store more than one identifier for each
                                                                                        patient record.

DC.1.1.4     Record Management              Identify and Maintain a Patient Record      The system SHALL associate key identifier
                                                                                        information (e.g., system ID, medical
                                                                                        record number) with each patient record.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                 Page 1 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.1.1.5     Record Management              Identify and Maintain a Patient Record      The system SHALL provide the ability to
                                                                                        uniquely identify a patient and tie the
                                                                                        record to a single patient.



DC.1.1.6     Record Management              Identify and Maintain a Patient Record      The system SHALL provide the ability,
                                                                                        through a controlled method, to merge or
                                                                                        link dispersed information for an
                                                                                        individual patient upon recognizing the
                                                                                        identity of the patient.


DC.1.1.7     Record Management              Identify and Maintain a Patient Record      IF health information has been mistakenly
                                                                                        associated with a patient, THEN the
                                                                                        system SHALL provide the ability to mark
                                                                                        the information as erroneous in the
                                                                                        record of the patient in which it was
                                                                                        mistakenly associated and represent that
                                                                                        information as erroneous in all outputs
                                                                                        containing that information.




DC.1.1.8     Record Management              Identify and Maintain a Patient Record      IF health information has been mistakenly
                                                                                        associated with a patient, THEN the
                                                                                        system SHALL provide the ability to
                                                                                        associate it with the correct patient.
                                                                                        erroneous in the record of the patient in
                                                                                        which it was mistakenly associated and
                                                                                        represent that information as erroneous
                                                                                        in all outputs containing that information.




DC.1.1.9     Record Management              Identify and Maintain a Patient Record      The system SHALL provide the ability to
                                                                                        retrieve parts of a patient record using a
                                                                                        primary identifier, secondary identifiers,
                                                                                        or other information which are not
                                                                                        identifiers, but could be used to help
                                                                                        identify the patient.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 2 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                      Capability
DC.1.1.10     Record Management              Identify and Maintain a Patient Record      The system SHALL provide the ability to           [NEED TO DISCLOSE WHAT BCHSD POLICY
                                                                                         obsolete, inactivate, nullify, destroy and        IS]
                                                                                         archive a patient's record in accordance
                                                                                         with local information which are not
                                                                                         identifiers, but could be used to help
                                                                                         identify the patient.


DC.1.1.11     Record Management              Identify and Maintain a Patient Record      IF related patients register with any
                                                                                         identical data, THEN the system MAY
                                                                                         provide the ability to propagate that data
                                                                                         to all their records.


DC.1.2.1      Record Management              Manage Patient Demographics                 The system SHALL capture demographic Capture and maintain demographic
                                                                                         information as part of the patient record. information. Where appropriate, the data
                                                                                                                                    should be clinically relevant and
                                                                                                                                    reportable. Contact information including
                                                                                                                                    addresses and phone numbers, as well as
                                                                                                                                    key demographic information such as
                                                                                                                                    date of birth, gender, and other
                                                                                                                                    information is stored and maintained for
                                                                                                                                    unique patient identification, reporting
                                                                                                                                    purposes and for the provision of care.
                                                                                                                                    Patient demographics are captured and
                                                                                                                                    maintained as discrete fields (e.g., patient
                                                                                                                                    names and addresses) and may be
                                                                                                                                    enumerated, numeric or codified.




                                                                                                                                           Key patient identifiers are shown on all
                                                                                                                                           patient information output (such as name
                                                                                                                                           and ID# on each screen of a patient's
                                                                                                                                           record). The system will track who
                                                                                                                                           updates demographic information, and
                                                                                                                                           when the demographic information is
                                                                                                                                           updated.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 3 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                       Capability
DC.1.2.2     Record Management              Manage Patient Demographics               The system SHALL store and retrieve
                                                                                      demographic information as discrete
                                                                                      data.

DC.1.2.3     Record Management              Manage Patient Demographics               The system SHALL provide the ability to
                                                                                      retrieve demographic data as part of the
                                                                                      patient record.

DC.1.2.4     Record Management              Manage Patient Demographics               The system SHALL provide the ability to
                                                                                      update demographic data.



DC.1.2.5     Record Management              Manage Patient Demographics               The system SHALL provide the ability to
                                                                                      report demographic data.

DC.1.2.6     Record Management              Manage Patient Demographics               The system SHALL store historical values
                                                                                      of demographic data over time.


DC.1.2.7     Record Management              Manage Patient Demographics               The system SHALL present a set of patient
                                                                                      identifying information at each
                                                                                      interaction with the patient record.



DC.1.3.1     Record Management              Capture Data and Documentation from       The system SHALL provide the ability to           External sources are those outside the
                                            External Clinical Sources                 capture external data and                         EHR system, including clinical,
                                                                                      documentation.                                    administrative, and financial information
                                                                                                                                        systems, other EHR systems, PHR
                                                                                                                                        systems, and data received through
                                                                                                                                        health information exchange networks.
                                                                                                                                        Mechanisms are available for capturing
                                                                                                                                        and incorporating external clinical data
                                                                                                                                        and documentation. This covers all types
                                                                                                                                        of data and documents received by the
                                                                                                                                        nursing facility that would typically be
                                                                                                                                        incorporated into a medical record,
                                                                                                                                        including but not limited to faxes, referral
                                                                                                                                        authorizations, consultant reports,




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                 Page 4 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                       Capability
                                                                                                                                        and patient/resident correspondence of a
                                                                                                                                        clinical nature. Intrinsic to the concept of
                                                                                                                                        electronic health records is the ability to
                                                                                                                                        exchange health information with other
                                                                                                                                        providers of health care services. Health
                                                                                                                                        information from these external sources
                                                                                                                                        needs to be received, stored in the
                                                                                                                                        patient record, and displayed upon
                                                                                                                                        request.




                                                                                                                                        Data incorporated through these
                                                                                                                                        mechanisms is presented alongside
                                                                                                                                        locally captured documentation and
                                                                                                                                        notes wherever appropriate.


DC.1.3.2     Record Management              Capture Data and Documentation from       IF lab results are received through an            Lab results received through an electronic
                                            External Clinical Sources                 electronic interface, THEN the system             interface -- This information is to be
                                                                                      SHALL receive and store the data                  received and stored in the resident record
                                                                                      elements into the patient record.                 as discrete data, which means that each
                                                                                                                                        separate element of the data needs to be
                                                                                                                                        stored in is own field. Therefore, if lab
                                                                                                                                        results are received through an electronic
                                                                                                                                        interface, the results are received in the
                                                                                                                                        EHR and the lab test name, result (value),
                                                                                                                                        and unit of measure are correctly
                                                                                                                                        displayed as discrete data (vs. report
                                                                                                                                        format).




DC.1.3.3     Record Management              Capture Data and Documentation from       IF lab results are received through an
                                            External Clinical Sources                 electronic interface, THEN the system
                                                                                      SHALL display them upon request.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                 Page 5 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
DC.1.3.4     Record Management              Capture Data and Documentation from       The system SHALL provide the ability to           Scanned documents received and stored
                                            External Clinical Sources                 receive, store and display scanned                as images (i.e., power of attorney forms,
                                                                                      documents as images.                              Living wills, etc.) -- These scanned
                                                                                                                                        documents are indexed and can be
                                                                                                                                        retrieved based on the document type,
                                                                                                                                        date of the original document, and the
                                                                                                                                        date of scanning.



DC.1.3.5     Record Management              Capture Data and Documentation from       The system SHALL provide the ability to
                                            External Clinical Sources                 index and retrieve scanned documents as
                                                                                      images based on the document type, the
                                                                                      date of the original document and the
                                                                                      date of scanning.


DC.1.3.6     Record Management              Capture Data and Documentation from       The system MAY provide the ability to             Clinical images from an external source
                                            External Clinical Sources                 store imaged documents or reference the           (i.e., radiographic images, digital images
                                                                                      imaged documents via links to imaging             from a diagnostic scan or graphical
                                                                                      systems.                                          images) -- These images may be stored
                                                                                                                                        within the system or be provided through
                                                                                                                                        direct linkage to an external source such
                                                                                                                                        as a hospital PACS system.



DC.1.3.7     Record Management              Capture Data and Documentation from       The system SHOULD provide the ability to          Medication detail (i.e., a medication
                                            External Clinical Sources                 receive, store and display clinical result        history) from an external source such as a
                                                                                      images (such as radiologic images)                retail pharmacy, the patient, or another
                                                                                      received from an external source.                 provider -- While the medication detail
                                                                                                                                        includes the medication name, strength,
                                                                                                                                        and SIG, this does not imply that the data
                                                                                                                                        will populate the medication module.




DC.1.3.8     Record Management              Capture Data and Documentation from       The system SHOULD provide the ability to
                                            External Clinical Sources                 receive, store and display other forms of
                                                                                      clinical results (such as wave files of EKG
                                                                                      tracings) received from an external
                                                                                      source.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                               Page 6 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                    Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
DC.1.3.9     Record Management              Capture Data and Documentation from        The system SHALL provide the ability to           Standards-based structured, codified data
                                            External Clinical Sources                  receive, store and present medication             (such as a Continuity of Care Record with
                                                                                       details from an external source.                  SNOMED CT)




DC.1.4.1     Record Management              Capture Patient-Originated Data            The system SHALL capture and explicitly           Capture and explicitly label patient
                                                                                       label patient- originated data.                   originated data, link the data source with
                                                                                                                                         the data, and support provider
                                                                                                                                         authentication for inclusion in patient
                                                                                                                                         health record. It is critically important to
                                                                                                                                         be able to distinguish clinically authored
                                                                                                                                         and authenticated data from patient-
                                                                                                                                         originated data that is either provided by
                                                                                                                                         the patient for inclusion in the EHR or
                                                                                                                                         entered directly into the EHR by the
                                                                                                                                         patient. Patient-originated data intended
                                                                                                                                         for use by providers will be available for
                                                                                                                                         their use.




                                                                                                                                         Patient-originated data may also be
                                                                                                                                         captured by devices and transmitted for
                                                                                                                                         inclusion into the electronic health
                                                                                                                                         record. Data entered by any of these
                                                                                                                                         must be stored with source information.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                 Page 7 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                    Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
                                                                                                                                         A provider must be able to indicate they
                                                                                                                                         have verified the accuracy of patient-
                                                                                                                                         originated data (when appropriate and
                                                                                                                                         when a verification source is available) for
                                                                                                                                         inclusion in the patient record. Such
                                                                                                                                         verification does not have to occur at
                                                                                                                                         each individual data field and can be at a
                                                                                                                                         higher level of the data.




DC.1.4.2     Record Management              Capture Patient-Originated Data            The system SHALL provide the ability to
                                                                                       capture patient originated data including,
                                                                                       but not limited to, demographics, past
                                                                                       medical history, medications, and
                                                                                       allergies.


DC.1.4.3     Record Management              Capture Patient-Originated Data            IF the system SHALL provides the ability
                                                                                       for direct entry by the patient, THEN the
                                                                                       system SHALL explicitly label the data as
                                                                                       patient entered.


DC.1.4.4     Record Management              Capture Patient-Originated Data            The system SHALL capture and label the
                                                                                       source of clinical data provided on behalf
                                                                                       of the patient.


DC.1.4.5     Record Management              Capture Patient-Originated Data            The system SHALL present patient-
                                                                                       originated data for use by care providers.



DC.1.4.6     Record Management              Capture Patient-Originated Data            The system SHALL provide the ability for a
                                                                                       provider to indicate they have verified the
                                                                                       accuracy of patient-originated data (when
                                                                                       appropriate and when a verification
                                                                                       source is available) for inclusion in the
                                                                                       patient record.


DC.1.4.7     Record Management              Capture Patient-Originated Data            The system SHALL provide the ability to
                                                                                       view or and comment, but not alter
                                                                                       patient-originated data.



           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                 Page 8 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                        Capability
DC.1.5.1     Record Management              Capture Patient Health Data Derived from The system SHALL provide the ability to              It is critically important to be able to
                                            Administrative and Financial Data and    capture and label patient health data                distinguish patient health data derived
                                            Documentation                            derived from administrative or financial             from administrative or financial data from
                                                                                     data.                                                clinically authenticated data. Sources of
                                                                                                                                          administrative and financial data relating
                                                                                                                                          to a patient's health may provide this
                                                                                                                                          data for entry into the health record or be
                                                                                                                                          given a mechanism for entering this data
                                                                                                                                          directly. The data must be explicitly
                                                                                                                                          labeled as derived from administrative or
                                                                                                                                          financial data, and information about the
                                                                                                                                          source must be linked with that data.




DC.1.5.2     Record Management              Capture Patient Health Data Derived from The system SHALL provide the ability to
                                            Administrative and Financial Data and    capture and link data about the source of
                                            Documentation                            patient health data derived from
                                                                                     administrative and financial data with
                                                                                     that patient data.


DC.1.5.3     Record Management              Capture Patient Health Data Derived from The system SHALL provide the ability to
                                            Administrative and Financial Data and    present labeled patient health
                                            Documentation                            information derived from administrative
                                                                                     or financial data and the source of that
                                                                                     data for use by authorized users.


DC.1.5.4     Record Management              Capture Patient Health Data Derived from The system SHOULD provide the ability to
                                            Administrative and Financial Data and    view health information data and or
                                            Documentation                            comment on patient health records or
                                                                                     documents derived from administrative
                                                                                     or financial data.


DC.1.5.5     Record Management              Capture Patient Health Data Derived from The system SHALL provide the ability to
                                            Administrative and Financial Data and    correct administrative and financial data.
                                            Documentation




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                Page 9 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #               Category                     Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
DC.1.5.6     Record Management              Capture Patient Health Data Derived from The system SHOULD provide the ability to
                                            Administrative and Financial Data and    request correction from the external
                                            Documentation                            source of the administrative or financial
                                                                                     data.

DC.1.6.1     Record Management              Produce a Summary Record of Care           The system SHALL present summarized               Create summary views and reports at the
                                                                                       views and reports of the patient's                conclusion of an episode of care.
                                                                                       comprehensive EHR, including, but not             Summarized views and reports of the
                                                                                       limited to, discharge summary                     episode of care must support
                                                                                       requirements as stated in the CMS State           requirements in the CMS State
                                                                                       Operations Manual.                                Operations Manual for a discharge
                                                                                                                                         summary and should support other
                                                                                                                                         secondary uses of information such as
                                                                                                                                         public health reporting. In addition,
                                                                                                                                         summarized health information must be
                                                                                                                                         produced as an HL7 compliant Continuity
                                                                                                                                         of Care Document (CCD) in order to
                                                                                                                                         support interoperable exchange of health
                                                                                                                                         information with other care providers.
                                                                                                                                         Output of the CCD should be supported in
                                                                                                                                         electronic and paper formats.




                                                                                                                                         At a minimum, the CCD must contain
                                                                                                                                         content for the Advance Directives,
                                                                                                                                         Problems, Alerts, and Medications
                                                                                                                                         sections.

DC.1.6.2     Record Management              Produce a Summary Record of Care           The system SHALL create an HL7
                                                                                       compliant Continuity of Care Document
                                                                                       (CCD).




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 10 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                       Capability
DC.1.6.3     Record Management              Produce a Summary Record of Care          The system SHALL provide the ability to           The Advance Directives section of the
                                                                                      produce a CCD that includes at least the          CCD contains data defining the patient's
                                                                                      following sections: Advance Directives,           advance directives and any reference to
                                                                                      Problems, Alerts, and Medications.                supporting documentation. The most
                                                                                                                                        recent and up-to-date directives are
                                                                                                                                        required, if known, and should be listed in
                                                                                                                                        as much detail as possible. This section
                                                                                                                                        contains data such as the existence of
                                                                                                                                        living wills, healthcare proxies, and CPR
                                                                                                                                        and resuscitation status. If referenced
                                                                                                                                        documents are available, they can be
                                                                                                                                        included in the CCD exchange package.




                                                                                                                                        The "Problems" section of the CCD lists
                                                                                                                                        and describes all relevant clinical
                                                                                                                                        problems at the time the summary is
                                                                                                                                        generated. At a minimum, all pertinent
                                                                                                                                        current and historical problems should be
                                                                                                                                        listed. The "Alerts" section of the CCD is
                                                                                                                                        used to list and describe any allergies,
                                                                                                                                        adverse reactions, and alerts that are
                                                                                                                                        pertinent to the patient's current or past
                                                                                                                                        medical history. At a minimum, currently
                                                                                                                                        active and any relevant historical allergies
                                                                                                                                        and adverse reactions should be listed.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                 Page 11 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #               Category                    Category Description                                Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                    Capability
                                                                                                                                        The "Medications" section of the CCD
                                                                                                                                        defines a patient's current medications
                                                                                                                                        and pertinent medication history. At a
                                                                                                                                        minimum, the currently active
                                                                                                                                        medications should be listed, with an
                                                                                                                                        entire medication history as an option,
                                                                                                                                        particularly when the summary document
                                                                                                                                        is used for comprehensive data export.
                                                                                                                                        The section may also include a patient's
                                                                                                                                        prescription history, and enables the
                                                                                                                                        determination of the source of a
                                                                                                                                        medication list (e.g., from a pharmacy
                                                                                                                                        system vs. from the patient).




DC.1.6.4     Record Management              Produce a Summary Record of Care          The system SHOULD provide the ability to
                                                                                      produce a CCD that includes the following
                                                                                      sections: Functional Status,
                                                                                      Immunizations, Medical Equipment and
                                                                                      Plan of Care.


DC.1.6.5     Record Management              Produce a Summary Record of Care          The system SHOULD provide the ability to          The system SHOULD provide the ability to
                                                                                      produce a CCD that includes the following         populate the following sections of an HL7
                                                                                      sections: Functional Status,                      compliant CCD without requiring
                                                                                      Immunizations, Medical Equipment and              additional input from clinicians: Advance
                                                                                      Plan of Care.                                     Directives, Problems, Alerts, and
                                                                                                                                        Medications.

DC.1.6.6     Record Management              Produce a Summary Record of Care          IF federally mandated assessments are
                                                                                      included in the Functional Status section
                                                                                      of the CCD, THEN those assessments
                                                                                      SHOULD comply with NCVHS/CHI
                                                                                      endorsed standards for the
                                                                                      representation of the assessment and
                                                                                      vocabulary content.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                              Page 12 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                    Category Description                                 Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                         Capability
DC.1.7.1     Record Management              Present Ad Hoc Views of the Health         The system SHALL provide the ability to           A key feature of an electronic health
                                            Record                                     create customized views of summarized             record is its ability to support the delivery
                                                                                       information based on sort and filter              of care by enabling prior information to
                                                                                       controls for date or date range, problem,         be found and meaningfully displayed. EHR
                                                                                       or other clinical parameters.                     systems should facilitate search, filtering,
                                                                                                                                         summarization, and presentation of
                                                                                                                                         available data needed for patient care.
                                                                                                                                         Systems should enable views to be
                                                                                                                                         customized, for example, specific data
                                                                                                                                         may be organized chronologically, by
                                                                                                                                         clinical category, or by consultant, or by
                                                                                                                                         discipline, depending on need.
                                                                                                                                         Jurisdictional laws and




                                                                                                                                         organizational policies that prohibit
                                                                                                                                         certain users from accessing certain
                                                                                                                                         patient information must be supported.


DC.1.7.2     Record Management              Present Ad Hoc Views of the Health         The system SHALL provide the ability to
                                            Record                                     access summarized information through
                                                                                       customized views based on prioritization
                                                                                       of chronology, problem, or other
                                                                                       pertinent clinical parameters.


DC.1.7.3     Record Management              Present Ad Hoc Views of the Health         The system SHALL provide the ability to
                                            Record                                     access summarized information through
                                                                                       customized views based on prioritization
                                                                                       of chronology, problem, or other
                                                                                       pertinent clinical parameters.


DC.1.8.1     Record Management              Manage Patient History                     The system SHALL provide the ability to           Capture and maintain medical,
                                                                                       capture, update and present current               procedural/surgical, social and family
                                                                                       patient history including pertinent               history including the capture of pertinent
                                                                                       positive and negative elements.                   positive and negative histories, patient-
                                                                                                                                         reported or externally available patient
                                                                                                                                         clinical history.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                  Page 13 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                    Vendor
Criteria #               Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                   Capability
DC.1.8.2     Record Management              Manage Patient History                    The system SHALL provide the ability to
                                                                                      capture structured data in the patient
                                                                                      history.

DC.1.8.3     Record Management              Manage Patient History                    The system MAY provide the ability to
                                                                                      capture the relationship between patient
                                                                                      and others.

DC.1.8.4     Record Management              Manage Patient History                    The system SHALL capture the complaint,
                                                                                      presenting problem or other reason(s) for
                                                                                      the visit or encounter.


DC.1.8.5     Record Management              Manage Patient History                    The system SHALL provide the ability to
                                                                                      capture the reason for visit/encounter
                                                                                      from the patient's perspective.


DC.1.9.1     Record Management              Manage Patient and Family Preferences     The system SHALL provide the ability to
                                                                                      capture, present, maintain and make
                                                                                      available for clinical decisions patient
                                                                                      preferences such as language, religion,
                                                                                      spiritual practices and cultural practices.




DC.1.9.2     Record Management              Manage Patient and Family Preferences     The system SHALL provide the ability to
                                                                                      capture, present, maintain and make
                                                                                      available for clinical decisions family
                                                                                      preferences such as language, religion,
                                                                                      spiritual practices and cultural practices.




DC.1.9.3     Record Management              Manage Patient and Family Preferences     The system SHOULD incorporate patient
                                                                                      and family preferences into decision
                                                                                      support systems.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 14 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                      Capability
DC.1.10.1     Record Management              Manage Patient Advance Directives         The system SHALL provide the ability to           Patient advance directives and provider
                                                                                       indicate that advance directives exist for        DNR orders are captured as well as the
                                                                                       the patient.                                      date and circumstances under which the
                                                                                                                                         directives were received, and the location
                                                                                                                                         of any paper records or legal
                                                                                                                                         documentation (e.g., the original) of
                                                                                                                                         advance directives as appropriate.




DC.1.10.2     Record Management              Manage Patient Advance Directives         The system SHALL provide the ability to
                                                                                       indicate the type of advance directives
                                                                                       completed for the patient such as living
                                                                                       will, durable power of attorney, preferred
                                                                                       interventions for known conditions, or
                                                                                       the existence of a "Do Not Resuscitate
                                                                                       order".



DC.1.10.3     Record Management              Manage Patient Advance Directives         The system SHALL provide the ability to
                                                                                       capture, present, maintain and make
                                                                                       available for clinical decisions patient
                                                                                       advance directives documents and "Do
                                                                                       Not Resuscitate" orders.


DC.1.10.4     Record Management              Manage Patient Advance Directives         The system SHALL provide the ability to
                                                                                       indicate when advanced directives were
                                                                                       last reviewed.


DC.1.10.5     Record Management              Manage Patient Advance Directives         The system SHALL provide the ability to
                                                                                       indicate the name and relationship of the
                                                                                       party completing the advance directive
                                                                                       for the patient.


DC.1.10.6     Record Management              Manage Patient Advance Directives         The system SHALL time and date stamp
                                                                                       the entry of advance directives
                                                                                       information.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                               Page 15 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
DC.1.10.7     Record Management              Manage Patient Advance Directives         The system SHOULD provide the ability to
                                                                                       capture the date and/or time a paper
                                                                                       advance directives document was
                                                                                       signed/completed.

DC.1.10.8     Record Management              Manage Patient Advance Directives         The system SHOULD provide the ability to
                                                                                       capture the date and/or time advance
                                                                                       directive information was received by the
                                                                                       provider.

DC.1.10.9     Record Management              Manage Patient Advance Directives         The system SHALL provide the ability to
                                                                                       document the location and or source of
                                                                                       any legal documentation regarding
                                                                                       advance directives.


DC.1.11.1     Record Management              Manage Consents and Authorizations        The system SHALL provide the ability to           Create, maintain, and verify patient
                                                                                       indicate that a patient has completed             decisions such as informed consent for
                                                                                       applicable consents and authorizations.           treatment and authorization/consent for
                                                                                                                                         disclosure when required. Decisions are
                                                                                                                                         documented and include the extent of
                                                                                                                                         information, verification levels and
                                                                                                                                         exposition of treatment options. This
                                                                                                                                         documentation helps ensure that
                                                                                                                                         decisions made at the discretion of the
                                                                                                                                         patient, family, or other responsible
                                                                                                                                         party, govern the actual care that is
                                                                                                                                         delivered or withheld.




DC.1.11.2     Record Management              Manage Consents and Authorizations        The system SHALL provide the ability to
                                                                                       indicate that a patient has withdrawn
                                                                                       applicable consents and authorizations.


DC.1.11.3     Record Management              Manage Consents and Authorizations        The system SHALL capture scanned paper
                                                                                       consent and authorization documents.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 16 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
DC.1.11.4     Record Management              Manage Consents and Authorizations        The system SHOULD provide the ability to
                                                                                       view and complete consent and
                                                                                       authorization forms on-line electronically.


DC.1.11.5     Record Management              Manage Consents and Authorizations        IF the system SHALL provides the ability
                                                                                       to complete consents and authorizations
                                                                                       electronically, THEN the system SHALL
                                                                                       provide the ability for patients to
                                                                                       electronically sign consent and
                                                                                       authorization forms.



DC.1.11.6     Record Management              Manage Consents and Authorizations        The system MAY provide the ability to
                                                                                       generate printable consent and
                                                                                       authorization forms form templates.



DC.1.11.7     Record Management              Manage Consents and Authorizations        IF the system allows completion of
                                                                                       electronic authorizations and consents,
                                                                                       THEN the system SHALL provide the
                                                                                       ability to generate printable consent and
                                                                                       authorization form templates.



DC.1.11.8     Record Management              Manage Consents and Authorizations        The system MAY display the consents and
                                                                                       authorizations associated with a specific
                                                                                       clinical activity, such as treatment (e.g.,
                                                                                       immunizations) or surgery (e.g., wound
                                                                                       debridement), along with that event in
                                                                                       the patient's electronic chart.




DC.1.11.9     Record Management              Manage Consents and Authorizations        The system SHALL provide the ability to
                                                                                       sort and display consents and
                                                                                       authorizations chronologically, reverse
                                                                                       chronologically, and by type.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 17 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                    Category Description                                 Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                       Capability
DC.1.11.10 Record Management                 Manage Consents and Authorizations         The system MAY provide the ability to
                                                                                        document an assent for patients legally
                                                                                        unable to consent.

DC.1.11.11 Record Management                 Manage Consents and Authorizations         IF the system SHALL provides the ability
                                                                                        to complete consents and authorizations
                                                                                        electronically, THEN the system SHALL
                                                                                        provide the ability to document the
                                                                                        source of each consent and authorization,
                                                                                        such as the patient or the patient's
                                                                                        personal representative if the patient is
                                                                                        legally unable to provide it.




DC.1.11.12 Record Management                 Manage Consents and Authorizations         IF the system SHALL provides the ability
                                                                                        to complete consents and authorizations
                                                                                        electronically, THEN the system SHALL
                                                                                        provide the ability to document the
                                                                                        patient's personal representative's level
                                                                                        of authority to make decisions on behalf
                                                                                        of the patient.



DC.1.12.1     Record Management              Manage Allergy, Intolerance and Adverse The system SHALL provide the ability to              Create and maintain patient-specific
                                             Reaction List                           capture true allergy, intolerance, and               allergy, intolerance and adverse reaction
                                                                                     adverse reaction to drug, dietary or                 lists. Allergens, including immunizations,
                                                                                     environmental triggers as unique,                    and substances are identified and coded
                                                                                     discrete entries.                                    (whenever possible) and the list is
                                                                                                                                          captured and maintained over time. All
                                                                                                                                          pertinent dates, including patient-
                                                                                                                                          reported events, are stored and the
                                                                                                                                          description of the patient allergy and
                                                                                                                                          adverse reaction is modifiable over time.
                                                                                                                                          The entire allergy history, including
                                                                                                                                          reaction, for any allergen is viewable.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                               Page 18 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #                Category                     Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                         Capability
                                                                                                                                          The list(s) includes all reactions including
                                                                                                                                          those that are classifiable as a true
                                                                                                                                          allergy, intolerance, side effect or other
                                                                                                                                          adverse reaction to drug, dietary or
                                                                                                                                          environmental triggers. Notations
                                                                                                                                          indicating whether item is patient
                                                                                                                                          reported and/or provider verified are
                                                                                                                                          maintained.


DC.1.12.2     Record Management              Manage Allergy, Intolerance and Adverse The system SHOULD provide the ability to
                                             Reaction List                           capture the reason for entry of the
                                                                                     allergy, intolerance or adverse reaction.


DC.1.12.3     Record Management              Manage Allergy, Intolerance and Adverse The system SHALL provide the ability to
                                             Reaction List                           capture the reaction type.

DC.1.12.4     Record Management              Manage Allergy, Intolerance and Adverse The system SHOULD provide the ability to
                                             Reaction List                           capture the severity of a reaction.


DC.1.12.5     Record Management              Manage Allergy, Intolerance and Adverse The system SHALL provide the ability to
                                             Reaction List                           capture a report of No Known Allergies
                                                                                     (NKA) for the patient.


DC.1.12.6     Record Management              Manage Allergy, Intolerance and Adverse The system SHALL provide the ability to
                                             Reaction List                           capture a report of No Known Drug
                                                                                     Allergies (NKDA) for the patient.


DC.1.12.7     Record Management              Manage Allergy, Intolerance and Adverse The system SHOULD provide the ability to
                                             Reaction List                           capture the source of allergy, intolerance,
                                                                                     and adverse reaction information.


DC.1.12.8     Record Management              Manage Allergy, Intolerance and Adverse The system SHALL provide the ability to
                                             Reaction List                           deactivate an item on the list.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                 Page 19 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                    Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.1.12.9     Record Management              Manage Allergy, Intolerance and Adverse The system SHALL provide the ability to
                                             Reaction List                           present allergies, intolerances and
                                                                                     adverse reactions that have been
                                                                                     deactivated as well as the reason for
                                                                                     deactivation.

DC.1.12.10 Record Management                 Manage Allergy, Intolerance and Adverse The system SHALL provide the ability to
                                             Reaction List                           record the identity of the user who
                                                                                     added, modified, inactivated, or removed
                                                                                     items from the allergy list, including
                                                                                     attributes of the changed items.



DC.1.12.11 Record Management                 Manage Allergy, Intolerance and Adverse The system SHOULD provide the ability to
                                             Reaction List                           display user defined sort order of list.


DC.1.12.12 Record Management                 Manage Allergy, Intolerance and Adverse The system SHOULD provide the ability to
                                             Reaction List                           indicate that the list of allergies to
                                                                                     medications and other agents has been
                                                                                     reviewed.

DC.1.12.13 Record Management                 Manage Allergy, Intolerance and Adverse They system SHALL provide the ability to
                                             Reaction List                           capture and display the date on which
                                                                                     allergy information was entered.



DC.1.12.14 Record Management                 Manage Allergy, Intolerance and Adverse The system SHOULD provide the ability to
                                             Reaction List                           capture and display the approximate date
                                                                                     of the allergy occurrence.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 20 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
DC.1.13.1     Record Management              Manage Medication List                    The system SHALL provide the ability to           Medication lists are managed over time,
                                                                                       capture patient-specific medication lists.        whether over the course of a visit or stay,
                                                                                                                                         or the lifetime of a patient. All pertinent
                                                                                                                                         dates, including medication start,
                                                                                                                                         modification, and end dates are stored.
                                                                                                                                         The entire medication history for any
                                                                                                                                         medication, including alternative
                                                                                                                                         supplements and herbal medications, is
                                                                                                                                         viewable. Medication lists are not limited
                                                                                                                                         to medication orders recorded by
                                                                                                                                         providers, but may include, for example,
                                                                                                                                         pharmacy dispense/supply records,
                                                                                                                                         patient-reported medications and
                                                                                                                                         additional information such as age
                                                                                                                                         specific dosage.




DC.1.13.2     Record Management              Manage Medication List                    The system SHALL display and report
                                                                                       patient-specific medication lists.


DC.1.13.3     Record Management              Manage Medication List                    The system SHALL provide the ability to
                                                                                       capture the details of the medication such
                                                                                       as ordering date, dose, route, and SIG
                                                                                       (description of the prescription, such as
                                                                                       the quantity) when known.


DC.1.13.4     Record Management              Manage Medication List                    The system SHALL provide the ability to
                                                                                       capture other dates associated with
                                                                                       medications such as start and end dates.


DC.1.13.5     Record Management              Manage Medication List                    The system SHALL provide the ability to
                                                                                       capture medications not reported on
                                                                                       existing medication lists or medication
                                                                                       histories.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                Page 21 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
DC.1.13.6     Record Management              Manage Medication List                    The system SHALL provide the ability to
                                                                                       capture non-prescription medications
                                                                                       including over the counter and
                                                                                       complementary medications such as
                                                                                       vitamins, herbs and supplements.



DC.1.13.7     Record Management              Manage Medication List                    The system SHALL present the current
                                                                                       medication lists associated with a patient.


DC.1.13.8     Record Management              Manage Medication List                    The system SHALL have the ability to
                                                                                       present the medication history associated
                                                                                       with a patient.

DC.1.13.9     Record Management              Manage Medication List                    The system SHALL present the
                                                                                       medication, prescriber, and medication
                                                                                       ordering dates when known.


DC.1.13.10 Record Management                 Manage Medication List                    The system SHALL provide the ability to
                                                                                       mark a medication as erroneously
                                                                                       captured and exclude should be excluded
                                                                                       from the presentation of current
                                                                                       medications.


DC.1.13.11 Record Management                 Manage Medication List                    The system SHALL provide the ability to
                                                                                       print a current medication list for patient
                                                                                       use.

DC.1.13.12 Record Management                 Manage Medication List                    The system MAY provide the ability to
                                                                                       capture information regarding the filling
                                                                                       of prescriptions (dispensation of
                                                                                       medications by pharmacies or other
                                                                                       providers).




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 22 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                      Capability
DC.1.14.1     Record Management              Manage Problem List                       The system SHALL capture, display and      A problem list includes at a minimum the
                                                                                       report all active problems associated with patient's active and historical diagnoses,
                                                                                       a patient.                                 and any problems/needs identified on the
                                                                                                                                  care plan. It may also include, but is not
                                                                                                                                  limited to: other chronic conditions,
                                                                                                                                  symptoms, functional limitations, visit or
                                                                                                                                  stay-specific conditions, or family and
                                                                                                                                  situational conditions adversely impacting
                                                                                                                                  the patient. Problem lists are managed
                                                                                                                                  over time, whether over the course of a
                                                                                                                                  visit or stay or the life of a patient,
                                                                                                                                  allowing documentation of historical
                                                                                                                                  information and tracking the changing
                                                                                                                                  character of problem(s) and their priority.




                                                                                                                                         The source (e.g., the provider, the system
                                                                                                                                         ID, or the patient) of the updates should
                                                                                                                                         be documented. In addition all pertinent
                                                                                                                                         dates are stored All pertinent dates are
                                                                                                                                         stored, including date noted or
                                                                                                                                         diagnosed, dates of any changes in
                                                                                                                                         problem specification or prioritization,
                                                                                                                                         and date of resolution. This might include
                                                                                                                                         time stamps, where useful and
                                                                                                                                         appropriate. The entire problem history
                                                                                                                                         for any problem in the list is viewable.




DC.1.14.2     Record Management              Manage Problem List                       The system SHALL capture, display and
                                                                                       report a history of all problems associated
                                                                                       with a patient.

DC.1.14.3     Record Management              Manage Problem List                       The system SHALL provide the ability to
                                                                                       capture onset date of problem when
                                                                                       known.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                               Page 23 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                             Vendor
Criteria #                Category                    Category Description                                  Criteria                                Discussion / Comments                                Vendor Comments
                                                                                                                                                                                            Capability
DC.1.14.4     Record Management              Manage Problem List                         The system SHOULD provide the ability to
                                                                                         capture the chronicity (chronic, acute/self-
                                                                                         limiting, etc.) of a problem.



DC.1.14.5     Record Management              Manage Problem List                         The system SHALL provide the ability to
                                                                                         capture the source, date and time of all
                                                                                         updates to the problem list.


DC.1.14.6     Record Management              Manage Problem List                         The system SHALL provide the ability to
                                                                                         deactivate a problem.

DC.1.14.7     Record Management              Manage Problem List                         The system MAY provide the ability to re-
                                                                                         activate a previously deactivated
                                                                                         problem.

DC.1.14.8     Record Management              Manage Problem List                         The system SHALL provide the ability to
                                                                                         display inactive and/or resolved
                                                                                         problems.

DC.1.14.9     Record Management              Manage Problem List                         The system SHALL provide the ability to
                                                                                         manually order/sort the problem list.


DC.1.14.10 Record Management                 Manage Problem List                         The system SHOULD provide the ability to
                                                                                         associate problems with other clinical
                                                                                         items or events (for example: encounters,
                                                                                         orders, medications and notes).


DC.1.15.1     Record Management              Manage Immunization List                    The system SHALL capture, display and             Immunization lists are managed over
                                                                                         report all immunizations associated with          time, whether over the course of a visit or
                                                                                         a patient.                                        stay, or the lifetime of a patient. Details of
                                                                                                                                           immunizations administered are captured
                                                                                                                                           as discrete data elements including date,
                                                                                                                                           type, manufacturer and lot number. The
                                                                                                                                           entire immunization history is viewable.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                   Page 24 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #                Category                    Category Description                                  Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                        Capability
DC.1.15.2     Record Management              Manage Immunization List                    The system SHALL record as discrete data
                                                                                         elements data associated with any
                                                                                         immunization given including date, type,
                                                                                         lot number and manufacturer.



DC.1.15.3     Record Management              Manage Immunization List                    The system SHOULD provide the ability to
                                                                                         prepare a report of a patient's
                                                                                         immunization history.

DC.1.16.1     Record Management              Manage Assessments                          The system SHALL provide the ability to           The EHR-S must be able to provide users
                                                                                         create "user-defined" and standard                with the clinically appropriate and
                                                                                         assessments for clinician use in assessing        regulatory mandated assessments
                                                                                         patient condition.                                required to be completed during a patient
                                                                                                                                           stay. To support this, the system must
                                                                                                                                           allow providers to create, maintain, and
                                                                                                                                           make available for clinician use: user-
                                                                                                                                           defined assessments reflecting
                                                                                                                                           assessment content and protocols as per
                                                                                                                                           facility policy (such as Nursing Admission
                                                                                                                                           assessments, Dietary admission
                                                                                                                                           assessments, Physical Therapy
                                                                                                                                           evaluations, etc.), and standard
                                                                                                                                           assessments




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                               Page 25 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                   Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
                                                                                                                                        reflecting assessment content and
                                                                                                                                        protocols as per industry and professional
                                                                                                                                        standards of practice (such as the
                                                                                                                                        Geriatric Depression Scale, AIMS, Mini-
                                                                                                                                        Mental, Falls Risk Assessment, etc.). In
                                                                                                                                        addition, the EHR-S must maintain and
                                                                                                                                        make available for clinician use any
                                                                                                                                        standardized assessment instruments
                                                                                                                                        (such as the MDS) that are required by
                                                                                                                                        jurisdictional regulation. The EHR-S must
                                                                                                                                        provide the ability for clinicians to
                                                                                                                                        complete these assessments (user-
                                                                                                                                        defined assessments, standard
                                                                                                                                        assessments, and standardized
                                                                                                                                        assessment instruments) and




                                                                                                                                        maintain them as part of the electronic
                                                                                                                                        patient record. The EHR-S should provide
                                                                                                                                        the ability to capture additional data to
                                                                                                                                        augment an assessment as necessary,
                                                                                                                                        and should link data from the assessment
                                                                                                                                        to the patient's problem list and care
                                                                                                                                        plan.




DC.1.16.2     Record Management              Manage Assessments                       The system SHALL provide the ability to
                                                                                      complete, maintain and transmit
                                                                                      standardized assessment instruments
                                                                                      (such as the Minimum Data Set) as
                                                                                      mandated by jurisdictional regulations.




            Dixon Hughes PLLC Confidential                                                                                  8/15/2010                                                                               Page 26 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                    Vendor
Criteria #                Category                   Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                   Capability
DC.1.16.3     Record Management              Manage Assessments                       The system SHALL provide the ability to [NEED TO STATE JURISDICTIONAL
                                                                                      complete and maintain "user-defined"        REGULATIONS AND FACILITY POLICY]
                                                                                      and standard assessments of resident
                                                                                      condition as required by: a) the
                                                                                      Conditions of Participation for Medicare
                                                                                      and Medicaid (i.e., assessments related to
                                                                                      resident risk of dehydration, unintended
                                                                                      weight loss, or pressure ulcers), b)
                                                                                      jurisdictional regulations, c) professional
                                                                                      standards of practice, and d) facility
                                                                                      policy.




DC.1.16.4     Record Management              Manage Assessments                       The system SHOULD provide the ability to
                                                                                      capture additional data to augment
                                                                                      standard assessments relative to
                                                                                      variances in medical conditions.



DC.1.16.5     Record Management              Manage Assessments                       The system SHOULD provide the ability to
                                                                                      link data from an assessment to a
                                                                                      problem list.

DC.1.16.6     Record Management              Manage Assessments                       The system SHOULD provide the ability to
                                                                                      link data from an assessment to an
                                                                                      individual care plan.



DC.1.16.7     Record Management              Manage Assessments                       The system MAY provide the ability to link
                                                                                      data from external sources, laboratory
                                                                                      results, and radiographic results to an
                                                                                      assessment.


DC.1.16.8     Record Management              Manage Assessments                       The system SHALL provide the ability to
                                                                                      complete, maintain and transmit
                                                                                      standardized assessment instruments
                                                                                      (such as the Minimum Data Set) as
                                                                                      mandated by jurisdictional regulations.




            Dixon Hughes PLLC Confidential                                                                                  8/15/2010                                                                             Page 27 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
DC.1.16.9     Record Management              Manage Assessments                        The system MAY provide the ability to
                                                                                       compare documented data against
                                                                                       standardized curves and display the
                                                                                       trends.

DC.1.16.10 Record Management                 Manage Assessments                        The system SHALL provide the ability to
                                                                                       retrieve prior versions of completed user-
                                                                                       defined and standard assessments.



DC.1.17.1     Record Management              Capture and Manage the CMS Resident       The system SHALL provide the ability to           The resident assessment process
                                             Assessment Instrument                     capture all data elements as defined in           mandated by the Centers for Medicare &
                                                                                       the most recent MDS data specification.           Medicaid Services (CMS) includes a
                                                                                                                                         standardized assessment instrument (the
                                                                                                                                         MDS), triggers and protocols for further
                                                                                                                                         assessment (Resident Assessment
                                                                                                                                         Protocols), and utilization guidelines that
                                                                                                                                         define the frequency, timeliness, error
                                                                                                                                         correction process, and data submission
                                                                                                                                         requirements for the Minimum Data Set.
                                                                                                                                         In addition, some state agencies impose
                                                                                                                                         further, more stringent requirements on
                                                                                                                                         MDS processes.




                                                                                                                                         The EHR-S must provide the ability to
                                                                                                                                         comply with all federal requirements
                                                                                                                                         related to the MDS, as well as the
                                                                                                                                         additional state level requirements
                                                                                                                                         imposed by the jurisdiction in which the
                                                                                                                                         system is implemented.



DC.1.17.2     Record Management              Capture and Manage the CMS Resident       The system SHALL perform Medicare
                                             Assessment Instrument                     payment calculations from MDS data
                                                                                       items in accordance with the most recent
                                                                                       algorithms provided by CMS and populate
                                                                                       the payment calculation value to the
                                                                                       appropriate MDS data element.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                Page 28 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
DC.1.17.3     Record Management              Capture and Manage the CMS Resident       The system SHALL perform State
                                             Assessment Instrument                     Medicaid payment calculations from MDS
                                                                                       data items in accordance with the most
                                                                                       recent algorithms provided by the state
                                                                                       agency of the jurisdiction in which the
                                                                                       system is implemented, and populate the
                                                                                       payment calculation value to the
                                                                                       appropriate data element as required by
                                                                                       jurisdictional law or regulation.



DC.1.17.4     Record Management              Capture and Manage the CMS Resident       The system SHALL perform data
                                             Assessment Instrument                     consistency edits as defined in the most
                                                                                       recent MDS data specification.



DC.1.17.5     Record Management              Capture and Manage the CMS Resident       The system SHALL calculate triggered
                                             Assessment Instrument                     Resident Assessment Protocols (RAPs) in
                                                                                       accordance with the most recent MDS
                                                                                       data specification.



DC.1.17.6     Record Management              Capture and Manage the CMS Resident       The system SHALL provide the ability to
                                             Assessment Instrument                     capture the clinician assessment process
                                                                                       for triggered Resident Assessment
                                                                                       Protocols (RAPs).


DC.1.17.7     Record Management              Capture and Manage the CMS Resident       The system SHALL create MDS data
                                             Assessment Instrument                     submission files in accordance with the
                                                                                       most recent MDS data specifications.


DC.1.17.8     Record Management              Capture and Manage the CMS Resident       The system SHALL implement MDS data
                                             Assessment Instrument                     correction and assessment locking
                                                                                       processes as defined in the most recent
                                                                                       version of the CMS MDS Correction
                                                                                       Policy.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 29 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
DC.1.17.9     Record Management              Capture and Manage the CMS Resident       The system SHOULD calculate and report
                                             Assessment Instrument                     quality calculations such as Quality
                                                                                       Indicators and Quality Measures.


DC.1.17.10 Record Management                 Capture and Manage the CMS Resident       The system SHALL report Medicare
                                             Assessment Instrument                     payment calculations.

DC.1.17.11 Record Management                 Capture and Manage the CMS Resident       The system SHOULD provide the ability to
                                             Assessment Instrument                     link data from the MDS to a problem list.


DC.1.17.12 Record Management                 Capture and Manage the CMS Resident       The system SHOULD provide the ability to
                                             Assessment Instrument                     link data from the MDS to an individual
                                                                                       care plan.

DC.1.17.13 Record Management                 Capture and Manage the CMS Resident       The system SHOULD provide the ability to
                                             Assessment Instrument                     exchange MDS assessment data in
                                                                                       conformance with HL7 CDA release 2 or
                                                                                       higher.

DC.1.17.14 Record Management                 Capture and Manage the CMS Resident       The system SHALL provide the ability to
                                             Assessment Instrument                     export MDS data in formats as required
                                                                                       by jurisdictional authority.


DC.1.17.15 Record Management                 Capture and Manage the CMS Resident       The system SHALL provide the ability to
                                             Assessment Instrument                     access, view, report and display all
                                                                                       previously completed MDS assessments.



DC.1.17.16 Record Management                 Capture and Manage the CMS Resident       The system MAY provide the ability to
                                             Assessment Instrument                     capture all data elements as defined in
                                                                                       previous MDS data specifications for
                                                                                       purposes of transitioning paper
                                                                                       documentation to electronic format.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 30 of 402
                                                                              Brown County Community Treatment Center - SNF Requirements

                                                                                                                 Vendor Capability Legend

                                                                   1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                   2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                   3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                  Vendor
Criteria #             Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                 Capability
DC.1.17.17 Record Management              Capture and Manage the CMS Resident       The system MAY create MDS data
                                          Assessment Instrument                     submission files in accordance with
                                                                                    previous MDS data specifications for
                                                                                    purposes of transitioning paper
                                                                                    documentation to electronic format.



DC.1.17.18 Record Management              Capture and Manage the CMS Resident       The system MAY implement MDS data
                                          Assessment Instrument                     correction and assessment locking
                                                                                    processes as defined in prior versions of
                                                                                    the CMS MDS Correction Policy for
                                                                                    purposes of transitioning paper
                                                                                    documentation to electronic format.


DC.1.17.19 Record Management              Capture and Manage the CMS Resident       The system MAY calculate triggered
                                          Assessment Instrument                     Resident Assessment Protocols (RAPs) in
                                                                                    accordance with previous MDS data
                                                                                    specifications for purposes of
                                                                                    transitioning paper documentation to
                                                                                    electronic format.



DC.1.17.20 Record Management              Capture and Manage the CMS Resident       The system MAY perform data
                                          Assessment Instrument                     consistency edits as defined in previous
                                                                                    MDS data specifications for purposes of
                                                                                    transitioning paper documentation to
                                                                                    electronic format.




         Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 31 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                           Vendor
Criteria #                Category                     Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                          Capability
DC.1.18.1     Record Management              Present Guidelines and Protocols for        The system SHALL provide the ability to           Present organizational guidelines for
                                             Planning Care                               present current guidelines and protocols          patient care as appropriate to support
                                                                                         to clinicians who are creating plans for          planning of care, including order entry
                                                                                         treatment and care.                               and clinical documentation. Guidelines,
                                                                                                                                           and protocols presented for planning care
                                                                                                                                           may be site specific, community or
                                                                                                                                           industry-wide standards. It is not the
                                                                                                                                           intent of this function to suggest that
                                                                                                                                           guidelines and protocols are presented
                                                                                                                                           for all entries in the care plan. Unlike the
                                                                                                                                           medical model used in acute care
                                                                                                                                           settings, the social model of care used in
                                                                                                                                           LTC does not lend itself as easily to the
                                                                                                                                           use of standard guidelines and protocols.




                                                                                                                                           LTC care planning incorporates the MDS
                                                                                                                                           and RAP process (as well as other
                                                                                                                                           assessments/orders) to identify social as
                                                                                                                                           well as physical strengths and deficits.
                                                                                                                                           There may be no "standard protocol" for
                                                                                                                                           how to measure or further assess
                                                                                                                                           "strength in faith". However where
                                                                                                                                           relevant guidelines and protocols do exist,
                                                                                                                                           they are presented to the user.



DC.1.18.2     Record Management              Present Guidelines and Protocols for        The system SHOULD provide the ability to
                                             Planning Care                               search for a guideline or protocol based
                                                                                         on appropriate criteria (such as problem).


DC.1.18.3     Record Management              Present Guidelines and Protocols for        The system SHOULD provide the ability to
                                             Planning Care                               present previous versions of guidelines
                                                                                         and protocols available to clinicians for
                                                                                         historical or legal purposes.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                 Page 32 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                      Capability
DC.1.18.4     Record Management              Present Guidelines and Protocols for        IF decision support prompts are used to
                                             Planning Care                               support a specific clinical guideline or
                                                                                         protocol, THEN the system SHALL
                                                                                         conform to function DC.1.8.6 (Manage
                                                                                         Documentation of Clinician Response to
                                                                                         Decision Support Prompts).


DC.1.19.1     Record Management              Manage Patient-Specific Care and            The system SHALL provide the ability to Provide administrative tools for
                                             Treatment Plans                             capture patient-specific plans of care and healthcare organizations to build care
                                                                                         treatment.                                 plans, guidelines and protocols for use
                                                                                                                                    during patient care planning and care.
                                                                                                                                    Care plans, guidelines or protocols may
                                                                                                                                    contain goals or targets for the patient,
                                                                                                                                    specific guidance to the providers,
                                                                                                                                    suggested orders, and nursing
                                                                                                                                    interventions, among other items.
                                                                                                                                    Tracking of implementation or approval
                                                                                                                                    dates, modifications and relevancy to
                                                                                                                                    specific domains or context is provided.
                                                                                                                                    Transfer of treatment and care plans may
                                                                                                                                    be implemented electronically using, for
                                                                                                                                    example, templates, or by printing plans
                                                                                                                                    to paper.




DC.1.19.2     Record Management              Manage Patient-Specific Care and            The system SHALL provide the ability to
                                             Treatment Plans                             use locally or non-locally developed
                                                                                         templates, guidelines, and protocols for
                                                                                         the creation of patient-specific plans of
                                                                                         care and treatment.


DC.1.19.3     Record Management              Manage Patient-Specific Care and            The system SHALL provide the ability to
                                             Treatment Plans                             use a patient's previously developed care
                                                                                         plans as a basis for the creation of new
                                                                                         plans of care and treatment.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 33 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                    Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.1.19.4     Record Management              Manage Patient-Specific Care and           The system SHALL provide the ability to
                                             Treatment Plans                            track updates to a patient's plan of care
                                                                                        and treatment including authors, creation
                                                                                        date, version history, references, local
                                                                                        sources and non-local sources in
                                                                                        accordance with scope of practice,
                                                                                        organizational policy and jurisdictional
                                                                                        law.


DC.1.19.5     Record Management              Manage Patient-Specific Care and           The system SHOULD provide the ability to
                                             Treatment Plans                            coordinate order sets with care plans.


DC.1.19.6     Record Management              Manage Patient-Specific Care and           The system MAY provide the ability to
                                             Treatment Plans                            derive suggest possible order sets from
                                                                                        care plans.

DC.1.19.7     Record Management              Manage Patient-Specific Care and           The system SHOULD provide the ability to
                                             Treatment Plans                            suggest care plans from order sets.


DC.1.19.8     Record Management              Manage Patient-Specific Care and           The system SHALL provide the ability to
                                             Treatment Plans                            transfer plans of care and treatment to
                                                                                        other care providers.

DC.1.19.9     Record Management              Manage Patient-Specific Care and           The system SHOULD incorporate care
                                             Treatment Plans                            plan items in the tasks assigned and
                                                                                        routed.

DC.1.19.10 Record Management                 Manage Patient-Specific Care and           The system SHOULD incorporate care
                                             Treatment Plans                            plan items in the tasks linked.

DC.1.19.11 Record Management                 Manage Patient-Specific Care and           The system SHOULD incorporate care
                                             Treatment Plans                            plan items in the tasks tracked.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 34 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                            Vendor
Criteria #                Category                    Category Description                                  Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                           Capability
DC.1.20.1     Record Management              Manage Medication Orders                    The system SHALL provide the ability to           Create prescriptions or other medication
                                                                                         create prescription or other medication           orders with detail adequate for correct
                                                                                         orders, such as over the counter (OTC),           filling and administration. Provide
                                                                                         with the details adequate for correct             information regarding compliance of
                                                                                         filling and administration captured as            medication orders with formularies.
                                                                                         discrete data.                                    Different medication orders, including
                                                                                                                                           discontinue, refill, and renew, require
                                                                                                                                           different levels and kinds of detail, as do
                                                                                                                                           medication orders placed in different
                                                                                                                                           situations. The correct details are
                                                                                                                                           recorded for each situation.
                                                                                                                                           Administration or patient instructions are
                                                                                                                                           available for selection by the ordering
                                                                                                                                           clinicians, or the ordering clinician




                                                                                                                                           is facilitated in creating such instructions.
                                                                                                                                           The system may allow for the creation of
                                                                                                                                           common content for prescription details,
                                                                                                                                           including content required in the NCPDP
                                                                                                                                           Codified SIG standard. Appropriate time
                                                                                                                                           stamps for all medication related activity
                                                                                                                                           are generated. This includes series of
                                                                                                                                           orders that are part of a therapeutic
                                                                                                                                           regimen (e.g., Renal Dialysis, Oncology).
                                                                                                                                           When a clinician places an order for a
                                                                                                                                           medication, that order may or may not
                                                                                                                                           comply with a formulary specific to the
                                                                                                                                           patient's location or insurance coverage,
                                                                                                                                           if applicable.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                  Page 35 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #                Category                    Category Description                                  Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                        Capability
                                                                                                                                           Whether the order complies with the
                                                                                                                                           formulary should be communicated to
                                                                                                                                           the ordering clinician at an appropriate
                                                                                                                                           point to allow the ordering clinician to
                                                                                                                                           decide whether to continue with the
                                                                                                                                           order. Formulary-compliant alternatives
                                                                                                                                           to the medication being ordered may also
                                                                                                                                           be presented. In addition, the system
                                                                                                                                           should present the clinician with clinical
                                                                                                                                           decision support (such as allergies, drug-
                                                                                                                                           drug- interactions, etc.) during the
                                                                                                                                           medication ordering process.




                                                                                                                                           Finally, the EHR-S must support the
                                                                                                                                           unique medication ordering processes
                                                                                                                                           required in the LTC nursing home
                                                                                                                                           environment, including the need to
                                                                                                                                           support: Communication of orders
                                                                                                                                           between the physician, nursing facility
                                                                                                                                           and pharmacy provider), Existing
                                                                                                                                           practices for monthly signature of
                                                                                                                                           renewal orders by physicians, or the
                                                                                                                                           facility nurse acting as an agent of the
                                                                                                                                           physician.


DC.1.20.2     Record Management              Manage Medication Orders                    The system SHALL provide the ability to
                                                                                         indicate that an existing order has been
                                                                                         renewed by the prescriber including
                                                                                         prescriber name, and the date and time
                                                                                         of renewal.


DC.1.20.3     Record Management              Manage Medication Orders                    The system SHALL capture user and date
                                                                                         stamp for all prescription related events.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                               Page 36 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                    Category Description                                  Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                      Capability
DC.1.20.4     Record Management              Manage Medication Orders                    The system SHALL update the appropriate
                                                                                         medication list with the prescribed
                                                                                         medications (in case of multiple
                                                                                         medication lists).

DC.1.20.5     Record Management              Manage Medication Orders                    The system SHALL provide a searchable
                                                                                         selection list for ordering medications
                                                                                         that includes both generic and brand
                                                                                         names.

DC.1.20.6     Record Management              Manage Medication Orders                    The system SHALL provide the ability to
                                                                                         maintain a selection list for ordering
                                                                                         medications with components in discrete
                                                                                         fields (such as medication name,
                                                                                         strength, form).


DC.1.20.7     Record Management              Manage Medication Orders                    The system SHALL provide the ability to [NEED TO STATE JURISDICTIONAL
                                                                                         order supplies associated with medication REGULATIONS AND FACILITY POLICY]
                                                                                         orders in accordance with scope of
                                                                                         practice, organizational policy or
                                                                                         jurisdictional law.


DC.1.20.8     Record Management              Manage Medication Orders                    The system SHOULD make common
                                                                                         content (such as drug, dose, route and
                                                                                         SIG) available to be selected by the
                                                                                         ordering clinician.

DC.1.20.9     Record Management              Manage Medication Orders                    The system SHALL provide the ability for
                                                                                         the ordering clinician to enter
                                                                                         prescription details (e.g., free text) as
                                                                                         needed.

DC.1.20.10 Record Management                 Manage Medication Orders                    The system MAY provide the ability to
                                                                                         include medication orders in order sets.


DC.1.20.11 Record Management                 Manage Medication Orders                    The system MAY make available common
                                                                                         patient medication instruction content to
                                                                                         be selected by the ordering clinician.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 37 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                    Vendor
Criteria #             Category                    Category Description                                  Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                   Capability
DC.1.20.12 Record Management              Manage Medication Orders                    The system MAY provide a list of
                                                                                      frequently-ordered medications by
                                                                                      diagnosis by provider which could include
                                                                                      the full details of the medication,
                                                                                      including SIG, quantity, refills, DAW, etc.


DC.1.20.13 Record Management              Manage Medication Orders                    The system SHOULD display the results of
                                                                                      electronic prescription eligibility and
                                                                                      health plan/payer formulary checking.


DC.1.20.14 Record Management              Manage Medication Orders                    The system MAY provide the ability to
                                                                                      create a medication order by using data
                                                                                      from a prior medication order (e.g.,
                                                                                      without re-entering previous data (e.g.
                                                                                      such as administration schedule,
                                                                                      quantity).

DC.1.20.15 Record Management              Manage Medication Orders                    IF the system SHOULD provides the ability
                                                                                      to create a medication order THEN the
                                                                                      system SHALL allow for editing of details
                                                                                      adequate for correct filling and
                                                                                      administration of medication (e.g. dose,
                                                                                      frequency, body weight).



DC.1.20.16 Record Management              Manage Medication Orders                    The system SHOULD check and report
                                                                                      allergies, drug-drug interactions, and
                                                                                      other potential adverse reactions, when
                                                                                      ordering medications.



DC.1.20.17 Record Management              Manage Medication Orders                    The system SHOULD check and report
                                                                                      other potential adverse reactions, when
                                                                                      new medications are ordered.


DC.1.20.18 Record Management              Manage Medication Orders                    The system SHOULD provide the ability to
                                                                                      suggest a weight-specific dose during the
                                                                                      order entry process.




         Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 38 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                    Category Description                                 Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                       Capability
DC.1.21.1     Record Management              Manage Orders for Diagnostic Tests         The system SHALLprovide the ability to            Enable the origination, documentation,
                                                                                        capture orders for diagnostic tests.              and tracking of orders for diagnostic
                                                                                                                                          tests. Orders for diagnostic tests (e.g.,
                                                                                                                                          diagnostic radiology, blood test) are
                                                                                                                                          captured and tracked including new,
                                                                                                                                          renewal and discontinue orders. Each
                                                                                                                                          order includes appropriate detail, such as
                                                                                                                                          order identification, instructions and
                                                                                                                                          clinical information necessary to perform
                                                                                                                                          the test. Orders and supporting detailed
                                                                                                                                          documentation shall be communicated to
                                                                                                                                          the service provider for completion of the
                                                                                                                                          diagnostic test(s).




                                                                                                                                          This communication should occur through
                                                                                                                                          electronic exchange of data using HITSP
                                                                                                                                          endorsed standards of interoperability,
                                                                                                                                          although other methods of data
                                                                                                                                          exchange, including by methods such as
                                                                                                                                          automated fax, may be used in the
                                                                                                                                          absence of recognized standards.




DC.1.21.2     Record Management              Manage Orders for Diagnostic Tests         The system SHALL provide the ability to
                                                                                        capture adequate order detail for correct
                                                                                        diagnostic test fulfillment.


DC.1.21.3     Record Management              Manage Orders for Diagnostic Tests         The system SHALLprovide the ability to
                                                                                        track the status (such as requisitioned,
                                                                                        completed, in process)of diagnostic
                                                                                        test(s).

DC.1.21.4     Record Management              Manage Orders for Diagnostic Tests         The system SHOULD provide the ability to
                                                                                        capture and present patientand
                                                                                        caregiverinstructions relevant to the
                                                                                        diagnostic test ordered.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                               Page 39 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                    Category Description                                 Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                       Capability
DC.1.21.5     Record Management              Manage Orders for Diagnostic Tests         The system SHALL provide the ability to
                                                                                        communicate orders to the service
                                                                                        provider of the diagnostic test.



DC.1.21.6     Record Management              Manage Orders for Diagnostic Tests         The system SHOULD communicate
                                                                                        supporting detailed documentation to the
                                                                                        correct service provider of the diagnostic
                                                                                        test.


DC.1.22.1     Record Management              Manage Orders for Blood Products and       The system SHALLprovide the ability to            Communicate with appropriate sources
                                             Other Biologics                            interface with systems of blood banks or          or registries to manage orders for blood
                                                                                        other sources to manage orders for blood          products or other biologics. Interact with
                                                                                        products or other biologics.                      a blood bank system or other source to
                                                                                                                                          support orders for blood products or
                                                                                                                                          other biologics including discontinuance
                                                                                                                                          orders. Use of such products in the
                                                                                                                                          provision of care is captured. Blood bank
                                                                                                                                          or other functionality that may come
                                                                                                                                          under jurisdictional law or other
                                                                                                                                          regulation (e.g., by the FDA in the United
                                                                                                                                          States) is not required; functional
                                                                                                                                          communication with such a system is
                                                                                                                                          required.




DC.1.22.2     Record Management              Manage Orders for Blood Products and       The system SHALL provide the ability to
                                             Other Biologics                            capture use of such products in the
                                                                                        provision of care.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                               Page 40 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
DC.1.23.1     Record Management              Manage Referrals                          The system SHALLprovide the ability to            Enable the origination, documentation
                                                                                       capture and communicate referral(s) to            and tracking of referrals between care
                                                                                       other care provider (s), whether internal         providers or health care organizations,
                                                                                       or external to the organization.                  including clinical and administrative
                                                                                                                                         details of the referral, and consents and
                                                                                                                                         authorizations for disclosures as required.
                                                                                                                                         Documentation and tracking of a referral
                                                                                                                                         from one care provider to another is
                                                                                                                                         supported, whether the referred to or
                                                                                                                                         referring providers are internal or
                                                                                                                                         external to the healthcare organization.
                                                                                                                                         The EHR-S provides the ability to capture
                                                                                                                                         completion of the referral appointment.




                                                                                                                                         This capture functionality can be
                                                                                                                                         accomplished via: external input such as
                                                                                                                                         receiving, accepting, downloading or
                                                                                                                                         importing a file(s) or internally creating
                                                                                                                                         the information by means such as
                                                                                                                                         entering, computing or recording
                                                                                                                                         information regarding the referral).



DC.1.23.2     Record Management              Manage Referrals                          The system SHALLprovide the ability to
                                                                                       capture clinical details as necessary for
                                                                                       the referral.

DC.1.23.3     Record Management              Manage Referrals                          The system SHALLprovide the ability to
                                                                                       capture administrative details (such as
                                                                                       insurance information, consents and
                                                                                       authorizations for disclosure) as
                                                                                       necessary for the referral.


DC.1.23.4     Record Management              Manage Referrals                          The system SHALL present captured
                                                                                       referral information.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                Page 41 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
DC.1.23.5     Record Management              Manage Referrals                          The system SHALL provide the ability to
                                                                                       capture completion of a referral
                                                                                       appointment.

DC.1.23.6     Record Management              Manage Referrals                          The system SHOULD provide diagnosis
                                                                                       based clinical guidelines for making a
                                                                                       referral.

DC.1.23.7     Record Management              Manage Referrals                          The system MAY provide order sets for
                                                                                       referral preparation.

DC.1.23.8     Record Management              Manage Referrals                          The system SHALL provide the ability to           [NEED TO STATE JURISDICTIONAL
                                                                                       document transfer of care according to            REGULATIONS AND FACILITY POLICY]
                                                                                       organizational policy, scope of practice,
                                                                                       and jurisdictional law.


DC.1.24.1     Record Management              Manage Order Sets                         The system SHALL provide the ability to           Order sets, which may include medication
                                                                                       present order set(s).                             and non-medication orders, allow a care
                                                                                                                                         provider to choose common orders for a
                                                                                                                                         particular circumstance or disease state
                                                                                                                                         according to standards or other criteria.
                                                                                                                                         Recommended order sets may be
                                                                                                                                         presented based on patient data or other
                                                                                                                                         contexts.


DC.1.24.2     Record Management              Manage Order Sets                         The system SHALL provide the ability to
                                                                                       customizeorders at the patient level from
                                                                                       presented order set templates.


DC.1.24.3     Record Management              Manage Order Sets                         The system SHALL provide the ability to
                                                                                       record each component of an order set
                                                                                       template that is ordered.


DC.1.24.4     Record Management              Manage Order Sets                         The system SHOULD provide the ability
                                                                                       for a provider to choose from among the
                                                                                       order sets pertinent to a certain disease
                                                                                       or other criteria.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                              Page 42 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
DC.1.25.1     Record Management              Manage Medication Administration          The system SHALL present the list of     Present providers with the list of
                                                                                       medications that are to be administered. medications that are to be administered
                                                                                                                                to a patient, necessary administration
                                                                                                                                information, and capture administration
                                                                                                                                details. In a setting in which medication
                                                                                                                                orders are to be administered by a
                                                                                                                                provider rather than the patient, the
                                                                                                                                necessary information is presented
                                                                                                                                including: the list of medication orders
                                                                                                                                that are to be administered;
                                                                                                                                administration instructions, times or
                                                                                                                                other conditions of administration; dose
                                                                                                                                and route, etc.




                                                                                                                                         The system shall securely relate
                                                                                                                                         medications to be administered to the
                                                                                                                                         unique identity of the patient (see
                                                                                                                                         DC.1.1.1). Additionally, the provider can
                                                                                                                                         record what actually was or was not
                                                                                                                                         administered, whether or not these facts
                                                                                                                                         conform to the order. Appropriate time
                                                                                                                                         stamps for all medication related activity
                                                                                                                                         are generated. For some settings that
                                                                                                                                         administer complete sets of medications
                                                                                                                                         from a variety of providers’ orders, it may
                                                                                                                                         be useful to provide an additional check
                                                                                                                                         for possible drug-drug or other
                                                                                                                                         interactions.




DC.1.25.2     Record Management              Manage Medication Administration          The system SHALL display the timing (e.g.,
                                                                                       frequency and hour of administration),
                                                                                       route of administration, and dose of all
                                                                                       medications on the list.



DC.1.25.3     Record Management              Manage Medication Administration          The system SHALL display order directions
                                                                                       (SIG) for administration of all medications
                                                                                       on the list.


            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                Page 43 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
DC.1.25.4     Record Management              Manage Medication Administration          The system SHALL notify the clinician
                                                                                       when medication related activities are
                                                                                       due.

DC.1.25.5     Record Management              Manage Medication Administration          The system SHOULD check and report
                                                                                       allergies, drug-drug interactions, and
                                                                                       other potential adverse reactions (e.g.,
                                                                                       drug to condition), when new
                                                                                       medications are about to be given.



DC.1.25.6     Record Management              Manage Medication Administration          The system SHOULD check and report
                                                                                       other potential adverse reactions, when
                                                                                       new medications are about to be given.



DC.1.25.7     Record Management              Manage Medication Administration          The system SHALL provide the ability to [NEED TO STATE JURISDICTIONAL
                                                                                       capture medication administration details REGULATIONS AND FACILITY POLICY]
                                                                                       -- including timestamps, observations,
                                                                                       complications, and reason if medication
                                                                                       was not given -- in accordance with
                                                                                       organizational policy, scope of practice,
                                                                                       and jurisdictional law.




DC.1.25.8     Record Management              Manage Medication Administration          The system SHALL provide the ability to
                                                                                       securely associate medication-related
                                                                                       activities to the unique identity of the
                                                                                       patient (e.g., verification of
                                                                                       administration to correct patient).




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 44 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                         Capability
DC.1.26.1     Record Management              Manage Immunization Administration        The system SHALL provide the ability to           Capture and maintain discrete data
                                                                                       recommend required immunizations, and             concerning immunizations given to a
                                                                                       when they are due, during an encounter            patient including date administered, type,
                                                                                       based on widely accepted immunization             manufacturer, lot number, and any
                                                                                       schedules (such as from the CDC or                allergic or adverse reactions. Facilitate the
                                                                                       applicable State departments of health)           interaction with an immunization registry
                                                                                                                                         to allow maintenance of a patient’s
                                                                                                                                         immunization history. During an
                                                                                                                                         encounter, recommendations based on
                                                                                                                                         accepted immunization schedules are
                                                                                                                                         presented to the provider. Allergen and
                                                                                                                                         adverse reaction histories are checked
                                                                                                                                         prior to giving the immunization. If an




                                                                                                                                         immunization is administered, discrete
                                                                                                                                         data elements associated with the
                                                                                                                                         immunization including date, type,
                                                                                                                                         manufacturer and lot number are
                                                                                                                                         recorded. Any new adverse or allergic
                                                                                                                                         reactions are noted. If required, a report
                                                                                                                                         is made to the public health immunization
                                                                                                                                         registry.


DC.1.26.2     Record Management              Manage Immunization Administration        The system MAY provide the ability to
                                                                                       recommend required immunizations
                                                                                       based on patient risk factors.


DC.1.26.3     Record Management              Manage Immunization Administration        The system SHALL check for and report
                                                                                       potential adverse or allergic reactions
                                                                                       (based on allergen history and adverse
                                                                                       reaction history) for all immunizations
                                                                                       immediately prior to administration.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                  Page 45 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
DC.1.26.4     Record Management              Manage Immunization Administration        The system SHALL provide the ability to
                                                                                       capture immunization administration
                                                                                       details, including date, type, lot number
                                                                                       and manufacturer.


DC.1.26.5     Record Management              Manage Immunization Administration        The system SHOULD provide the ability to
                                                                                       capture other clinical data pertinent to
                                                                                       the immunization administration (e.g.,
                                                                                       vital signs).

DC.1.26.6     Record Management              Manage Immunization Administration        The system SHALL record as discrete data
                                                                                       elements the data associated with each
                                                                                       immunization administration.



DC.1.26.7     Record Management              Manage Immunization Administration        The system SHOULD provide the ability to
                                                                                       associate standard codes with discrete
                                                                                       data elements associated with an
                                                                                       immunization.

DC.1.26.8     Record Management              Manage Immunization Administration        The system SHALL provide the ability to
                                                                                       update the immunization schedule.


DC.1.26.9     Record Management              Manage Immunization Administration        The system SHOULD provide the ability to
                                                                                       prepare a report of a patient‘s
                                                                                       immunization history upon request for
                                                                                       appropriate authorities.


DC.1.26.10 Record Management                 Manage Immunization Administration        The system MAY transmit required
                                                                                       immunization information to a public
                                                                                       health immunization registry.


DC.1.26.11 Record Management                 Manage Immunization Administration        The system MAY receive immunization
                                                                                       histories from a public health
                                                                                       immunization registry.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 46 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
DC.1.27.1     Record Management              Manage Patient Clinical Measurements      The system SHALL provide the ability to           Patient measures such as vital signs are
                                                                                       capture patient vital signs such as blood         captured and managed as discrete data to
                                                                                       pressure, temperature, heart rate,                facilitate reporting and provision of care.
                                                                                       respiratory rate, and severity of pain as         Other clinical measures (such as
                                                                                       discrete elements of structured or                expiratory flow rate, size of lesion, etc.)
                                                                                       unstructured data.                                are captured and managed, and may be
                                                                                                                                         discrete data.



DC.1.27.2     Record Management              Manage Patient Clinical Measurements      The system SHALL provide the ability to
                                                                                       capture mood and behavior and daily
                                                                                       functioning as either structured or
                                                                                       unstructured data.



DC.1.27.3     Record Management              Manage Patient Clinical Measurements      The system SHOULD provide the ability to
                                                                                       capture other clinical measures (e.g.,
                                                                                       peak expiratory flow rate, size of lesions,
                                                                                       oxygen saturation, height, weight, and
                                                                                       body mass index) as discrete elements of
                                                                                       either structured or unstructured data.




DC.1.27.4     Record Management              Manage Patient Clinical Measurements      The system MAY compute and display
                                                                                       percentile values when data with
                                                                                       normative distributions are entered.



DC.1.27.5     Record Management              Manage Patient Clinical Measurements      The system MAY provide normal ranges
                                                                                       for data based on age and other
                                                                                       parameters such as height, weight, ethnic
                                                                                       background, gestational age.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                Page 47 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
DC.1.28.1     Record Management              Manage Clinical Documents and Notes       The system SHALL provide the ability to           Create, addend, correct, authenticate and
                                                                                       capture clinical documentation                    close, as needed, transcribed or directly-
                                                                                       (henceforth "documentation") including            entered clinical documentation and
                                                                                       original, update by amendment in order            notes. Clinical documents and notes may
                                                                                       to correct, and addenda.                          be unstructured and created in a
                                                                                                                                         narrative form, which may be based on a
                                                                                                                                         template, graphical, audio, etc. The
                                                                                                                                         documents may also be structured
                                                                                                                                         documents that result in the capture of
                                                                                                                                         coded data. Each of these forms of clinical
                                                                                                                                         documentation is important and
                                                                                                                                         appropriate for different users and
                                                                                                                                         situations.




DC.1.28.2     Record Management              Manage Clinical Documents and Notes       The system SHALL provide the ability to
                                                                                       capture free text documentation.



DC.1.28.3     Record Management              Manage Clinical Documents and Notes       The system MAY present documentation
                                                                                       templates (structured or free text) to
                                                                                       facilitate creating documentation.


DC.1.28.4     Record Management              Manage Clinical Documents and Notes       The system SHALL provide the ability to
                                                                                       view other documentation within the
                                                                                       patient's logical record while creating
                                                                                       documentation.



DC.1.28.5     Record Management              Manage Clinical Documents and Notes       The system SHOULD provide the ability to
                                                                                       associate documentation for a specific
                                                                                       patient with a given event, such as a
                                                                                       physician office visit, phone
                                                                                       communication, pharmacist consult,
                                                                                       resident injury, lab result, etc.


DC.1.28.6     Record Management              Manage Clinical Documents and Notes       The system SHOULD provide the ability to
                                                                                       associate documentation with problems
                                                                                       and/or diagnoses.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                Page 48 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
DC.1.28.7     Record Management              Manage Clinical Documents and Notes       The system SHALL provide the ability to
                                                                                       update documentation prior to marking it
                                                                                       as complete (finalizing) it.



DC.1.28.8     Record Management              Manage Clinical Documents and Notes       The system SHALL provide the ability to
                                                                                       mark a document or note as complete
                                                                                       (finalize).

DC.1.28.9     Record Management              Manage Clinical Documents and Notes       The system SHALL provide the ability to
                                                                                       attribute, record and display the identity
                                                                                       of all users contributing to or finalizing a
                                                                                       document or note, including the date and
                                                                                       time of entry.



DC.1.28.10 Record Management                 Manage Clinical Documents and Notes       The system SHALL present captured
                                                                                       documentation.

DC.1.28.11 Record Management                 Manage Clinical Documents and Notes       The system SHALL provide the ability to
                                                                                       filter, search or sort notes.


DC.1.28.12 Record Management                 Manage Clinical Documents and Notes       The system MAY provide documentation
                                                                                       templates for data exchange.


DC.1.29.1     Record Management              Manage Documentation of Clinician         IF decision support prompts are used,             Capture the decision support prompts
                                             Response to Decision Support Prompts      THEN the system SHALL provide the                 and manage decisions to accept or
                                                                                       ability to capture clinical decision support      override decision support prompts.
                                                                                       prompts and user decisions to accept or           Clinician actions in response to decision
                                                                                       override those prompts.                           support prompts are captured and can be
                                                                                                                                         managed at the patient level or
                                                                                                                                         aggregated for organizational trending.




DC.1.29.2     Record Management              Manage Documentation of Clinician         The system SHALL provide the ability to
                                             Response to Decision Support Prompts      record the reason for variation from the
                                                                                       decision support prompt.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                              Page 49 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #                Category                    Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                         Capability
DC.1.29.3     Record Management              Manage Documentation of Clinician          The system SHOULD provide the ability to
                                             Response to Decision Support Prompts       display recorded variances upon request
                                                                                        by authorized users of the EHR.


DC.1.30.1     Record Management              Generate and Record Patient-Specific       IF decision support prompts are used,             Generate and record patient-specific
                                             Instructions                               THEN the system SHALL provide the                 instructions related to pre- and post-
                                                                                        ability to capture clinical decision support      procedural and post- discharge
                                                                                        prompts and user decisions to accept or           requirements. When a patient is
                                                                                        override those prompts.                           scheduled for a test, procedure, or
                                                                                                                                          discharge, specific instructions about diet,
                                                                                                                                          clothing, transportation assistance,
                                                                                                                                          convalescence, follow-up with physician,
                                                                                                                                          etc., may be generated and recorded,
                                                                                                                                          including the timing relative to the
                                                                                                                                          scheduled event.


DC.1.30.2     Record Management              Generate and Record Patient-Specific       The system SHALL provide the ability to
                                             Instructions                               generate instructions pertinent to the
                                                                                        patient and subject to the clinician’s
                                                                                        judgment.


DC.1.30.3     Record Management              Generate and Record Patient-Specific       The system SHALL provide the ability to
                                             Instructions                               include details on further care such as
                                                                                        follow up, return visits and appropriate
                                                                                        timing of further care.



DC.1.30.4     Record Management              Generate and Record Patient-Specific       The system SHALL provide the ability to
                                             Instructions                               record that instructions were given to the
                                                                                        patient.


DC.1.30.5     Record Management              Generate and Record Patient-Specific       The system SHALL provide the ability to
                                             Instructions                               record the actual instructions given to the
                                                                                        patient or reference the document(s)
                                                                                        containing those instructions.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                 Page 50 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                       Vendor Capability Legend

                                                                         1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                         2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                         3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                     Category Description                                  Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                       Capability
DC.1.30.6     Record Management              Generate and Record Patient-Specific         IF decision support prompts are used,
                                             Instructions                                 THEN the system SHALL provide the
                                                                                          ability to capture clinical decision support
                                                                                          prompts and user decisions to accept or
                                                                                          override those prompts.


DC.2.1.1      Clinical Decision Support      Clinical Decision Support                    IF the system is used to enter, modify or
                                                                                          exchange data, THEN the system SHALL
                                                                                          guarantee that the sources and receivers
                                                                                          of data cannot deny that they entered/
                                                                                          sent/received the data.



DC.2.1.2      Clinical Decision Support      Clinical Decision Support                    IF the system exchanges data outside of a
                                                                                          secure network, THEN the system SHALL
                                                                                          ensure that the data are protected.


DC.2.1.3      Clinical Decision Support      Clinical Decision Support                    IF the system exchanges outside of a
                                                                                          secure network, THEN the system SHALL
                                                                                          ensure that the exchange occurs only
                                                                                          among authorized senders and receivers.



DC.2.1.4      Clinical Decision Support      Clinical Decision Support                    IF the system is used to enter or modify
                                                                                          data in the health record, THEN the
                                                                                          system SHALL show authorship and
                                                                                          responsibility for the data.


DC.2.1.5      Clinical Decision Support      Clinical Decision Support                    IF the system is used to extract data for
                                                                                          analysis and reporting, THEN the system
                                                                                          SHALL support data extraction across the
                                                                                          complete health record of an individual.




DC.2.1.6      Clinical Decision Support      Clinical Decision Support                    IF the system stores unstructured data,
                                                                                          THEN the system SHALL ensure data
                                                                                          integrity through all changes.




            Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                             Page 51 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                       Vendor Capability Legend

                                                                         1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                         2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                         3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                     Category Description                                  Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                       Capability
DC.2.1.7      Clinical Decision Support      Clinical Decision Support                    IF the system stores structured data,
                                                                                          THEN the system SHALL ensure data
                                                                                          integrity through all changes.

DC.2.1.8      Clinical Decision Support      Clinical Decision Support                    IF the system processes data for which
                                                                                          generally accepted standard
                                                                                          terminologies have been established,
                                                                                          THEN the system SHALL support semantic
                                                                                          interoperability.


DC.2.1.9      Clinical Decision Support      Clinical Decision Support                    IF the system processes data for which
                                                                                          generally accepted standard
                                                                                          terminologies have been established,
                                                                                          THEN the system SHALL preserve the
                                                                                          semantics of coded data over time.



DC.2.1.10     Clinical Decision Support      Clinical Decision Support                    IF the system exchanges data for which
                                                                                          generally accepted interchange standards
                                                                                          have been established, THEN the system
                                                                                          SHALL support interoperability.


DC.2.1.11     Clinical Decision Support      Clinical Decision Support                    IF the system exchanges data for which
                                                                                          generally accepted interchange standards
                                                                                          have been established, THEN the system
                                                                                          SHALL accommodate the inevitable
                                                                                          evolution of interchange standards.




DC.2.1.12     Clinical Decision Support      Clinical Decision Support                    IF the system exchanges data with other
                                                                                          systems outside itself, THEN the system
                                                                                          SHALL define how the sender and receiver
                                                                                          will exchange data.




            Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                             Page 52 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                      Capability
DC.2.2.1     Clinical Decision Support      Support for Standard Assessments          The system SHALL provide the ability to           Offer prompts to support the adherence
                                                                                      access standard assessments in the                to care plans, guidelines, and protocols at
                                                                                      patient record.                                   the point of information capture. When a
                                                                                                                                        clinician fills out an assessment, data
                                                                                                                                        entered triggers the system to prompt
                                                                                                                                        the assessor to consider issues that would
                                                                                                                                        help assure a complete/accurate
                                                                                                                                        assessment. A simple demographic value
                                                                                                                                        or presenting problem (or combination)
                                                                                                                                        could provide a template for data
                                                                                                                                        gathering that represents best practice in
                                                                                                                                        this situation, (e.g., Type II diabetic
                                                                                                                                        review, fall and 70+, rectal




                                                                                                                                        bleeding, etc. risk assessments,
                                                                                                                                        psychotherapeutic drug use,
                                                                                                                                        incontinence, etc. Examples of accessing
                                                                                                                                        'best practices' include internal
                                                                                                                                        application links to clinical resources or
                                                                                                                                        evidence-based resources, facility defined
                                                                                                                                        help text, etc.)



DC.2.2.2     Clinical Decision Support      Support for Standard Assessments          The system SHALL provide the ability to
                                                                                      access health standards and practices
                                                                                      related to standard assessment and
                                                                                      appropriate to the EHR user’s scope of
                                                                                      practice.

DC.2.2.3     Clinical Decision Support      Support for Standard Assessments          The system SHOULD provide the ability to
                                                                                      compare elements of assessments
                                                                                      captured by the clinician and those
                                                                                      available as best practices and/or
                                                                                      evidence based resources.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                Page 53 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #               Category                     Category Description                                 Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                      Capability
DC.2.2.4     Clinical Decision Support      Support for Standard Assessments            The system MAY provide the ability to
                                                                                        derive supplemental assessment data
                                                                                        from evidence based standard
                                                                                        assessments, practice standards, or other
                                                                                        generally accepted, verifiable, and
                                                                                        regularly updated standard clinical
                                                                                        sources.

DC.2.2.5     Clinical Decision Support      Support for Standard Assessments            The system SHOULD provide prompts
                                                                                        based on practice standards to
                                                                                        recommend additional assessment
                                                                                        functions.


DC.2.2.6     Clinical Decision Support      Support for Standard Assessments            The system SHOULD provide the ability to
                                                                                        update the problem list by activating new
                                                                                        problems and de-activating old problems
                                                                                        as identified by conduct of standard
                                                                                        assessments.


DC.2.2.7     Clinical Decision Support      Support for Standard Assessments            The system SHOULD provide the ability to
                                                                                        prompt additional areas to be assessed as
                                                                                        triggered by the problem list.



DC.2.3.1     Clinical Decision Support      Support for Patient Context- Driven         The system SHALL provide the ability to           Offer prompts based on patient-specific
                                            Assessments                                 access health assessment data in the              data at the point of information capture
                                                                                        patient record.                                   for assessment purposes. When a
                                                                                                                                          clinician fills out an assessment, data
                                                                                                                                          entered is matched against data already
                                                                                                                                          in the system to identify potential
                                                                                                                                          linkages. For example, the system could
                                                                                                                                          scan the medication list and the
                                                                                                                                          knowledge base to see if any of the
                                                                                                                                          symptoms are side effects of medication
                                                                                                                                          already prescribed. Important diagnoses
                                                                                                                                          could be brought to the doctor’s
                                                                                                                                          attention, for instance appendicitis in a
                                                                                                                                          geriatric patient who has abdominal pain.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                              Page 54 of 402
                                                                                      Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                            Vendor
Criteria #               Category                     Category Description                                  Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                           Capability
DC.2.3.2     Clinical Decision Support      Support for Patient Context- Driven          The system SHOULD provide the ability to
                                            Assessments                                  compare assessment data entered during
                                                                                         the encounter and the accessed health
                                                                                         evidence based standards and best
                                                                                         practices.


DC.2.3.3     Clinical Decision Support      Support for Patient Context- Driven          The system SHOULD provide the ability to
                                            Assessments                                  compare health data and patient context-
                                                                                         driven assessments to practice standards,
                                                                                         providing prompts such as additional
                                                                                         assessments, testing, possible diagnoses,
                                                                                         or adjunctive treatment.


DC.2.3.4     Clinical Decision Support      Support for Patient Context- Driven          The system SHOULD provide the ability to
                                            Assessments                                  correlate assessment data and the data in
                                                                                         the patient specific problem list.



DC.2.4.1     Clinical Decision Support      Support for Identification of Potential      The system SHALL provide the ability to           Identify trends that may lead to
                                            Problems and Trends                          access standard assessment data in the            significant problems, and provide
                                                                                         patient record.                                   prompts for consideration. When
                                                                                                                                           personal health information is collected
                                                                                                                                           directly during a patient visit, input by the
                                                                                                                                           patient, or acquired from an external
                                                                                                                                           source (lab results), it is important to be
                                                                                                                                           able to identify potential problems and
                                                                                                                                           trends that may be patient-specific, given
                                                                                                                                           the individual's personal health profile, or
                                                                                                                                           changes warranting further assessment.
                                                                                                                                           For example: significant trends (lab
                                                                                                                                           results, weight); a decrease in creatinine
                                                                                                                                           clearance for a patient on metformin, an
                                                                                                                                           abnormal




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                                  Page 55 of 402
                                                                                      Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                  Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                        Capability
                                                                                                                                           increase in INR for a patient on warfarin,
                                                                                                                                           an increase in suicidal ideation; presence
                                                                                                                                           of methamphetamines; or absence of
                                                                                                                                           therapeutic levels of antidepressants.




DC.2.4.2     Clinical Decision Support      Support for Identification of Potential      The system SHOULD provide the ability to
                                            Problems and Trends                          access health standards and practices
                                                                                         appropriate to the EHR user’s scope of
                                                                                         practice at the time of the encounter.


DC.2.4.3     Clinical Decision Support      Support for Identification of Potential      The system SHOULD provide the ability to
                                            Problems and Trends                          compare patient context-driven
                                                                                         assessments and additional health
                                                                                         information to best practices in order to
                                                                                         identify patient specific growth or
                                                                                         development patterns, health trends and
                                                                                         potential health problems.




DC.2.4.4     Clinical Decision Support      Support for Identification of Potential      The system SHOULD provide the ability to
                                            Problems and Trends                          configure rules defining abnormal trends.



DC.2.4.5     Clinical Decision Support      Support for Identification of Potential      The system SHOULD prompt the provider
                                            Problems and Trends                          with abnormal trends.

DC.2.4.6     Clinical Decision Support      Support for Identification of Potential      The system SHOULD prompt the provider
                                            Problems and Trends                          for additional assessments, testing or
                                                                                         adjunctive treatment.


DC.2.4.7     Clinical Decision Support      Support for Identification of Potential      The system MAY provide the ability to
                                            Problems and Trends                          integrate health information contained in
                                                                                         the record with appropriate teaching
                                                                                         materials.




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                               Page 56 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                           Vendor Comments
                                                                                                                                                                                      Capability
DC.2.5.1     Clinical Decision Support      Support for Patient and Family              The system SHALL provide for the ability          Support the integration of patient and
                                            Preferences                                 to capture and manage patient and family          family preferences into clinical decision
                                                                                        preferences as they pertain to current            support. Decision support functions
                                                                                        treatment plans.                                  should permit consideration of patient/
                                                                                                                                          family preferences and concerns, such as
                                                                                                                                          with language, religion, culture,
                                                                                                                                          medication choice, invasive testing, and
                                                                                                                                          advance directives. Such preferences
                                                                                                                                          should be captured in a manner that
                                                                                                                                          allows for their integration with the
                                                                                                                                          health record and easy retrieval from the
                                                                                                                                          health record. Preferences may be
                                                                                                                                          specified across all treatment plans or
                                                                                                                                          specifically to a treatment plan.




DC.2.5.2     Clinical Decision Support      Support for Patient and Family              The system SHALL provide the ability to
                                            Preferences                                 update care guidelines and options
                                                                                        relating to documented patient and
                                                                                        family preferences, including standards of
                                                                                        practice (e.g., treatment options for
                                                                                        individuals who hydration as part of their
                                                                                        advanced directives).



DC.2.5.3     Clinical Decision Support      Support for Patient and Family              The system MAY provide the ability to
                                            Preferences                                 compare care guidelines and options
                                                                                        relating to documented patient and
                                                                                        family preferences, including standards of
                                                                                        practice.

DC.2.5.4     Clinical Decision Support      Support for Patient and Family              The system MAY prompt the provider for
                                            Preferences                                 testing and treatment options based on
                                                                                        patient and family preferences and
                                                                                        provide the ability to compare to
                                                                                        standard practice.


DC.2.5.5     Clinical Decision Support      Support for Patient and Family              The system MAY provide the ability to
                                            Preferences                                 integrate preferences with appropriate
                                                                                        teaching materials.



           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                              Page 57 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                         Capability
DC.2.5.6     Clinical Decision Support      Support for Patient and Family              The system SHALL provide the ability to
                                            Preferences                                 integrate necessary documentation of
                                                                                        preferences, such as advance directives,
                                                                                        health care proxies, specific consents or
                                                                                        releases.


DC.2.6.1     Clinical Decision Support      Support for Standard Care Plans,            The system SHALL provide the ability to           Support the use of appropriate standard
                                            Guidelines, Protocols                       access standard care plans, protocols and         care plans, guidelines and/or protocols
                                                                                        guidelines when requested within the              for the management of specific
                                                                                        context of a clinical encounter.                  conditions. Before they can be accessed
                                                                                                                                          upon request standard care plans,
                                                                                                                                          protocols, and guidelines must be
                                                                                                                                          created. These documents may reside
                                                                                                                                          within the system or be provided through
                                                                                                                                          links to external sources, and can be
                                                                                                                                          modified and used on a site specific basis.
                                                                                                                                          To facilitate retrospective decision
                                                                                                                                          support, variances from standard care
                                                                                                                                          plans, guidelines, and protocols




                                                                                                                                          can be identified and reported. It is not
                                                                                                                                          the intent of this function to suggest that
                                                                                                                                          guidelines and protocols are presented
                                                                                                                                          for all entries in the care plan. Unlike the
                                                                                                                                          medical model used in acute care
                                                                                                                                          settings, the social model of care used in
                                                                                                                                          LTC does not lend itself as easily to the
                                                                                                                                          use of standard guidelines and
                                                                                                                                          protocols. LTC care planning incorporates
                                                                                                                                          the MDS and RAP process (as well as
                                                                                                                                          other assessments/orders) to identify
                                                                                                                                          social as well as physical strengths and
                                                                                                                                          deficits. There may be no "standard
                                                                                                                                          protocol" for how to




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                 Page 58 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                          Vendor Comments
                                                                                                                                                                                     Capability
                                                                                                                                          measure or further assess "strength in
                                                                                                                                          faith". However where relevant
                                                                                                                                          guidelines and protocols do exist, they
                                                                                                                                          are presented to the user.



DC.2.6.2     Clinical Decision Support      Support for Standard Care Plans,            The system SHOULD provide the ability to
                                            Guidelines, Protocols                       create and use site-specific care plans,
                                                                                        protocols, and guidelines.


DC.2.6.3     Clinical Decision Support      Support for Standard Care Plans,            The system SHALL provide the ability to
                                            Guidelines, Protocols                       access standard care plans, protocols and
                                                                                        guidelines when requested within the
                                                                                        context of a clinical encounter.



DC.2.6.4     Clinical Decision Support      Support for Standard Care Plans,            The system SHOULD provide the ability to
                                            Guidelines, Protocols                       make site-specific modifications to
                                                                                        standard care plans, protocols, and
                                                                                        guidelines obtained from outside sources.



DC.2.6.5     Clinical Decision Support      Support for Standard Care Plans,            The system SHOULD identify, track and
                                            Guidelines, Protocols                       provide alerts, notifications and reports
                                                                                        about significant variances from standard
                                                                                        care plans, guidelines and protocols.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 59 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                        Capability
DC.2.7.1     Clinical Decision Support      Support for Context-Sensitive Care Plans, The system SHALL provide the ability to             Identify and present the appropriate care
                                            Guidelines, Protocols                     access care and treatment plans that are            plans, guidelines and/or protocols for the
                                                                                      sensitive to the context of patient data            management of patient specific
                                                                                      and assessments.                                    conditions that are identified in a patient
                                                                                                                                          clinical encounter. At the time of the
                                                                                                                                          clinical encounter (problem
                                                                                                                                          identification), recommendations for
                                                                                                                                          tests, treatments, medications,
                                                                                                                                          immunizations, referrals and evaluations
                                                                                                                                          are presented based on evaluation of
                                                                                                                                          patient specific data such as age, gender,
                                                                                                                                          developmental stage, their health




                                                                                                                                          profile, and any site-specific
                                                                                                                                          considerations. These may be modified
                                                                                                                                          on the basis of new clinical data at
                                                                                                                                          subsequent encounters.



DC.2.7.2     Clinical Decision Support      Support for Context-Sensitive Care Plans, The system MAY provide the ability to
                                            Guidelines, Protocols                     capture care processes across the
                                                                                      continuum of care.

DC.2.7.3     Clinical Decision Support      Support for Context-Sensitive Care Plans, The system MAY present care processes
                                            Guidelines, Protocols                     from across the continuum of care.


DC.2.7.4     Clinical Decision Support      Support for Context-Sensitive Care Plans, The system MAY provide the ability to
                                            Guidelines, Protocols                     document the choice of action in
                                                                                      response to care plan suggestions.

DC.2.7.5     Clinical Decision Support      Support for Context-Sensitive Care Plans, The system SHOULD identify, track and
                                            Guidelines, Protocols                     provide alerts, notifications and reports
                                                                                      about significant variances from standard
                                                                                      care plans, guidelines and protocols.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                Page 60 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                    Category Description                                Criteria                                 Discussion / Comments                               Vendor Comments
                                                                                                                                                                                         Capability
DC.2.8.1     Clinical Decision Support      Support Consistent Healthcare             The system SHALL provide the ability to           Provide the ability to identify and
                                            Management of Patient Groups or           identify patients eligible for healthcare         consistently manage healthcare, over
                                            Populations                               management protocols based on criteria            time and across populations or groups of
                                                                                      identified within the protocol.                   patients, that share diagnoses, problems,
                                                                                                                                        functional limitations, treatment,
                                                                                                                                        medications, and demographic
                                                                                                                                        characteristics that may impact care,
                                                                                                                                        (e.g., population management, disease
                                                                                                                                        management, wellness management or
                                                                                                                                        care management). Populations or
                                                                                                                                        groups of patients that share diagnoses
                                                                                                                                        (such as diabetes or hypertension),
                                                                                                                                        problems, functional limitations,
                                                                                                                                        treatment, medication, and




                                                                                                                                        demographic characteristics such as race,
                                                                                                                                        ethnicity, religion, socio-economic status
                                                                                                                                        that may impact care are identified for
                                                                                                                                        the clinician. The clinician is advised and
                                                                                                                                        assisted with management of these
                                                                                                                                        patients to optimize the clinician’s ability
                                                                                                                                        to provide appropriate care. For example,
                                                                                                                                        a clinician is alerted to racial, cultural,
                                                                                                                                        religious, socio-economic, living situation
                                                                                                                                        and functional accommodations of the
                                                                                                                                        patient that are required to provide
                                                                                                                                        appropriate care. A further example --
                                                                                                                                        the clinician may be




                                                                                                                                        notified of eligibility for a particular test,
                                                                                                                                        therapy, or follow-up; availability of
                                                                                                                                        supportive resources in the community;
                                                                                                                                        or results from audits of compliance of
                                                                                                                                        these populations with disease
                                                                                                                                        management protocols.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                   Page 61 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.2.8.2     Clinical Decision Support      Support Consistent Healthcare               The system SHALL provide the ability to
                                            Management of Patient Groups or             include or exclude a patient from an
                                            Populations                                 existing health care management
                                                                                        protocol group.

DC.2.8.3     Clinical Decision Support      Support Consistent Healthcare               The system SHOULD provide the ability to
                                            Management of Patient Groups or             audit compliance of selected populations
                                            Populations                                 and groups that are the subjects of
                                                                                        healthcare management protocols.


DC.2.9.1     Clinical Decision Support      Support for Research Protocols Relative     The system SHALL provide the ability to Provide support for the management of
                                            to Individual Patient Care                  present protocols for patients enrolled in patients enrolled in research protocols.
                                                                                        research studies.                          The clinician is presented with
                                                                                                                                   appropriate protocols for patients
                                                                                                                                   participating in research studies, and is
                                                                                                                                   supported in the management and
                                                                                                                                   tracking of study participants.


DC.2.9.2     Clinical Decision Support      Support for Research Protocols Relative     The system SHOULD enable participation
                                            to Individual Patient Care                  in research studies.

DC.2.9.3     Clinical Decision Support      Support for Research Protocols Relative     The system SHOULD provide the ability to
                                            to Individual Patient Care                  identify and track patients participating in
                                                                                        research studies.


DC.2.9.4     Clinical Decision Support      Support for Research Protocols Relative     The system MAY provide the ability to
                                            to Individual Patient Care                  capture appropriate details of patient
                                                                                        condition and response to treatment as
                                                                                        required for patients enrolled in research
                                                                                        studies.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 62 of 402
                                                                                     Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                     Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                       Capability
DC.2.10.1     Clinical Decision Support      Support Self-Care                          The system SHALL provide the ability to           Provide the patient with decision support
                                                                                        present patient guidance and reminders            for self-management of a condition
                                                                                        appropriate for self-management of                between patient-provider encounters.
                                                                                        clinical conditions.                              Patients with specific conditions need to
                                                                                                                                          follow self-management plans that may
                                                                                                                                          include schedules for home monitoring,
                                                                                                                                          lab tests, and clinical check ups;
                                                                                                                                          recommendations about nutrition,
                                                                                                                                          physical activity, tobacco use, etc.; and
                                                                                                                                          guidance or reminders about
                                                                                                                                          medications. Information to support self-
                                                                                                                                          care may be appropriately provided to:
                                                                                                                                          1. the patient, 2. a surrogate (parent,
                                                                                                                                          spouse, guardian), or 3. others involved
                                                                                                                                          directly in the patients self care.




DC.2.10.2     Clinical Decision Support      Support Self-Care                          The system SHALL provide the ability to
                                                                                        manage and/or develop patient guidance
                                                                                        and reminders related to specific clinical
                                                                                        conditions.


DC.2.11.1     Clinical Decision Support      Support for Drug Interaction Checking      The system SHALL check for and alert              Identify drug interaction warnings time of
                                                                                        providers to interactions between                 medication ordering. The clinician is
                                                                                        prescribed drugs and medications on the           alerted to drug-drug, drug-allergy, and
                                                                                        current medication list.                          drug-food interactions at levels
                                                                                                                                          appropriate to the health care setting and
                                                                                                                                          with respect to the patient condition.
                                                                                                                                          These alerts may be customized to suit
                                                                                                                                          the user or group.


DC.2.11.2     Clinical Decision Support      Support for Drug Interaction Checking      The system SHALL relate medication
                                                                                        allergies to medications to facilitate
                                                                                        allergy checking decision support for
                                                                                        medication orders.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                               Page 63 of 402
                                                                                     Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                     Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.2.11.3     Clinical Decision Support      Support for Drug Interaction Checking      The system SHOULD provide the ability to
                                                                                        document that a provider was presented
                                                                                        with and acknowledged a drug interaction
                                                                                        warning.


DC.2.11.4     Clinical Decision Support      Support for Drug Interaction Checking      The system SHALL provide the ability to
                                                                                        prescribe a medication despite alerts for
                                                                                        interactions and/or allergies being
                                                                                        present.

DC.2.11.5     Clinical Decision Support      Support for Drug Interaction Checking      The system MAY provide the ability to set
                                                                                        the severity level at which warnings
                                                                                        should be displayed.

DC.2.11.6     Clinical Decision Support      Support for Drug Interaction Checking      The system SHALL provide the ability to
                                                                                        check for duplicate therapies.



DC.2.11.7     Clinical Decision Support      Support for Drug Interaction Checking      The system SHALL provide the ability to
                                                                                        document why a drug interaction warning
                                                                                        was overridden.



DC.2.11.8     Clinical Decision Support      Support for Drug Interaction Checking      The system MAY check for interactions
                                                                                        between prescribed drugs and food
                                                                                        detailing changes in a drug's effects
                                                                                        potentially caused by food (including
                                                                                        beverages) consumed during the same
                                                                                        time period.


DC.2.11.9     Clinical Decision Support      Support for Drug Interaction Checking      The system SHOULD check for drug-lab
                                                                                        interactions, to indicate to the prescriber
                                                                                        that certain lab test results may be
                                                                                        impacted by a patient’s drugs.


DC.2.11.10 Clinical Decision Support         Support for Drug Interaction Checking      The system SHOULD provide the ability to
                                                                                        check medications against a list of drugs
                                                                                        noted to be ineffective for the patient in
                                                                                        the past.



            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 64 of 402
                                                                                     Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #                Category                     Category Description                                 Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                        Capability
DC.2.11.11 Clinical Decision Support         Support for Drug Interaction Checking       The system SHOULD identify
                                                                                         contraindications between a drug and
                                                                                         patient conditions at the time of
                                                                                         medication ordering.

DC.2.12.1     Clinical Decision Support      Support for Patient Specific Dosing and     The system SHALL provide the ability to           Identify and present appropriate dose
                                             Warnings                                    identify an appropriate drug dosage               recommendations based on known
                                                                                         range, specific for each known patient            patient-conditions and characteristics at
                                                                                         condition (e.g., diagnosis) and parameter         the time of medication ordering. The
                                                                                         (e.g., height, weight, pulse, etc.) at the        clinician is alerted to drug-condition
                                                                                         time of medication ordering.                      interactions and patient specific
                                                                                                                                           contraindications and warnings such as
                                                                                                                                           hepatic or renal insufficiency. The
                                                                                                                                           preferences of the patient may also be
                                                                                                                                           presented reluctance to use an antibiotic.
                                                                                                                                           Additional patient parameters, such as
                                                                                                                                           age, height, weight, BSA, shall also be
                                                                                                                                           incorporated.




DC.2.12.2     Clinical Decision Support      Support for Patient Specific Dosing and     The system SHALL provide the ability to
                                             Warnings                                    automatically alert the provider if
                                                                                         contraindications to the ordered dosage
                                                                                         range are identified.


DC.2.12.3     Clinical Decision Support      Support for Patient Specific Dosing and     The system SHALL provide the ability for
                                             Warnings                                    the provider to override a drug dosage
                                                                                         warning.

DC.2.12.4     Clinical Decision Support      Support for Patient Specific Dosing and     The system SHALL provide the ability to
                                             Warnings                                    document reasons for overriding a drug
                                                                                         alert or warning at the time of ordering.



DC.2.12.5     Clinical Decision Support      Support for Patient Specific Dosing and     The system SHALL transmit documented
                                             Warnings                                    reasons for overriding a drug alert to the
                                                                                         pharmacy to enable communication
                                                                                         between the clinician and the pharmacist.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                               Page 65 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                      Capability
DC.2.12.6     Clinical Decision Support      Support for Patient Specific Dosing and     The system SHOULD transmit
                                             Warnings                                    documented reasons for overriding a
                                                                                         drug alert to the consulting pharmacist
                                                                                         system (when available) to enable
                                                                                         communication between the clinician and
                                                                                         the consulting pharmacist .




DC.2.12.7     Clinical Decision Support      Support for Patient Specific Dosing and     IF the maximum daily doses are known,
                                             Warnings                                    THEN the system SHALL indicate the
                                                                                         maximum dose per day in dosing decision
                                                                                         support.


DC.2.12.8     Clinical Decision Support      Support for Patient Specific Dosing and     The system SHOULD compute drug doses,
                                             Warnings                                    based on appropriate dosage ranges,
                                                                                         using the patient’s body weight.



DC.2.12.9     Clinical Decision Support      Support for Patient Specific Dosing and     The system SHOULD provide the ability to
                                             Warnings                                    specify an alternative “dosing weight” for
                                                                                         the purposes of dose calculation.


DC.2.12.10 Clinical Decision Support         Support for Patient Specific Dosing and     The system SHOULD perform drug dosage
                                             Warnings                                    functions using any component of a
                                                                                         combination drug (e.g., acetaminophen-
                                                                                         hydrocodone).



DC.2.12.11 Clinical Decision Support         Support for Patient Specific Dosing and     The system SHOULD provide the ability to
                                             Warnings                                    display the factors (e.g., lab values,
                                                                                         weight, age, etc.) used to calculate the
                                                                                         dose for a given.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 66 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.2.13.1     Clinical Decision Support      Support for Medication                    The system SHOULD present                         The system should provide
                                             Recommendations                           recommendations for medication                    recommendations and options in
                                                                                       regimens based on the patient diagnosis           medication and monitoring on the basis
                                                                                       (es) (e.g., recommendations.                      of patient diagnosis, cost, local
                                                                                                                                         formularies or therapeutic guidelines and
                                                                                                                                         protocols. Offer alternative medications
                                                                                                                                         on the basis of practice standards (e.g.,
                                                                                                                                         cost or adherence to guidelines), a
                                                                                                                                         generic brand, a different dosage, a
                                                                                                                                         different drug, or no drug (watchful
                                                                                                                                         waiting). Suggest lab order monitoring as
                                                                                                                                         indicated by the medication or the
                                                                                                                                         medical condition to be affected by the
                                                                                                                                         medication. Support expedited




                                                                                                                                         entry of series of medications that are
                                                                                                                                         part of a treatment regimen (i.e., renal
                                                                                                                                         dialysis, Oncology, transplant
                                                                                                                                         medications, etc.).

DC.2.13.2     Clinical Decision Support      Support for Medication                    The system SHALL present alternative
                                             Recommendations                           treatments in medications on the basis of
                                                                                       practice standards, cost, formularies, or
                                                                                       protocols.


DC.2.13.3     Clinical Decision Support      Support for Medication                    The system SHOULD present suggested
                                             Recommendations                           lab monitoring (such as labs, behaviors,
                                                                                       adverse reactions, side effects) as
                                                                                       appropriate to a particular medication.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                              Page 67 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                     Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                       Capability
DC.2.14.1     Clinical Decision Support      Support for Medication and Immunization The system SHALL present information                 Alert providers to potential
                                             Administration                          necessary to correctly identify the patient          administration errors (such as wrong
                                                                                     and accurately administer medications                patient, wrong drug, wrong dose, wrong
                                                                                     and immunizations such as medication                 route and wrong time) in support of safe
                                                                                     name, strength, dose, route and                      and accurate medication administration
                                                                                     frequency, and patient name, patient                 and support medication administration
                                                                                     photo, or other means of positive patient            workflow. To reduce medication errors at
                                                                                     identification.                                      the time of administration of a
                                                                                                                                          medication, the patient is positively
                                                                                                                                          identified; checks on the drug, the dose,
                                                                                                                                          the route and the time are facilitated and
                                                                                                                                          appropriate alerts are provided at the
                                                                                                                                          point of care. Documentation is a by-
                                                                                                                                          product of this checking; administration
                                                                                                                                          details and




                                                                                                                                          additional patient information, such as
                                                                                                                                          injection site, vital signs, and pain
                                                                                                                                          assessments, are captured. Access to
                                                                                                                                          drug monograph information may be
                                                                                                                                          provided to allow providers to check
                                                                                                                                          details about a drug and enhance patient
                                                                                                                                          education. Workflow for medication
                                                                                                                                          administration is supported through
                                                                                                                                          prompts and reminders regarding the
                                                                                                                                          “window” for timely administration of
                                                                                                                                          medications.




DC.2.14.2     Clinical Decision Support      Support for Medication and Immunization The system SHALL alert providers to
                                             Administration                          potential administration errors ( such as
                                                                                     wrong patient, wrong drug, wrong dose,
                                                                                     wrong route and wrong time) as it relates
                                                                                     to medication and immunizations
                                                                                     administration.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                               Page 68 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                     Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.2.14.3     Clinical Decision Support      Support for Medication and Immunization The system SHALL alert providers to
                                             Administration                          potential medication administration
                                                                                     errors at the point of medication
                                                                                     administration.

DC.2.14.4     Clinical Decision Support      Support for Medication and Immunization The system SHALL provide the ability to
                                             Administration                          capture all pertinent details of the
                                                                                     medication administration including
                                                                                     medication name, strength, dose, route,
                                                                                     time of administration, exceptions to
                                                                                     administration, and administrator of the
                                                                                     medication.


DC.2.14.5     Clinical Decision Support      Support for Medication and Immunization The system SHALL provide the ability to
                                             Administration                          capture the administrator of the
                                                                                     immunization and the immunization
                                                                                     information.

DC.2.14.6     Clinical Decision Support      Support for Medication and Immunization IF the system has an electronic means for
                                             Administration                          verification of patient, medication, dose,
                                                                                     route and time THEN the system SHALL
                                                                                     automatically capture the details of
                                                                                     medication or immunization
                                                                                     administration.


DC.2.14.7     Clinical Decision Support      Support for Medication and Immunization The system SHOULD prompt or remind
                                             Administration                          providers regarding the date/time range
                                                                                     for timely administration of medications.


DC.2.14.8     Clinical Decision Support      Support for Medication and Immunization The system MAY suggest alternative
                                             Administration                          administration techniques based on age,
                                                                                     developmental stage, weight,
                                                                                     physiological status, mental status,
                                                                                     educational level, and past physical
                                                                                     history of the patient.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 69 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                    Category Description                                 Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                      Capability
DC.2.14.9     Clinical Decision Support      Support for Medication and Immunization The system SHOULD provide to the ability
                                             Administration                          for a provider to access drug monograph
                                                                                     information.


DC.2.15.1     Clinical Decision Support      Create Order Set Templates                 The system SHALL provide the ability to           Create, capture, maintain and display
                                                                                        create order set templates.                       order set templates based on patient data
                                                                                                                                          or preferred standards or other criteria.
                                                                                                                                          Order set templates, which may include
                                                                                                                                          medication orders, allow a care provider
                                                                                                                                          to choose common orders for a particular
                                                                                                                                          circumstance or disease state according
                                                                                                                                          to standards or other criteria.
                                                                                                                                          Recommended order sets may be
                                                                                                                                          presented based on patient data or other
                                                                                                                                          contexts.




DC.2.15.2     Clinical Decision Support      Create Order Set Templates                 The system SHALL provide the ability to
                                                                                        maintain order set templates, including
                                                                                        version control.


DC.2.15.3     Clinical Decision Support      Create Order Set Templates                 The system SHOULD provide the ability
                                                                                        for providers to create individually
                                                                                        customized order set templates.


DC.2.15.4     Clinical Decision Support      Create Order Set Templates                 The system MAY capture order sets based
                                                                                        on patient data that may be provided by
                                                                                        the provider or that may be in accordance
                                                                                        with preferred standards.


DC.2.15.5     Clinical Decision Support      Create Order Set Templates                 The system MAY provide the ability to
                                                                                        create order set templates for conditions
                                                                                        or diseases.

DC.2.15.6     Clinical Decision Support      Create Order Set Templates                 The system SHALL present the order set
                                                                                        templates to the provider.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                              Page 70 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #                Category                    Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
DC.2.15.7     Clinical Decision Support      Create Order Set Templates                The system MAY provide the ability to
                                                                                       capture the basis of the practice
                                                                                       standards or criteria for the creation of
                                                                                       the order set templates.

DC.2.15.8     Clinical Decision Support      Create Order Set Templates                The system MAY provide the ability to
                                                                                       present order set templates to providers
                                                                                       based on diagnoses, conditions, or
                                                                                       symptoms to aid decision support.



DC.2.16.1     Clinical Decision Support      Support for Non-Medication Ordering       The system SHALL identify required order Display and request provider validation of
                                                                                       entry components for non-medication      information necessary for non-medication
                                                                                       orders.                                  orders that make the order pertinent,
                                                                                                                                relevant and resource-conservative at the
                                                                                                                                time of provider order entry. Possible
                                                                                                                                order entry support includes, but is not
                                                                                                                                limited to: notification of missing results
                                                                                                                                required for the order, suggested
                                                                                                                                corollary orders, notification of duplicate
                                                                                                                                orders, institution-specific order
                                                                                                                                guidelines, guideline-based orders/order
                                                                                                                                sets, order sets, order reference text,
                                                                                                                                patient diagnosis specific
                                                                                                                                recommendations pertaining to the
                                                                                                                                order.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 71 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
                                                                                                                                         Also, warnings for orders that may be
                                                                                                                                         inappropriate or contraindicated for
                                                                                                                                         specific patients (e.g., X-rays for pregnant
                                                                                                                                         women) are presented. Non-medication
                                                                                                                                         orders include orders such as: 1. DNR
                                                                                                                                         order, 2. leave of absence, 3. supplies
                                                                                                                                         such as 4x4’s and ACE bandages, 4. non-
                                                                                                                                         medical devices such as TTY phones for
                                                                                                                                         the hearing impaired, 5. groups of
                                                                                                                                         supplies or kits common to an
                                                                                                                                         organization, 6. simple durable medical
                                                                                                                                         equipment (DME) such as crutches or
                                                                                                                                         walkers, 7. complex




                                                                                                                                         DME such as wheelchairs and hospital
                                                                                                                                         beds, 8. therapies and other services that
                                                                                                                                         may require a referral and/or an
                                                                                                                                         authorization for insurance coverage.



DC.2.16.2     Clinical Decision Support      Support for Non-Medication Ordering        The system SHALL present an alert at the
                                                                                       time of order entry, if a non-medication
                                                                                       order is missing required information.



DC.2.16.3     Clinical Decision Support      Support for Non-Medication Ordering       The system MAY present an alert via
                                                                                       warnings of orders that may be
                                                                                       inappropriate or contraindicated for
                                                                                       specific patients at the time of provider
                                                                                       order entry.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                 Page 72 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #                Category                     Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                         Capability
DC.2.17.1     Clinical Decision Support      Support for Result Interpretation           The system SHALL present alerts for a             Evaluate results and notify provider of
                                                                                         result that is outside of a normal value          results within the context of the patient’s
                                                                                         range.                                            healthcare data. Possible result
                                                                                                                                           interpretations include, but are not
                                                                                                                                           limited to: abnormal result evaluation/
                                                                                                                                           notification, trending of results (such as
                                                                                                                                           discrete lab values), evaluation of
                                                                                                                                           pertinent results at the time of provider
                                                                                                                                           order entry (such as evaluation of lab
                                                                                                                                           results at the time of ordering a radiology
                                                                                                                                           exam), evaluation of incoming results
                                                                                                                                           against active medication orders.




DC.2.17.2     Clinical Decision Support      Support for Result Interpretation           The system SHOULD provide the ability to
                                                                                         trend results.

DC.2.17.3     Clinical Decision Support      Support for Result Interpretation           The system MAY provide the ability to
                                                                                         evaluate pertinent results at the time of
                                                                                         provider order entry (such as evaluation
                                                                                         of lab results at the time of ordering a
                                                                                         radiology exam).


DC.2.18.1     Clinical Decision Support      Support for Referral Process                The system SHALL provide the ability to           Evaluate referrals within the context of a
                                                                                         include clinical and administrative data          patient’s healthcare data. When a
                                                                                         (e.g., insurance information) as part of          healthcare referral is made, health
                                                                                         the referral process.                             information, including pertinent clinical
                                                                                                                                           and behavioral health results,
                                                                                                                                           demographic and insurance data
                                                                                                                                           elements (or lack thereof) are presented
                                                                                                                                           to the provider. Standardized or evidence
                                                                                                                                           based protocols for appropriate workup
                                                                                                                                           prior to referral may be presented.




DC.2.18.2     Clinical Decision Support      Support for Referral Process                The system SHALL provide the ability to
                                                                                         include test and procedure results with a
                                                                                         referral.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                Page 73 of 402
                                                                                     Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #                Category                     Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                         Capability
DC.2.18.3     Clinical Decision Support      Support for Referral Process                The system MAY provide the ability to
                                                                                         include standardized or evidence based
                                                                                         protocols with the referral.


DC.2.18.4     Clinical Decision Support      Support for Referral Process                The system SHOULD allow clinical,
                                                                                         administrative data, and test and
                                                                                         procedure results to be transmitted to
                                                                                         the referral clinician or clinical setting.


DC.2.19.1     Clinical Decision Support      Support for Referral Recommendations        The system SHALL present                          Evaluate patient data and recommend
                                                                                         recommendations for potential referrals           that a patient be referred based on the
                                                                                         based on diagnosis(es).                           specific patient's healthcare data. Entry
                                                                                                                                           of specific patient conditions may lead to
                                                                                                                                           recommendations for referral (e.g., of
                                                                                                                                           depression recommends referral to
                                                                                                                                           psychologist).




DC.2.19.2     Clinical Decision Support      Support for Referral Recommendations        The system SHALL present
                                                                                         recommendations for potential referrals
                                                                                         based on patient condition (e.g.
                                                                                         conditions triggered from MDS such as
                                                                                         declining ADL's, vision or hearing
                                                                                         problems, abnormal lab values,
                                                                                         recommendation for medication
                                                                                         evaluation, etc. ).



DC.2.20.1     Clinical Decision Support      Support for Safe Blood Administration       The system SHALL present information              Provide checking in real-time for potential
                                                                                         necessary to correctly identify the patient       blood administration errors. To reduce
                                                                                         and accurately administer blood products          errors at the time of blood product
                                                                                         including patient name, blood product             administration, the patient is positively
                                                                                         number, amount, route, product                    identified. Additionally, checks on blood
                                                                                         expiration date and time of                       product identification, amount to be
                                                                                         administration.                                   delivered, route and time of
                                                                                                                                           administration are captured, and alerts
                                                                                                                                           are provided as appropriate.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                Page 74 of 402
                                                                                     Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                     Category Description                                Criteria                                Discussion / Comments                          Vendor Comments
                                                                                                                                                                                     Capability
DC.2.20.2     Clinical Decision Support      Support for Safe Blood Administration      The system SHALL capture validation of
                                                                                        the correct matching of the patient to the
                                                                                        blood product.


DC.2.20.3     Clinical Decision Support      Support for Safe Blood Administration      The system SHALL capture the blood
                                                                                        product number, amount, route and time
                                                                                        of administration.


DC.2.20.4     Clinical Decision Support      Support for Safe Blood Administration      The system SHALL capture the blood
                                                                                        pressure, temperature, pulse,
                                                                                        respirations of the patient receiving the
                                                                                        product.

DC.2.21.1     Clinical Decision Support      Support for Accurate Specimen Collection The system SHALL provide the ability to             Provide checking to ensure accurate
                                                                                      present information necessary to                    specimen collection is supported. To
                                                                                      correctly identify the patient and                  ensure the accuracy of specimen
                                                                                      accurately identify the specimen to be              collection, the patient and specimen are
                                                                                      collected including, but not limited to,            positively identified. The provider is
                                                                                      patient name, specimen type, specimen               notified in real-time of potential
                                                                                      source, means of collection, date and               collection errors such as wrong patient,
                                                                                      time.                                               wrong specimen type, wrong means of
                                                                                                                                          collection, wrong site, and wrong date
                                                                                                                                          and time.


DC.2.21.2     Clinical Decision Support      Support for Accurate Specimen Collection The system SHALL report variation
                                                                                      between the type of specimen order
                                                                                      placed and actual specimen received.


DC.2.21.3     Clinical Decision Support      Support for Accurate Specimen Collection The system SHALL capture the details of
                                                                                      specimen collection.

DC.2.21.4     Clinical Decision Support      Support for Accurate Specimen Collection The system SHOULD notify the provider in
                                                                                      real-time of a variation between the type
                                                                                      of specimen order placed and the actual
                                                                                      specimen received.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 75 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                       Vendor Capability Legend

                                                                         1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                         2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                         3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #                Category                     Category Description                                  Criteria                                Discussion / Comments                           Vendor Comments
                                                                                                                                                                                        Capability
DC.2.22.1     Clinical Decision Support      Present Alerts for Preventive Services and The system SHALL provide the ability to             At the point of clinical decision making,
                                             Wellness                                   establish criteria for the identification of        identify patient specific
                                                                                        preventive care and wellness services               suggestions/reminders, screening
                                                                                        based on patient demographics (e.g., age,           tests/exams, and other preventive
                                                                                        gender).                                            services in support of routine preventive
                                                                                                                                            and wellness patient care standards. At
                                                                                                                                            the time of an encounter, the provider or
                                                                                                                                            patient is presented with due or overdue
                                                                                                                                            activities based on protocols for
                                                                                                                                            preventive care and wellness. Examples
                                                                                                                                            include but are not limited to, routine
                                                                                                                                            immunizations, screening such as
                                                                                                                                            mammograms and prostate cancer
                                                                                                                                            checks, colonoscopy, etc. The provider
                                                                                                                                            may wish to provide reminders to the
                                                                                                                                            patient based on the alert.




DC.2.22.2     Clinical Decision Support      Present Alerts for Preventive Services and The system SHALL provide the ability to
                                             Wellness                                   modify the established criteria that
                                                                                        trigger the alerts.

DC.2.22.3     Clinical Decision Support      Present Alerts for Preventive Services and The system SHOULD present
                                             Wellness                                   recommended preventative or wellness
                                                                                        services needed based upon clinical test
                                                                                        results.

DC.2.22.4     Clinical Decision Support      Present Alerts for Preventive Services and The system SHALL present alerts to the
                                             Wellness                                   provider of all patient specific preventive
                                                                                        services that are due.

DC.2.22.5     Clinical Decision Support      Present Alerts for Preventive Services and The system MAY provide the ability to
                                             Wellness                                   produce a list of all alerts along with the
                                                                                        scheduled date and time for the
                                                                                        preventive service.

DC.2.22.6     Clinical Decision Support      Present Alerts for Preventive Services and The system MAY provide the ability to
                                             Wellness                                   produce a history of all alerts that were
                                                                                        generated for the patient in the record.




            Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                              Page 76 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #                Category                     Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                         Capability
DC.2.23.1     Clinical Decision Support      Support for Epidemiological Investigations The system SHALL provide the ability to            Support internal and external
                                             of Clinical Health Within a Population     aggregate patient information based on             epidemiological investigations of clinical
                                                                                        user-identified criteria.                          health of aggregate patient data for use in
                                                                                                                                           identifying health risks from the
                                                                                                                                           environment and/or population in
                                                                                                                                           accordance with jurisdictional law.
                                                                                                                                           Standardized surveillance performance
                                                                                                                                           measures that are based on known
                                                                                                                                           patterns of disease presentation can be
                                                                                                                                           identified by aggregating data from
                                                                                                                                           multiple input mechanisms. For example,
                                                                                                                                           elements include, but are not limited to
                                                                                                                                           patient demographics, resource
                                                                                                                                           utilization, presenting symptoms, acute
                                                                                                                                           treatment




                                                                                                                                           regimens, laboratory and imaging study
                                                                                                                                           orders and results and genomic and
                                                                                                                                           proteomic data elements. Identification
                                                                                                                                           of known patterns of existing diseases
                                                                                                                                           involves aggregation and analysis of these
                                                                                                                                           data elements by existing relationships.
                                                                                                                                           However, the identification of new
                                                                                                                                           patterns of disease requires more
                                                                                                                                           sophisticated pattern recognition
                                                                                                                                           analysis. Early recognition of new
                                                                                                                                           patterns requires data points available
                                                                                                                                           early in the disease presentation.
                                                                                                                                           Demographics,




                                                                                                                                           ordering patterns and resource use (e.g.,
                                                                                                                                           ventilator or intensive care utilization
                                                                                                                                           pattern changes) are often available
                                                                                                                                           earlier in the presentation of non-
                                                                                                                                           predictable diseases. Consumer-
                                                                                                                                           generated information is also valuable
                                                                                                                                           with respect to surveillance efforts.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                Page 77 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                      Capability
DC.2.23.2     Clinical Decision Support      Support for Epidemiological Investigations The system SHALL apply local privacy and
                                             of Clinical Health Within a Population     confidentially rules when assembling
                                                                                        aggregate data to prevent identification
                                                                                        of individuals by unauthorized parties.




DC.2.23.3     Clinical Decision Support      Support for Epidemiological Investigations The system SHOULD provide the ability to
                                             of Clinical Health Within a Population     use demographic or clinical information
                                                                                        as criteria for aggregation.



DC.2.23.4     Clinical Decision Support      Support for Epidemiological Investigations The system SHOULD present aggregate
                                             of Clinical Health Within a Population     data in the form of reports for external
                                                                                        use.

DC.2.23.5     Clinical Decision Support      Support for Epidemiological Investigations The system SHOULD provide the ability to
                                             of Clinical Health Within a Population     save report definitions for later use.



DC.2.23.6     Clinical Decision Support      Support for Epidemiological Investigations The system MAY present aggregate data
                                             of Clinical Health Within a Population     in an electronic format for use by other
                                                                                        analytical programs.

DC.2.23.7     Clinical Decision Support      Support for Epidemiological Investigations The system MAY provide the ability to
                                             of Clinical Health Within a Population     derive statistical information from
                                                                                        aggregate data.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 78 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #                Category                     Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                         Capability
DC.2.24.1     Clinical Decision Support      Support for Notification and Response      The system SHALL provide the ability to           Upon notification by an external,
                                                                                        identify individual care providers or care        authoritative source of a health risk
                                                                                        managers within the facility.                     within the cared for population, alert
                                                                                                                                          relevant providers regarding specific
                                                                                                                                          potentially at-risk patients with the
                                                                                                                                          appropriate level of notification. After
                                                                                                                                          receiving a notice of a health risk within a
                                                                                                                                          cared-for population from public health
                                                                                                                                          authorities or other external authoritative
                                                                                                                                          sources: 1. Identify and notify individual
                                                                                                                                          care providers or care managers that a
                                                                                                                                          risk has been identified and requires
                                                                                                                                          attention; and 2. Provide




                                                                                                                                          suggestions on the appropriate course of
                                                                                                                                          action. A care provider now has the
                                                                                                                                          ability to decide how patients are
                                                                                                                                          notified, if necessary. For example, this
                                                                                                                                          function may be used after detection of a
                                                                                                                                          local outbreak of hepatitis A, advising
                                                                                                                                          providers of the at-risk population and
                                                                                                                                          potential prophylactic treatment.
                                                                                                                                          Notifications to clinicians or patients may
                                                                                                                                          occur by telephone, email, FAX or other
                                                                                                                                          methods.




DC.2.24.2     Clinical Decision Support      Support for Notification and Response      The system SHALL provide the ability to
                                                                                        prepare a response notification to the
                                                                                        care providers or care managers.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                 Page 79 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                     Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.2.24.3     Clinical Decision Support      Support for Notification and Response      The system SHALL provide the ability to
                                                                                        capture notification of a health risk within
                                                                                        the resident/patient population from
                                                                                        public health authorities or other external
                                                                                        authoritative sources as either free-text
                                                                                        or a structured message (or by other
                                                                                        means).


DC.2.24.4     Clinical Decision Support      Support for Notification and Response      The system SHOULD provide the ability to
                                                                                        coordinate with local and national
                                                                                        programs to disseminate notifications of
                                                                                        health risk to individual care providers or
                                                                                        care-managers within the facility.


DC.2.24.5     Clinical Decision Support      Support for Notification and Response      The system MAY provide the ability to
                                                                                        notify patients, directly or indirectly, who
                                                                                        are described by the health risk alert.



DC.2.24.6     Clinical Decision Support      Support for Notification and Response      The system MAY present suggestions to
                                                                                        the care provider indicating an
                                                                                        appropriate course of action.


DC.2.24.7     Clinical Decision Support      Support for Notification and Response      The system SHALL provide the ability to
                                                                                        notify public health authorities or other
                                                                                        external authoritative sources of a health
                                                                                        risk within the resident/patient
                                                                                        population in accordance with scope of
                                                                                        practice, organizational policy and
                                                                                        jurisdictional law.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 80 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                       Vendor Capability Legend

                                                                         1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                         2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                         3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                           Vendor
Criteria #                Category                     Category Description                                  Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                          Capability
DC.2.25.1     Clinical Decision Support      Support for Monitoring Response              The system SHALL present specific actions In the event of a health risk alert and
                                             Notifications Regarding a Specific           to be taken at the patient level for a    subsequent notification related to a
                                             Patient’s Health                             health risk alert.                        specific patient, monitor if expected
                                                                                                                                    actions have been taken, and execute
                                                                                                                                    follow-up notification if they have not.
                                                                                                                                    Identifies that expected follow-up for a
                                                                                                                                    specific patient event (e.g., follow up to
                                                                                                                                    error alerts or absence of an expected lab
                                                                                                                                    result) has not occurred and
                                                                                                                                    communicate the omission to appropriate
                                                                                                                                    care providers in the chain of authority.
                                                                                                                                    The notification process requires a




                                                                                                                                            security infrastructure that provides the
                                                                                                                                            ability to match a care provider’s clinical
                                                                                                                                            privileges with the clinical requirements
                                                                                                                                            of the notification.



DC.2.25.2     Clinical Decision Support      Support for Monitoring Response              The system SHALL notify appropriate care
                                             Notifications Regarding a Specific           providers of specific patient actions
                                             Patient’s Health                             required by a health risk alert.


DC.2.25.3     Clinical Decision Support      Support for Monitoring Response              The system SHALL provide the ability to
                                             Notifications Regarding a Specific           identify those patients who have not
                                             Patient’s Health                             received appropriate action in response
                                                                                          to a health risk alert.


DC.2.25.4     Clinical Decision Support      Support for Monitoring Response              The system SHOULD provide the ability to
                                             Notifications Regarding a Specific           produce a report on the omission of an
                                             Patient’s Health                             appropriate response to the health risk
                                                                                          alert in specific patients.




            Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                                Page 81 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #                Category                    Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
DC.2.26.1     Clinical Decision Support      Access Healthcare Guidance                The system SHALL provide the ability to           Provide pertinent information from
                                                                                       access evidence-based healthcare                  available evidence-based knowledge, at
                                                                                       recommendations, with documentation               the point of care, for use in healthcare
                                                                                       of sources                                        decisions and care planning. The
                                                                                                                                         information available regarding disease,
                                                                                                                                         disease processes, diagnostic testing,
                                                                                                                                         pharmaceuticals, treatment patterns and
                                                                                                                                         all aspects of healthcare is constantly
                                                                                                                                         changing. The practitioner should be able
                                                                                                                                         to access a wide variety of sources that
                                                                                                                                         provide relevant, accurate information
                                                                                                                                         about any given subject. Examples of
                                                                                                                                         resources include, but are not




                                                                                                                                         limited to: evidence on treatment of
                                                                                                                                         specific medical conditions, maintenance
                                                                                                                                         of wellness, drug or device trials, context-
                                                                                                                                         specific information available through
                                                                                                                                         online journals, printed resources such as
                                                                                                                                         books and specialty organizations
                                                                                                                                         resources. For example, when a condition
                                                                                                                                         is diagnosed the provider might be
                                                                                                                                         directed to relevant resources that give
                                                                                                                                         updated clinical research, useful
                                                                                                                                         pharmaceutical combinations, surgical
                                                                                                                                         techniques, products or other
                                                                                                                                         information useful in the management of
                                                                                                                                         the specific condition under
                                                                                                                                         consideration.




DC.2.26.2     Clinical Decision Support      Access Healthcare Guidance                The system SHALL provide the ability to
                                                                                       access evidenced-based documentation
                                                                                       appropriate for the care provider to
                                                                                       render a timely judgment.




            Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                                 Page 82 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #                Category                    Category Description                                  Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                        Capability
DC.2.26.3     Clinical Decision Support      Access Healthcare Guidance                  The system SHOULD provide the ability to
                                                                                         access external evidence-based
                                                                                         documentation.

DC.2.27.1     Clinical Decision Support      Patient Knowledge Access                    The system SHALL provide the ability to           Provide the ability to access reliable
                                                                                         access information about wellness,                information about wellness, disease
                                                                                         disease management, treatments, and               management, treatments, peer support
                                                                                         related information that is relevant for a        groups and related information that is
                                                                                         specific patient.                                 relevant for a specific patient. An
                                                                                                                                           individual will be able to find reliable
                                                                                                                                           information to research a health
                                                                                                                                           question, follow up from a clinical visit,
                                                                                                                                           identify treatment options, or other
                                                                                                                                           health information needs. The
                                                                                                                                           information may be linked directly from
                                                                                                                                           entries in the health record, or may be
                                                                                                                                           accessed through other means such as
                                                                                                                                           key word search.




                                                                                                                                           The information may be provided as part
                                                                                                                                           of the EHR system but may also include
                                                                                                                                           patient information from external
                                                                                                                                           databases or specific websites.



DC.2.27.2     Clinical Decision Support      Patient Knowledge Access                    The system MAY provide the ability to
                                                                                         access information related to a health
                                                                                         question directly from data in the health
                                                                                         record or other means such as key word
                                                                                         search.

DC.2.27.3     Clinical Decision Support      Patient Knowledge Access                    The system MAY provide the ability to
                                                                                         access patient educational information
                                                                                         from external sources.

DC.2.27.4     Clinical Decision Support      Patient Knowledge Access                    IF the information is external-based,
                                                                                         THEN the system MAY provide the ability
                                                                                         to identify links specific to the
                                                                                         information.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                               Page 83 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                  Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                         Capability
DC.3.1.1     Operations Management          Clinical Workflow Tasking                                                                      Schedule and manage tasks with
             and Communication                                                                                                             appropriate timeliness. Since the
                                                                                                                                           electronic health record will replace the
                                                                                                                                           paper chart, tasks that were based on the
                                                                                                                                           paper artifact must be effectively
                                                                                                                                           managed in the electronic environment.
                                                                                                                                           Functions must exist in the EHR-S that
                                                                                                                                           support electronically any workflow that
                                                                                                                                           previously depended on the existence of
                                                                                                                                           a physical artifact (such as the paper
                                                                                                                                           chart, a phone message slip) in a paper
                                                                                                                                           based system. Tasks differ from other
                                                                                                                                           more generic communication among
                                                                                                                                           participants in the care




                                                                                                                                           process because they are a call to action
                                                                                                                                           and target completion of a specific
                                                                                                                                           workflow in the context of a patient's
                                                                                                                                           health record (including a specific
                                                                                                                                           component of the record). Tasks also
                                                                                                                                           require disposition (final resolution). The
                                                                                                                                           initiator may optionally require a
                                                                                                                                           response. For example, in a paper based
                                                                                                                                           system, physically placing charts in piles
                                                                                                                                           for review creates a physical queue of
                                                                                                                                           tasks related to those charts. This queue
                                                                                                                                           of tasks (for example, a set of patient
                                                                                                                                           phone calls to be returned) must be
                                                                                                                                           supported electronically so that




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                                Page 84 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                           Vendor
Criteria #               Category                     Category Description                                Criteria                                 Discussion / Comments                               Vendor Comments
                                                                                                                                                                                          Capability
                                                                                                                                         the list (of patients to be called) is visible
                                                                                                                                         to the appropriate user or role for
                                                                                                                                         disposition. Tasks are time-limited (or
                                                                                                                                         finite). The state transition (e.g., created,
                                                                                                                                         performed and resolved) may be
                                                                                                                                         managed by the user explicitly or
                                                                                                                                         automatically based on rules. For
                                                                                                                                         example, if a user has a task to signoff on
                                                                                                                                         a test result, that task should
                                                                                                                                         automatically be marked complete by the
                                                                                                                                         EHR when the test result linked to the
                                                                                                                                         task is signed in the system. Patients will
                                                                                                                                         become more involved in the care
                                                                                                                                         process by receiving tasks related to their




                                                                                                                                          care. Examples of patient related tasks
                                                                                                                                         include acknowledgement of receipt of a
                                                                                                                                         test result forwarded from the provider,
                                                                                                                                         or a request to schedule an appointment
                                                                                                                                         for a pap smear (based on age and
                                                                                                                                         frequency criteria) generated
                                                                                                                                         automatically by the EHR-S on behalf of
                                                                                                                                         the provider.



DC.3.2.1     Operations Management          Clinical Task Assignment and Routing       The system SHALL provide the ability for          Assignment, delegation and/or
             and Communication                                                         users to create manual clinical tasks.            transmission of tasks to the appropriate
                                                                                                                                         parties. Tasks are at all times assigned to
                                                                                                                                         at least one user or role for disposition.
                                                                                                                                         Whether the task is assignable and to
                                                                                                                                         whom the task can be assigned will be
                                                                                                                                         determined by the specific needs of
                                                                                                                                         practitioners in a care setting. Task-
                                                                                                                                         assignment lists help users prioritize and
                                                                                                                                         complete assigned tasks. For example,
                                                                                                                                         after receiving communication (e.g. a
                                                                                                                                         phone call or e-mail) from a physician for
                                                                                                                                         a urinalysis, the nurse routes or assigns a
                                                                                                                                         task to




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                   Page 85 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                         Capability
                                                                                                                                         clinical staff to collect a urine specimen.
                                                                                                                                         Task creation and assignment may be
                                                                                                                                         automated, where appropriate. An
                                                                                                                                         example of a system-triggered task is
                                                                                                                                         when lab results are received
                                                                                                                                         electronically; a task to review the result
                                                                                                                                         is automatically generated and assigned
                                                                                                                                         to a clinician. Task assignment ensures
                                                                                                                                         that all tasks are disposed of by the
                                                                                                                                         appropriate person or role and allows
                                                                                                                                         efficient interaction of entities in the care
                                                                                                                                         process.




DC.3.2.2     Operations Management          Clinical Task Assignment and Routing       The system SHALL provide the ability to
             and Communication                                                         automate clinical task creation.



DC.3.2.3     Operations Management          Clinical Task Assignment and Routing       The system SHALL provide the ability to
             and Communication                                                         manually modify and update task status
                                                                                       (e.g., created, performed, held, canceled,
                                                                                       pended, denied, and resolved).



DC.3.2.4     Operations Management          Clinical Task Assignment and Routing       The system SHOULD provide the ability to
             and Communication                                                         automatically modify or update the status
                                                                                       of tasks based on workflow rules.



DC.3.2.5     Operations Management          Clinical Task Assignment and Routing       The system SHOULD provide the ability to
             and Communication                                                         assign, and change the assignment of,
                                                                                       tasks to individuals or to clinical roles.



DC.3.2.6     Operations Management          Clinical Task Assignment and Routing       The system SHOULD provide the ability to
             and Communication                                                         manage workflow task routing to multiple
                                                                                       individuals or roles in succession and/or
                                                                                       in parallel.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                  Page 86 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                     Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.3.2.7      Operations Management          Clinical Task Assignment and Routing       The system SHOULD provide the ability to
              and Communication                                                         prioritize tasks based on urgency assigned
                                                                                        to the task.

DC.3.2.8      Operations Management          Clinical Task Assignment and Routing       The system SHOULD provide the ability to
              and Communication                                                         restrict task assignment based on
                                                                                        appropriate role as defined by the entity.



DC.3.2.9      Operations Management          Clinical Task Assignment and Routing       The system MAY provide the ability to
              and Communication                                                         restrict task assignment based on an
                                                                                        individual as defined by the entity .



DC.3.2.10     Operations Management          Clinical Task Assignment and Routing       The system SHOULD provide the ability to
              and Communication                                                         escalate clinical tasks manually or per
                                                                                        business rules as appropriate to ensure
                                                                                        timely completion.


DC.3.2.11     Operations Management          Clinical Task Assignment and Routing       IF the system is used to enter, modify, or
              and Communication                                                         exchange data, THEN the system SHALL
                                                                                        guarantee that the sources and receivers
                                                                                        of data cannot deny that they entered/
                                                                                        modified/sent/received the data.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 87 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                      Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                        Capability
DC.3.3.1     Operations Management          Clinical Task Linking                       The system SHALL provide the ability to           Linkage of tasks to patients and/or a
             and Communication                                                          link a clinical task to the component of          relevant part of the electronic health
                                                                                        the EHR required to complete the task             record. Clinical tasks must include
                                                                                        (e.g., a task to take weights links to the        information or provide an electronic link
                                                                                        ‘Weights and Vitals’ screen to record the         to information that is required to
                                                                                        result; a task to complete a Fall                 complete the task. For example, this may
                                                                                        assessment links to the Fall assessment           include a patient location in a facility, a
                                                                                        form to be completed; the weekly task to          family’s contact information, or a link to
                                                                                        perform skin checks links to the                  new lab results in the patient’s EHR. An
                                                                                        documentation template for skin                   example of a well defined task is "Dr.
                                                                                        assessment).                                      Jones must review Mr. Smith's blood
                                                                                                                                          work results." Efficient workflow is
                                                                                                                                          facilitated by navigating to the
                                                                                                                                          appropriate area of the record to




                                                                                                                                          ensure that the appropriate test result for
                                                                                                                                          the correct patient is reviewed. Other
                                                                                                                                          examples of tasks might involve
                                                                                                                                          fulfillment of orders or responding to
                                                                                                                                          family phone calls.



DC.3.4.1     Operations Management          Clinical Task Tracking                      The system SHALL provide the ability to           Track tasks to facilitate monitoring for
             and Communication                                                          track the status of tasks.                        timely and appropriate completion of
                                                                                                                                          each task. In order to reduce the risk of
                                                                                                                                          errors during the care process due to
                                                                                                                                          missed tasks, the provider is able to view
                                                                                                                                          and track un-disposed tasks, current work
                                                                                                                                          lists, the status of each task, unassigned
                                                                                                                                          tasks or other tasks where a risk of
                                                                                                                                          omission exists. The timeliness of certain
                                                                                                                                          tasks can be tracked, or reports
                                                                                                                                          generated, in accordance with relevant
                                                                                                                                          law and accreditation standards. For
                                                                                                                                          example, a provider is able to create a
                                                                                                                                          report that




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                Page 88 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #               Category                     Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
                                                                                                                                         shows tests that have not yet been
                                                                                                                                         performed such as urine specimen
                                                                                                                                         obtained, blood work drawn, etc.

DC.3.4.2     Operations Management          Clinical Task Tracking                     The system SHALL provide the ability to
             and Communication                                                         notify providers of the status of tasks.



DC.3.4.3     Operations Management          Clinical Task Tracking                     The system SHALL provide the ability to
             and Communication                                                         sort clinical tasks by status.



DC.3.4.4     Operations Management          Clinical Task Tracking                     The system SHOULD provide the ability to
             and Communication                                                         present current clinical tasks as work lists.



DC.3.4.5     Operations Management          Clinical Task Tracking                     The system SHOULD provide the ability to
             and Communication                                                         sort or filter clinical task lists presented in
                                                                                       reports or on the screen.


DC.3.4.6     Operations Management          Clinical Task Tracking                     IF the system is used to enter, modify, or
             and Communication                                                         exchange data, THEN the system SHALL
                                                                                       guarantee that the sources and receivers
                                                                                       of data cannot deny that they entered/
                                                                                       modified/sent/received the data.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 89 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                       Vendor Capability Legend

                                                                         1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                         2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                         3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                   Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                         Capability
DC.3.5.1     Operations Management          Support for Inter-Provider                    The system SHALL provide the ability to           Support exchange of information
             and Communication              Communication                                 document in the patient record                    between providers as part of the patient
                                                                                          verbal/telephone communication                    care process, and the appropriate
                                                                                          between providers.                                documentation of such exchanges.
                                                                                                                                            Support secure communication to protect
                                                                                                                                            the privacy of information as required by
                                                                                                                                            federal or jurisdictional law.
                                                                                                                                            Communication among providers
                                                                                                                                            involved in the care process can range
                                                                                                                                            from real time communication (for
                                                                                                                                            example, communication between a
                                                                                                                                            therapist and nurse), to asynchronous
                                                                                                                                            communication (for example, consult
                                                                                                                                            reports between physicians). Some forms
                                                                                                                                            of inter-




                                                                                                                                            practitioner communication will be paper
                                                                                                                                            based and the EHR-S must be able to
                                                                                                                                            produce appropriate documents. The
                                                                                                                                            system should provide for both verbal
                                                                                                                                            and written communication. These
                                                                                                                                            exchanges would include, but not be
                                                                                                                                            limited to, consults and referrals as well
                                                                                                                                            as possible exchanges within the office as
                                                                                                                                            part of the provision and administration
                                                                                                                                            of patient care (for example, the
                                                                                                                                            communication of new information
                                                                                                                                            obtained within the office environment
                                                                                                                                            during the process of administration of a
                                                                                                                                            tetanus shot while the patient is in




                                                                                                                                            the exam room). The system should
                                                                                                                                            support the creation and acceptance of
                                                                                                                                            paper artifacts where appropriate.




           Dixon Hughes PLLC Confidential                                                                                       8/15/2010                                                                               Page 90 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                       Vendor Capability Legend

                                                                         1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                         2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                         3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                   Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                        Capability
DC.3.5.2     Operations Management          Support for Inter-Provider                    The system SHALL provide the ability to
             and Communication              Communication                                 incorporate scanned documents from
                                                                                          providers into the patient record.


DC.3.5.3     Operations Management          Support for Inter-Provider                    The system SHOULD provide the ability to
             and Communication              Communication                                 communicate using real-time messaging.



DC.3.5.4     Operations Management          Support for Inter-Provider                    The system SHOULD provide the ability to
             and Communication              Communication                                 communicate clinical information (e.g.
                                                                                          referrals) via secure e-mail or other
                                                                                          electronic means (such as a CCD).


DC.3.5.5     Operations Management          Support for Inter-Provider                    The system MAY provide the ability to
             and Communication              Communication                                 transmit electronic multi-media data
                                                                                          types representing pictures, sound clips,
                                                                                          or video as part of the patient record.



DC.3.6.1     Operations Management          Support for Provider -Pharmacy                The system SHALL provide the ability to           Provide features to enable secure bi-
             and Communication              Communication                                 order medications.                                directional communication of information
                                                                                                                                            electronically between practitioners and
                                                                                                                                            pharmacies or between practitioner and
                                                                                                                                            intended recipient of pharmacy orders.
                                                                                                                                            When a medication is prescribed, the
                                                                                                                                            order is routed to the pharmacy or other
                                                                                                                                            intended recipient of pharmacy orders.
                                                                                                                                            This information is used to avoid
                                                                                                                                            transcription errors and facilitate
                                                                                                                                            detection of potential adverse reactions.
                                                                                                                                            If there is a question from the pharmacy,
                                                                                                                                            that communication can be presented to
                                                                                                                                            the provider with




           Dixon Hughes PLLC Confidential                                                                                       8/15/2010                                                                              Page 91 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                    Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
                                                                                                                                         their other tasks. In the nursing facility,
                                                                                                                                         medication order creation is a
                                                                                                                                         collaborative process involving the
                                                                                                                                         prescriber and facility staff. Accordingly,
                                                                                                                                         this function applies to communication
                                                                                                                                         process between the prescriber, facility
                                                                                                                                         and the pharmacy or other intended
                                                                                                                                         recipient of pharmacy orders.



DC.3.6.2     Operations Management          Support for Provider -Pharmacy             The system SHALL electronically
             and Communication              Communication                              communicate orders between the
                                                                                       prescriber/facility and pharmacy, as
                                                                                       necessary, to initiate, change, or renew a
                                                                                       medication order.

DC.3.6.3     Operations Management          Support for Provider -Pharmacy             The system SHOULD provide the ability to
             and Communication              Communication                              communicate a request to the pharmacy
                                                                                       (based on an existing order) that
                                                                                       additional medication be delivered (i.e.,
                                                                                       re-supply request).


DC.3.6.4     Operations Management          Support for Provider -Pharmacy             The system SHALL receive any
             and Communication              Communication                              acknowledgements, prior authorizations,
                                                                                       renewals, inquiries and fill notifications
                                                                                       provided by the pharmacy or other
                                                                                       participants in the electronic prescription
                                                                                       and make it available for entry in the
                                                                                       patient record.


DC.3.6.5     Operations Management          Support for Provider -Pharmacy             The system SHALL receive any
             and Communication              Communication                              acknowledgements, prior authorizations,
                                                                                       renewals, inquiries and fill notifications
                                                                                       provided by the pharmacy or other
                                                                                       participants in the electronic prescription
                                                                                       and make it available for entry in the
                                                                                       patient record.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                Page 92 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #                Category                    Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.3.6.6      Operations Management          Support for Provider -Pharmacy             The system SHALL have the ability to
              and Communication              Communication                              indicate that a NCPDP SCRIPT message
                                                                                        has been sent or received, and display
                                                                                        that message in human readable form.



DC.3.6.7      Operations Management          Support for Provider -Pharmacy             The system SHOULD have the ability to
              and Communication              Communication                              exchange Drug Utilization Review (DUR)
                                                                                        findings and Formulary & Benefits (F&B)
                                                                                        data with the pharmacy using NCPDP
                                                                                        SCRIPT (version 10.2 or higher).



DC.3.6.8      Operations Management          Support for Provider -Pharmacy             The system SHOULD have the ability to
              and Communication              Communication                              notify the user when an NCPDP SCRIPT
                                                                                        message has been received from an
                                                                                        external source (such as pharmacy or
                                                                                        prescriber).

DC.3.6.9      Operations Management          Support for Provider -Pharmacy             The system MAY provide the ability for
              and Communication              Communication                              providers and pharmacies to
                                                                                        communicate clinical information via
                                                                                        secure e-mail or other electronic means,
                                                                                        on both general and specific orders.



DC.3.6.10     Operations Management          Support for Provider -Pharmacy             The system SHALL transmit in real-time.
              and Communication              Communication

DC.3.6.11     Operations Management          Support for Provider -Pharmacy             The system MAY provide the ability to
              and Communication              Communication                              include workflow tasks as part of
                                                                                        communication to the provider.

DC.3.6.12     Operations Management          Support for Provider -Pharmacy             IF the system is used to enter, modify, or
              and Communication              Communication                              exchange data, THEN the system SHALL
                                                                                        guarantee that the sources and receivers
                                                                                        of data cannot deny that they entered/
                                                                                        modified/ sent/received the data.




            Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 93 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                            Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                                Vendor Comments
                                                                                                                                                                                           Capability
DC.3.7.1     Operations Management          Support for Communications Between          The system SHALL provide the ability to           Facilitate communications between
             and Communication              Provider and Patient and/or the Patient     capture documentation of                          providers and patients and/or the patient
                                            Representative                              communications between providers and              representatives. Providers are able to
                                                                                        patients and/ or the patient                      communicate with patients and others,
                                                                                        representatives.                                  capturing the nature and content of
                                                                                                                                          electronic communication, or the time
                                                                                                                                          and details of other communication. The
                                                                                                                                          "capture of communication" can be in the
                                                                                                                                          form of progress notes that are
                                                                                                                                          designated as "communication" or
                                                                                                                                          through automated processes. Eaxmple:
                                                                                                                                          1. Notification of patient surrogate of the
                                                                                                                                          results of tests (such as x-ray) or
                                                                                                                                          assessments




                                                                                                                                          (such as Fall Risk), 2. e-Mail notification of
                                                                                                                                          care plan conference schedules, 3.
                                                                                                                                          Automated notification regarding annual
                                                                                                                                          flu shots.



DC.3.7.2     Operations Management          Support for Communications Between          The system SHALL provide the ability to
             and Communication              Provider and Patient and/or the Patient     incorporate scanned documents.
                                            Representative

DC.3.7.3     Operations Management          Support for Communications Between          The system SHALL provide the ability to
             and Communication              Provider and Patient and/or the Patient     document communication originating
                                            Representative                              with the patient or patient representative
                                                                                        (e.g. date, entity, details of
                                                                                        communication).

DC.3.7.4     Operations Management          Support for Communications Between          The system SHOULD provide the ability to
             and Communication              Provider and Patient and/or the Patient     communicate between providers and
                                            Representative                              patients or their representative using a
                                                                                        secure internet connection.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                   Page 94 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                      Capability
DC.3.7.5      Operations Management          Support for Communications Between          The system SHALL provide the ability to
              and Communication              Provider and Patient and/or the Patient     manage documentation regarding family
                                             Representative                              member or patient representative
                                                                                         authorizations to receive patient related
                                                                                         health information.



DC.3.7.6      Operations Management          Support for Communications Between          The system SHOULD alert providers to the
              and Communication              Provider and Patient and/or the Patient     presence of patient or patient
                                             Representative                              representative originated
                                                                                         communications.

DC.3.7.7      Operations Management          Support for Communications Between          The system MAY provide the ability to
              and Communication              Provider and Patient and/or the Patient     alert patients or patient representative to
                                             Representative                              provider absences (e.g., vacations) and
                                                                                         recommend rerouting of the information
                                                                                         or request.



DC.3.7.8      Operations Management          Support for Communications Between          The system MAY provide the ability to
              and Communication              Provider and Patient and/or the Patient     remind the patient or patient
                                             Representative                              representative of events related to their
                                                                                         care (e.g. upcoming appointments) as
                                                                                         agreed upon by the patient and/or the
                                                                                         patient representative.



DC.3.7.9      Operations Management          Support for Communications Between          The system SHOULD alert providers to the
              and Communication              Provider and Patient and/or the Patient     presence of patient or patient
                                             Representative                              representative originated
                                                                                         communications.

DC.3.7.10     Operations Management          Support for Communications Between          IF the system is used to enter, modify, or
              and Communication              Provider and Patient and/or the Patient     exchange data, THEN the system SHALL
                                             Representative                              guarantee that the sources and receivers
                                                                                         of data cannot deny that they entered/
                                                                                         modified/sent/received the data.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 95 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                           Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                          Capability
DC.3.8.1     Operations Management          Patient, Family and Care Giver Education The system SHALL provide the ability to              Facilitate access to educational or support
             and Communication                                                       access to a library of educational material          resources pertinent to, and usable by, the
                                                                                     for health concerns, conditions, and/or              patient or patient representative. The
                                                                                     diagnosis.                                           provider or patient is presented with a
                                                                                                                                          library of educational materials. Material
                                                                                                                                          may be made available in the language or
                                                                                                                                          dialect understood by the patient or
                                                                                                                                          representative. Material should be at the
                                                                                                                                          level of the patient or representative’s
                                                                                                                                          level of understanding and sensory
                                                                                                                                          capability. Special needs are documented.
                                                                                                                                          Material may be disseminated via a mode
                                                                                                                                          available to and acceptable by the patient
                                                                                                                                          (e.g., printed, electronically or otherwise).




                                                                                                                                          The review of material between the
                                                                                                                                          clinician and the patient, and the patient’s
                                                                                                                                          understanding of the review, is
                                                                                                                                          documented when desired by the
                                                                                                                                          clinician. The patient or patient’s
                                                                                                                                          representatives are able to obtain
                                                                                                                                          educational information independently
                                                                                                                                          without formal review with the clinician if
                                                                                                                                          desired.



DC.3.8.2     Operations Management          Patient, Family and Care Giver Education The system SHALL provide the ability to
             and Communication                                                       communicate applicable educational
                                                                                     materials to the patient and/or patient
                                                                                     representative.


DC.3.8.3     Operations Management          Patient, Family and Care Giver Education The system MAY provide educational
             and Communication                                                       material in multiple languages.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                                  Page 96 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
DC.3.8.4     Operations Management          Patient, Family and Care Giver Education The system MAY provide patient
             and Communication                                                       educational materials using alternative
                                                                                     modes to accommodate patient sensory
                                                                                     capabilities.

DC.3.8.5     Operations Management          Patient, Family and Care Giver Education The system MAY provide the ability to use
             and Communication                                                       rules-based support to identify the most
                                                                                     pertinent educational material, based on
                                                                                     the patient health status, condition
                                                                                     and/or diagnosis.


DC.3.8.6     Operations Management          Patient, Family and Care Giver Education The system MAY provide the ability to
             and Communication                                                       document who received the educational
                                                                                     material provided (the patient or the
                                                                                     patient representative).



DC.3.8.7     Operations Management          Patient, Family and Care Giver Education The system MAY provide the ability to
             and Communication                                                       document that the educational material
                                                                                     was reviewed with the patient and/or
                                                                                     patient representative and their
                                                                                     comprehension of the material.



DC.3.8.8     Operations Management          Patient, Family and Care Giver Education The system MAY provide educational
             and Communication                                                       materials for the patient and/or patient
                                                                                     representative educational materials
                                                                                     written for various ages and/or reading
                                                                                     ability.


DC.3.8.9     Operations Management          Patient, Family and Care Giver Education IF the system is used to enter, modify, or
             and Communication                                                       exchange data, THEN the system SHALL to
                                                                                     guarantee that the sources and receivers
                                                                                     of data cannot deny that they
                                                                                     entered/modified/sent/received the data.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 97 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #                Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                      Capability
DC.3.8.10     Operations Management          Patient, Family and Care Giver Education The system MAY provide the ability for
              and Communication                                                       direct access to the educational material
                                                                                      available, by patients and/or patient
                                                                                      representatives.

DC.3.8.11     Operations Management          Patient, Family and Care Giver Education The system SHALL provide the ability to
              and Communication                                                       communicate applicable educational
                                                                                      materials to the patient and/or patient
                                                                                      representative.


DC.3.9.1      Operations Management          Communication with Medical Devices          The system SHALL provide the ability to           Support communication and presentation
              and Communication                                                          collect accurate electronic data from             of data captured from medical devices.
                                                                                         medical devices according to scope of             Communication with medical devices is
                                                                                         practice, organizational policy or                supported. Examples include: vital
                                                                                         jurisdictional law.                               signs/pulse-oximeter, home diagnostic
                                                                                                                                           devices for chronic disease management,
                                                                                                                                           laboratory machines, bar coded artifacts
                                                                                                                                           (medicine, immunizations, demographics,
                                                                                                                                           history, and identification), etc.




DC.3.9.2      Operations Management          Communication with Medical Devices          The system SHALL provide the ability to
              and Communication                                                          present information collected from
                                                                                         medical devices as part of the medical
                                                                                         record.




            Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 98 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #              Category                     Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                      Capability
S.1.1.1      Clinical Support              Registry Notification                      The system SHALL provide the ability to           [NEED TO STATE JURISDICTIONAL
                                                                                       transfer formatted demographic and               REGULATIONS AND FACILITY POLICY]
                                                                                      clinical information to local disease             Enable the automated transfer of
                                                                                      specific registries (or other notifiable          formatted demographic and clinical
                                                                                      registries) as directed by scope of               information to and from local disease
                                                                                      practice, organizational policy or                specific registries (and other notifiable
                                                                                      jurisdictional law.                               registries) for patient monitoring and
                                                                                                                                        subsequent epidemiological analysis. The
                                                                                                                                        user can export personal health
                                                                                                                                        information to disease specific registries,
                                                                                                                                        other notifiable registries such as
                                                                                                                                        immunization registries, through standard
                                                                                                                                        data transfer protocols or messages. The
                                                                                                                                        user can update and configure
                                                                                                                                        communication for new registries.




S.1.1.2      Clinical Support              Registry Notification                      The system MAY provide the ability to
                                                                                      automate the retrieval of formatted
                                                                                      demographic and clinical information
                                                                                      from local disease specific registries (or
                                                                                      other notifiable registries).


S.1.1.3      Clinical Support              Registry Notification                      The system SHALL provide the ability to
                                                                                      add, change, or remove access to
                                                                                      registries.

S.1.2.1      Clinical Support              Donor Management Support                   The system SHALL provide the ability to           Provide capability to capture or receive,
                                                                                      capture demographic and clinical                  and share needed information on
                                                                                      information needed for the donation.              potential donors and recipients. The
                                                                                                                                        user is able to capture or receive
                                                                                                                                        information on potential donors and
                                                                                                                                        recipients (for products such as blood,
                                                                                                                                        organs, eye, cadaver, etc.). The user can
                                                                                                                                        make this information available to
                                                                                                                                        internal and external donor matching
                                                                                                                                        agencies.




          Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                                Page 99 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                    Vendor
Criteria #              Category                     Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                   Capability
S.1.2.2      Clinical Support              Donor Management Support                   The system MAY communicate
                                                                                      documented demographic and clinical
                                                                                      information about potential donors with
                                                                                      appropriate outside parties.


S.1.2.3      Clinical Support              Donor Management Support                   The system MAY communicate
                                                                                      documented demographic and clinical
                                                                                      information about the donation with
                                                                                      appropriate outside parties (e.g. donor
                                                                                      management organization, eye bank,
                                                                                      surgeon).

S.1.3.1      Clinical Support              Provider Access Levels                     The system SHALL create and maintain a [NEED TO STATE JURISDICTIONAL
                                                                                      registry or directory of all personnel who REGULATIONS AND FACILITY POLICY]
                                                                                      currently use or access the system.        Provide a current registry or directory of
                                                                                                                                 practitioners that contains data needed
                                                                                                                                 to determine levels of access required by
                                                                                                                                 the system.



S.1.3.2      Clinical Support              Provider Access Levels                     The system SHALL provide the ability to
                                                                                      capture realm-specific legal identifiers
                                                                                      required for care delivery as discrete data
                                                                                      elements, including the NPI, practitioner's
                                                                                      license number and other identifiers as
                                                                                      required by scope of practice,
                                                                                      organizational policy, or jurisdictional law.




S.1.3.3      Clinical Support              Provider Access Levels                     The system SHALL provide the ability to
                                                                                      add, update, and inactivate entries in the
                                                                                      directory.

S.1.3.4      Clinical Support              Provider Access Levels                     The system SHOULD contain, in the
                                                                                      directory, the information necessary to
                                                                                      determine levels of access required by
                                                                                      the system security functionality.




          Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                         Page 100 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                       Vendor Capability Legend

                                                                         1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                         2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                         3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                             Vendor
Criteria #              Category                     Category Description                                    Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                            Capability
S.1.3.5      Clinical Support              Provider Access Levels                         The system SHOULD create and maintain
                                                                                          a directory of clinical personnel external
                                                                                          to the organization, that are not users of
                                                                                          the system, to facilitate communication
                                                                                          and information exchange (i.e., e-mail
                                                                                          alert for change in condition, critical lab
                                                                                          value to a dialysis center, etc.).




S.1.4.1      Clinical Support              Provider's Location Within Facility            The system SHALL provide the ability to           Provide provider location or contact
                                                                                          input or create information on provider           information on a facility's premises. The
                                                                                          location or contact information on a              identification of provider’s location within
                                                                                          facility's premises.                              a facility may facilitate the handling of
                                                                                                                                            critical care situations. This may include
                                                                                                                                            the location of on site practitioners by
                                                                                                                                            name or immediate required specialty. A
                                                                                                                                            real-time tracking system may provide
                                                                                                                                            automatic update of such information.




S.1.4.2      Clinical Support              Provider's Location Within Facility            The system SHALL provide the ability to
                                                                                          add, update, or inactivate information on
                                                                                          provider's location or contact information
                                                                                          on a facility's premises, so that it is
                                                                                          current.



S.1.5.1      Clinical Support              Provider's On Call Location                    The system SHALL provide the ability to           Provide provider location or contact
                                                                                          input or create information on provider           information when on call. The provider
                                                                                          on-call location or contact information           immediate contact information. This may
                                                                                          when on call.                                     include on call practitioners on a facility’s
                                                                                                                                            premises as well as on call contact
                                                                                                                                            information (e.g., phone number, pager,
                                                                                                                                            cell phone, etc.) after scheduled working
                                                                                                                                            hours.




          Dixon Hughes PLLC Confidential                                                                                        8/15/2010                                                                              Page 101 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                       Vendor Capability Legend

                                                                         1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                         2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                         3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                            Vendor
Criteria #              Category                     Category Description                                    Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                           Capability
S.1.5.2      Clinical Support              Provider's On Call Location                    The system SHALL provide the ability to
                                                                                          add, update, or obsolete inactivate
                                                                                          information on a provider's on call
                                                                                          location or contact information, so that it
                                                                                          is current.


S.1.6.1      Clinical Support              Provider's Location(s) or Office(s)            The system SHALL contain capture                  Provide locations or contact information
                                                                                          information necessary to identify and             for the provider in order to direct patients
                                                                                          contact primary and secondary practice            or queries. Providers may have multiple
                                                                                          locations or offices of providers to              locations or offices where they practice.
                                                                                          support communication and access.                 The system shall capture and maintain
                                                                                                                                            information necessary to identify and
                                                                                                                                            contact practice locations or offices of
                                                                                                                                            providers, and may include information
                                                                                                                                            such as on the primary location, any
                                                                                                                                            secondary locations, as well as the
                                                                                                                                            scheduled hours at each location,
                                                                                                                                            Information maintained may include web
                                                                                                                                            sites, maps, office locations, etc.




S.1.6.2      Clinical Support              Provider's Location(s) or Office(s)            The system SHALL provide the ability to
                                                                                          add, update and inactivate obsolete
                                                                                          information necessary to identify and
                                                                                          contact on the provider's primary and
                                                                                          secondary practice locations or offices of
                                                                                          providers.




          Dixon Hughes PLLC Confidential                                                                                        8/15/2010                                                                             Page 102 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #              Category                    Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                       Capability
S.1.7.1      Clinical Support              Team/Group of Providers Registry or        The system SHALL provide the ability to           [NEED TO STATE JURISDICTIONAL
                                           Directory                                  access a current directory, registry or           REGULATIONS AND FACILITY POLICY]
                                                                                      repository of Teams or Groups of                  Provide access to a current directory,
                                                                                      providers in accordance with relevant             registry or repository of information on
                                                                                      laws, regulations, and organization or            Teams or Groups of providers in
                                                                                      internal requirements.                            accordance with relevant laws,
                                                                                                                                        regulations, and organization or internal
                                                                                                                                        requirements. An organization may
                                                                                                                                        assign caregivers to teams that need to
                                                                                                                                        be registered as such. In another
                                                                                                                                        scenario, an organization might contract
                                                                                                                                        with a group of providers. The group
                                                                                                                                        would be listed by the group name or
                                                                                                                                        individually or both. A caregiver might be
                                                                                                                                        part of more than 1 team or group.




                                                                                                                                        All of these factors need to be supported.
                                                                                                                                        Information includes, but is not limited to;
                                                                                                                                        full name, address or physical location,
                                                                                                                                        and a 24x7 telecommunications address
                                                                                                                                        (e.g., phone or pager access number).




S.1.7.2      Clinical Support              Team/Group of Providers Registry or        The system MAY provide the ability to use
                                           Directory                                  registries or directories to identify
                                                                                      healthcare resources and devices for
                                                                                      resource management purposes.


S.1.7.3      Clinical Support              Team/Group of Providers Registry or        The system SHALL provide the ability to
                                           Directory                                  specify the role of each provider
                                                                                      associated with a patient such as
                                                                                      encounter provider, primary care
                                                                                      provider, attending physician,
                                                                                      ophthalmologist, psychologist, dentist,
                                                                                      podiatrist, geriatric nurse practitioner,
                                                                                      physician assistant, resident, or
                                                                                      consultant.




          Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 103 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #              Category                     Category Description                                 Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                         Capability
S.1.8.1      Clinical Support              Provider Caseload/Panel                     The system SHALL provide the ability to           Provide access to a provider's caseload or
                                                                                       access a provider's resident caseload             panel information. A facility may
                                                                                       information.                                      maintain a caseload or panel of patients
                                                                                                                                         to facilitate continuity of care and
                                                                                                                                         distribution of work. For example, a
                                                                                                                                         wound care nurse (or team) may have a
                                                                                                                                         list of assigned residents based upon the
                                                                                                                                         resident's care needs. A list of these
                                                                                                                                         residents would be produced to assist
                                                                                                                                         that nurse in delivering care. A
                                                                                                                                         somewhat different example of this
                                                                                                                                         functionality would be the ability to
                                                                                                                                         identify those providers able to accept
                                                                                                                                         new patients .




S.1.8.2      Clinical Support              Provider Caseload/Panel                     The system SHALL provide the ability to
                                                                                       add, update, and remove access to the
                                                                                       provider’s resident caseload information.



S.1.9.1      Clinical Support              Provider Registry or Directory              The system SHALL provide the ability to           [NEED TO STATE JURISDICTIONAL
                                                                                       use registries or directories to uniquely         REGULATIONS AND FACILITY POLICY]
                                                                                       identify providers for the provision of           Provide access to a current directory,
                                                                                       care.                                             registry or repository of provider
                                                                                                                                         information in accordance with relevant
                                                                                                                                         laws, regulations, and organization or
                                                                                                                                         internal requirements. A system
                                                                                                                                         maintains or has access to provider
                                                                                                                                         information needed in the provision of
                                                                                                                                         care. This is typically a directory, registry
                                                                                                                                         or repository. Information includes, but is
                                                                                                                                         not limited to; full name, specialty,
                                                                                                                                         credentials, address or physical location,
                                                                                                                                         and a 24x7 telecommunications address
                                                                                                                                         (e.g., phone or pager access number).




          Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                              Page 104 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #              Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
S.1.9.2      Clinical Support              Provider Registry or Directory              The system SHALL contain provider
                                                                                       information including (but not limited to)
                                                                                       full name and contact information,
                                                                                       and NPI and license number (where
                                                                                       applicable), in accordance with scope of
                                                                                       practice, organizational policy and
                                                                                       jurisdictional law.


S.1.9.3      Clinical Support              Provider Registry or Directory              The system SHALL provide the ability to
                                                                                       add, update, and remove access to
                                                                                       entries in the registry or directory so that
                                                                                       it is current.

S.1.9.4      Clinical Support              Provider Registry or Directory              The system MAY provide a directory of
                                                                                       clinical personnel external to the
                                                                                       organization that are not users of the
                                                                                       system to facilitate documentation.


S.1.9.5      Clinical Support              Provider Registry or Directory              The systems SHALL provide the ability to
                                                                                       restrict the view of selected elements of
                                                                                       the registry or directory information,
                                                                                       subject to the user's security level and
                                                                                       access needs.




          Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                         Page 105 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
S.1.10.1     Clinical Support               Patient Directory                                                                            Provide a current directory of patient
                                                                                                                                         information in accordance with relevant
                                                                                                                                         privacy and other applicable laws,
                                                                                                                                         regulations, and conventions. The patient
                                                                                                                                         directory may capture information
                                                                                                                                         including but not limited to, full name,
                                                                                                                                         address or physical location, alternate
                                                                                                                                         contact person, primary phone number,
                                                                                                                                         and relevant health status information.
                                                                                                                                         The view of this information may vary
                                                                                                                                         based on purpose, scope of practice,
                                                                                                                                         organizational policy or jurisdictional law.
                                                                                                                                         Several specific directory views are
                                                                                                                                         described in the following functions.




S.1.11.1     Clinical Support               Patient Demographics                       The system MAY provide the ability to             Support interactions with other systems,
                                                                                       reconcile add and update patient                  applications, and modules to enable the
                                                                                       demographic information (subject to               maintenance of updated demographic
                                                                                       authorized user approval) through                 information in accordance with realm-
                                                                                       interaction with other systems,                   specific recordkeeping requirements. The
                                                                                       applications and modules.                         minimum demographic data set must
                                                                                                                                         include the data required by
                                                                                                                                         organizational policy and jurisdictional
                                                                                                                                         law governing health care transactions
                                                                                                                                         and reporting. For example, this may
                                                                                                                                         include data input of death status
                                                                                                                                         information, or may include support to
                                                                                                                                         identify multiple names, such as updating




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 106 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                            Vendor
Criteria #               Category                     Category Description                                  Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                           Capability
                                                                                                                                           from John Doe, to patient’s given name.
                                                                                                                                           This function addresses exchange of
                                                                                                                                           demographic information with systems
                                                                                                                                           both internal and external to the
                                                                                                                                           organization such as between: 1. The
                                                                                                                                           facility and the external pharmacy
                                                                                                                                           services provider, 2. The EHR ADT module
                                                                                                                                           and the facility’s Dietary Management
                                                                                                                                           system.



S.1.11.2     Clinical Support               Patient Demographics                         The system SHALL accept and retrieve
                                                                                         patient demographic information.


S.1.12.1     Clinical Support               Patient's Location Within a Facility         IF the patient has an assigned location,          Provide the patient's location information
                                                                                         THEN the system SHALL provide the                 within a facility's premises. This function
                                                                                         ability to identify and display/view the          is intended to support maintaining and/or
                                                                                         patient’s assigned location.                      providing access to information on the
                                                                                                                                           patient's location during an episode of
                                                                                                                                           care. This function can be as simple as
                                                                                                                                           displaying the assigned bed for a patient
                                                                                                                                           (i.e., Adam, West Wing Rm #214). It can
                                                                                                                                           also be a function that supports real-time
                                                                                                                                           information on the patient location as
                                                                                                                                           they receive ancillary services in other
                                                                                                                                           parts of a facility (such as physical therapy
                                                                                                                                           in the Rehab Department). The




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                              Page 107 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                  Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                         Capability
                                                                                                                                           system shall support viewing a patient’s
                                                                                                                                           specific location in terms that may include
                                                                                                                                           campus, building, wing, unit, room, bed.
                                                                                                                                           The system support jurisdictional laws
                                                                                                                                           related to patient consent on disclosure.
                                                                                                                                           The patient location information also be
                                                                                                                                           available when the provider is not in the
                                                                                                                                           patient record. As such, the systems may
                                                                                                                                           need to provide a query feature on
                                                                                                                                           patient location information.




S.1.12.2     Clinical Support               Patient's Location Within a Facility         The system support consents as they
                                                                                         apply to the release of patient location
                                                                                         information according to scope of
                                                                                         practice, organization policy, or
                                                                                         jurisdictional laws.

S.1.12.4     Clinical Support               Patient's Location Within a Facility         The system MAY provide the ability to
                                                                                         identify the patient’s current, real-time
                                                                                         location, unambiguously, within a facility.



S.1.12.5     Clinical Support               Patient's Location Within a Facility         The system SHALL provide the ability to
                                                                                         query patient location information.



S.1.12.6     Clinical Support               Patient's Location Within a Facility         The system MAY provide the ability to
                                                                                         query patient location by alternate
                                                                                         identifying names.




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                            Page 108 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                        Capability
S.1.13.1     Clinical Support               Patient's Residence for the Provision and The system SHALL provide the ability to             Provide the patient's residence
                                            Administration of Services                identify the patient’s primary residence.           information for the provision and
                                                                                                                                          administration of services to the patient,
                                                                                                                                          patient transport, and as required for
                                                                                                                                          public health reporting. This function is
                                                                                                                                          intended to support the provision of
                                                                                                                                          services to patients at their place of
                                                                                                                                          residence. Examples include but are not
                                                                                                                                          limited to the following: 1. A patient with
                                                                                                                                          a mobility problem may require transport
                                                                                                                                          to and from a clinic appointment., 2.
                                                                                                                                          Support identification of multiple
                                                                                                                                          residences related to a patient such as a
                                                                                                                                          guardians with Winter/ Summer
                                                                                                                                          residences.




S.1.13.2     Clinical Support               Patient's Residence for the Provision and The system SHALL provide the ability to
                                            Administration of Services                identify the patient’s secondary or
                                                                                      alternate residence.

S.1.13.3     Clinical Support               Patient's Residence for the Provision and The system MAY provide the ability to
                                            Administration of Services                enter and update patient information
                                                                                      related to the provision of service.



S.1.13.4     Clinical Support               Patient's Residence for the Provision and The system SHALL provide the ability to
                                            Administration of Services                enter and update patient information
                                                                                      related to transport, such as, mobility
                                                                                      status, special needs and facility access
                                                                                      (stairs, elevator, wheelchair access).



S.1.13.5     Clinical Support               Patient's Residence for the Provision and The system SHALL provide the ability to
                                            Administration of Services                enter and update patient residence
                                                                                      information as necessary for public health
                                                                                      reporting.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                            Page 109 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                      Capability
S.1.14.1     Clinical Support               Patient Bed Assignment                    The system SHALL support interactions as          Support interactions with other systems,
                                                                                      required to support facilitate patient bed        applications, and modules to ensure that
                                                                                      assignment internal or external to within         the patient's bed assignments within the
                                                                                      the system.                                       facility optimize care and minimize risks
                                                                                                                                        (e.g., of exposure to contagious patients).
                                                                                                                                        Access to a list of available beds is
                                                                                                                                        important to safely manage the care of
                                                                                                                                        patients whose bed requirements may
                                                                                                                                        change based on change in condition or
                                                                                                                                        risk factors (for example, by
                                                                                                                                        gender, certification level, need for a
                                                                                                                                        room with special equipment such as
                                                                                                                                        oxygen, or need to be close to the nursing
                                                                                                                                        station/cohort by condition or to be in a
                                                                                                                                        private room, etc.).




S.1.14.2     Clinical Support               Patient Bed Assignment                    The system support interactions as
                                                                                      required to facilitate patient bed
                                                                                      assignment external to the system.

S.1.14.3     Clinical Support               Patient Bed Assignment                    The system MAY provide patient
                                                                                      information to an external system to
                                                                                      facilitate bed assignment that optimizes
                                                                                      care and minimizes risk.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                            Page 110 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                        Capability
S.1.15.1     Clinical Support               De-Identified Data Request Management The system SHALL provide de-identified                [NEED TO STATE JURISDICTIONAL
                                                                                  views of data in accordance with scope of             REGULATIONS AND FACILITY POLICY]
                                                                                  practice, organizational policy and                   Provide patient data in a manner that
                                                                                  jurisdictional law.                                   meets local requirements for de-
                                                                                                                                        identification. When an internal or
                                                                                                                                        external party requests patient data and
                                                                                                                                        that party requests de-identified data (or
                                                                                                                                        is not entitled to identified patient
                                                                                                                                        information, either by scope of practice,
                                                                                                                                        organizational policy or jurisdictional law),
                                                                                                                                        the user can export the data in a fashion
                                                                                                                                        that meets requirements for de-
                                                                                                                                        identification as required by scope of
                                                                                                                                        practice, organizational policy or




                                                                                                                                        jurisdictional law. An auditable record of
                                                                                                                                        these requests and associated exports
                                                                                                                                        shall be maintained by the system. This
                                                                                                                                        record could be implemented in any way
                                                                                                                                        that would allow the who, what, why and
                                                                                                                                        when of a request and export to be
                                                                                                                                        recoverable for review. A random re-
                                                                                                                                        identification key may be added to the
                                                                                                                                        data, to support re-identification for the
                                                                                                                                        purpose of alerting providers of potential
                                                                                                                                        patient safety issues. For example, if it is
                                                                                                                                        discovered that a patient is a risk for
                                                                                                                                        clinical complications (such as hip




                                                                                                                                        fracture), the provider could be notified
                                                                                                                                        of this risk, allowing the provider to
                                                                                                                                        identify the patient from the random key.



S.1.15.2     Clinical Support               De-Identified Data Request Management The system SHALL provide the ability to
                                                                                  de-identify extracted information.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                              Page 111 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                    Category Description                                 Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
S.1.16.1     Clinical Support               De-Identified Data Request Management The system SHALL provide the ability to                Support interactions with other systems,
                                                                                  access data/features, from other internal              applications, and modules to provide the
                                                                                  systems that are necessary for scheduling              necessary data to a scheduling system for
                                                                                  patient care or patient resources/                     optimal efficiency in the scheduling of
                                                                                  devices.                                               patient care, for either the patient or a
                                                                                                                                         resource/device. The system may
                                                                                                                                         support user access to scheduling
                                                                                                                                         systems as required. Relevant clinical or
                                                                                                                                         demographic information required in the
                                                                                                                                         scheduling process could be linked to the
                                                                                                                                         task.




S.1.16.2     Clinical Support               De-Identified Data Request Management The system MAY provide the ability to
                                                                                  access scheduling features, either internal
                                                                                  or external to the system, for patient care
                                                                                  devices/ equipment.


S.1.16.3     Clinical Support               De-Identified Data Request Management The system MAY incorporate relevant
                                                                                  clinical or demographic information in the
                                                                                  scheduling process.



S.1.16.4     Clinical Support               De-Identified Data Request Management The system MAY pass relevant clinical or
                                                                                  demographic information to support
                                                                                  efficient scheduling with other system.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                          Page 112 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                        Capability
S.1.17.1     Clinical Support               Healthcare Resource Availability            The system SHALL capture information on           Support the collection and distribution of
                                                                                        health care resource availability through         local health care resource information,
                                                                                        interactions with other, applications, and        through interactions with other systems,
                                                                                        modules.                                          applications, and modules, to enable
                                                                                                                                          planning and response to extraordinary
                                                                                                                                          events such as local or national
                                                                                                                                          emergencies. In times of identified local
                                                                                                                                          or national emergencies and upon
                                                                                                                                          request from authorized bodies, provide
                                                                                                                                          current status of the organization’s
                                                                                                                                          physical and human health care resources
                                                                                                                                          including, but not limited to, available
                                                                                                                                          beds, providers, support personnel,




                                                                                                                                          ancillary care areas and devices, medical
                                                                                                                                          supplies/equipment, vaccines, and
                                                                                                                                          pharmaceuticals. The intent is to enable
                                                                                                                                          the authorized body to distribute or re-
                                                                                                                                          distribute either resources or patient load
                                                                                                                                          to maximize efficient healthcare delivery.
                                                                                                                                          In addition, these functions may also be
                                                                                                                                          used for internal assessment and
                                                                                                                                          planning purposes by facility
                                                                                                                                          administrators.




S.1.17.2     Clinical Support               Healthcare Resource Availability            The system MAY provide the ability to
                                                                                        access information on health care
                                                                                        resource availability for internal
                                                                                        assessment and planning purposes.
                                                                                        Health care resources may include, but is
                                                                                        not limited to available beds, providers,
                                                                                        support personnel, ancillary care areas
                                                                                        and devices, medical supplies/
                                                                                        equipment, vaccines, and
                                                                                        pharmaceuticals.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                            Page 113 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                       Capability
S.1.17.3     Clinical Support               Healthcare Resource Availability            The system SHALL provide the ability to
                                                                                        export information on healthcare
                                                                                        resource availability to authorized
                                                                                        external parties.

S.1.18.1     Clinical Support               Information View                            The system SHALL provide authorized               Views of the information can be tailored
                                                                                        administrators the ability to tailor the          for or by the user (or department or "job
                                                                                        presentation of information for                   classification”) for their presentation
                                                                                        preferences of the user, department/area          preferences, within local or facility
                                                                                        or user type.                                     established rules. For example, a nursing
                                                                                                                                          supervisor may elect or prefer to see
                                                                                                                                          summary data on all patients as the
                                                                                                                                          default view.



S.1.18.2     Clinical Support               Information View                            The system MAY provide authorized users
                                                                                        the ability to tailor their presentation of
                                                                                        information for their preferences.


S.2.1.1      Measurement, Analysis,         Outcome Measures and Analysis               The system SHALL provide the ability to           [NEED TO STATE JURISDICTIONAL
             Research and Reports                                                       export or retrieve data required to               REGULATIONS AND FACILITY POLICY]
                                                                                        evaluate patient outcomes as required by          Support the capture and subsequent
                                                                                        organizational policy or jurisdictional law.      export or retrieval of data necessary for
                                                                                                                                          the reporting on patient outcome of care
                                                                                                                                          by population, facility, provider or
                                                                                                                                          community. Many regions require
                                                                                                                                          regular reporting on the health care
                                                                                                                                          provided to individuals and populations.
                                                                                                                                          The system needs to provide the report
                                                                                                                                          generating capability to easily create
                                                                                                                                          these reports or provide for the export of
                                                                                                                                          data to external report generating
                                                                                                                                          software. The system may also provide
                                                                                                                                          the functionality to prompt




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                           Page 114 of 402
                                                                               Brown County Community Treatment Center - SNF Requirements

                                                                                                                  Vendor Capability Legend

                                                                    1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                    2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                    3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                    Vendor
Criteria #              Category                    Category Description                                Criteria                                Discussion / Comments                           Vendor Comments
                                                                                                                                                                                   Capability
                                                                                                                                       for the collection of necessary
                                                                                                                                       information at the appropriate time in a
                                                                                                                                       patient encounter if such collection need
                                                                                                                                       can be properly defined in a supportive
                                                                                                                                       workflow.


S.2.1.2      Measurement, Analysis,        Outcome Measures and Analysis             The system MAY provide data detailed by
             Research and Reports                                                    physician, facility, facility subsection,
                                                                                     community or other selection criteria.



S.2.1.3      Measurement, Analysis,        Outcome Measures and Analysis             The system SHALL provide the ability to
             Research and Reports                                                    define outcome measures for specific
                                                                                     patient diagnosis.


S.2.1.4      Measurement, Analysis,        Outcome Measures and Analysis             The system SHALL provide the ability to
             Research and Reports                                                    define outcome measures to meet
                                                                                     various regional requirements.


S.2.1.5      Measurement, Analysis,        Outcome Measures and Analysis             The system SHALL provide for the
             Research and Reports                                                    acceptance and retrieval of unique
                                                                                     outcome data defined to meet regional
                                                                                     requirements.

S.2.1.6      Measurement, Analysis,        Outcome Measures and Analysis             The system MAY provide the ability to
             Research and Reports                                                    define report formats for the export of
                                                                                     data. This formatted data could be
                                                                                     viewed, transmitted electronically or
                                                                                     printed.

S.2.1.7      Measurement, Analysis,        Outcome Measures and Analysis             The system MAY provide the ability to
             Research and Reports                                                    define prompts in the clinical care setting
                                                                                     that would request information needed
                                                                                     to comply with regional requirements
                                                                                     when specific triggers are met (e.g., have
                                                                                     user defined/customizable fields to
                                                                                     collect required information).




          Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                          Page 115 of 402
                                                                               Brown County Community Treatment Center - SNF Requirements

                                                                                                                  Vendor Capability Legend

                                                                    1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                    2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                    3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #              Category                    Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                      Capability
S.2.1.8      Measurement, Analysis,        Outcome Measures and Analysis             The system MAY export data or provide a
             Research and Reports                                                    limited query access to data through a
                                                                                     secure data service.

S.2.2.1      Measurement, Analysis,        Performance and Accountability            The system SHALL provide the ability to           [NEED TO STATE JURISDICTIONAL
             Research and Reports          Measures                                  export or retrieve data required to assess        REGULATIONS AND FACILITY POLICY]
                                                                                     health care quality, performance and              Support the capture and subsequent
                                                                                     accountability.                                   export or retrieval of data necessary to
                                                                                                                                       provide quality, performance, and
                                                                                                                                       accountability measurements which
                                                                                                                                       providers, facilities, delivery systems, and
                                                                                                                                       communities are held accountable. Many
                                                                                                                                       regions require regular reporting on the
                                                                                                                                       health care provided to individuals and
                                                                                                                                       populations (quality measures, report
                                                                                                                                       cards, dashboards, etc.).




                                                                                                                                       These reports may include measures
                                                                                                                                       related to process, outcomes, costs of
                                                                                                                                       care, may be used in 'pay for
                                                                                                                                       performance' monitoring and adherence
                                                                                                                                       to best practice guidelines. The system
                                                                                                                                       needs to provide the report generating
                                                                                                                                       capability to easily create these reports or
                                                                                                                                       provide for the export of data to external
                                                                                                                                       report generating software.




S.2.2.2      Measurement, Analysis,        Performance and Accountability            The system SHALL provide the ability to
             Research and Reports          Measures                                  define multiple data sets required for
                                                                                     performance and accountability
                                                                                     measures.

S.2.2.3      Measurement, Analysis,        Performance and Accountability            The system SHALL provide the data
             Research and Reports          Measures                                  export in a report format that could be
                                                                                     displayed, transmitted electronically or
                                                                                     printed.




          Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 116 of 402
                                                                               Brown County Community Treatment Center - SNF Requirements

                                                                                                                  Vendor Capability Legend

                                                                    1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                    2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                    3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                    Vendor
Criteria #              Category                    Category Description                                Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                   Capability
S.2.2.4      Measurement, Analysis,        Performance and Accountability            The system MAY export data or provide a
             Research and Reports          Measures                                  limited query access to data through a
                                                                                     secure data service.


S.2.2.5      Measurement, Analysis,        Performance and Accountability            The system calculate and report quality
             Research and Reports          Measures                                  calculations such as CMS Quality
                                                                                     Indicators (QIs) from the MDS, or other
                                                                                     required instruments, in accordance with
                                                                                     the most recent jurisdictional
                                                                                     specifications and export the information
                                                                                     to administrative and financial systems.




S.2.2.6      Measurement, Analysis,        Performance and Accountability            The system calculate and report quality
             Research and Reports          Measures                                  calculations such as CMS Quality
                                                                                     Measures (QMs) from the MDS, or other
                                                                                     required instruments, in accordance with
                                                                                     the most recent jurisdictional
                                                                                     specifications and export the information
                                                                                     to administrative and financial systems.




S.2.3.1      Measurement, Analysis,        Report Generation                                                                           Support the export of data or access to
             Research and Reports                                                                                                      data necessary for report generation and
                                                                                                                                       ad hoc analysis. Providers and
                                                                                                                                       administrators need access to data in the
                                                                                                                                       EHR-S for the generation of both standard
                                                                                                                                       and ad hoc reports. These reports may be
                                                                                                                                       needed for clinical, administrative, and
                                                                                                                                       financial decision-making, as well as for
                                                                                                                                       patient use. Reports may be based on
                                                                                                                                       structured data and/or unstructured text
                                                                                                                                       from the patient's health record.




          Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                          Page 117 of 402
                                                                               Brown County Community Treatment Center - SNF Requirements

                                                                                                                  Vendor Capability Legend

                                                                    1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                    2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                    3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #              Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                     Capability
S.2.4.1      Measurement, Analysis,        Health Record Output                      The system SHALL provide the ability to Support the definition of the formal
             Research and Reports                                                    generate reports consisting of all and part health record, a partial record for referral
                                                                                     of an individual patient’s record.          purposes, or sets of records for other
                                                                                                                                 necessary disclosure purposes. Provide
                                                                                                                                 hardcopy and electronic output that fully
                                                                                                                                 chronicles the health care process,
                                                                                                                                 supports selection of specific sections of
                                                                                                                                 the health record, and allows health care
                                                                                                                                 organizations to define the report and/or
                                                                                                                                 documents that will comprise the formal
                                                                                                                                 health record for disclosure purposes. A
                                                                                                                                 mechanism be provided for both
                                                                                                                                 chronological and specified record




                                                                                                                                       element output. This may include defined
                                                                                                                                       reporting groups (i.e., print sets). For
                                                                                                                                       example: Print Set A = Patient
                                                                                                                                       Demographics, History & Physical,
                                                                                                                                       Consultation Reports, and Discharge
                                                                                                                                       Summaries. Print Set B = all information
                                                                                                                                       created by one caregiver. Print Set C = all
                                                                                                                                       information from a specified encounter.
                                                                                                                                       An auditable record of these requests and
                                                                                                                                       associated exports may be maintained by
                                                                                                                                       the system. This record could be
                                                                                                                                       implemented in any way that would allow
                                                                                                                                       the who, what, why and when of a
                                                                                                                                       request and export to be recoverable for
                                                                                                                                       review.




S.2.4.2      Measurement, Analysis,        Health Record Output                      The system SHALL provide the ability to
             Research and Reports                                                    define the records or reports that are
                                                                                     considered the formal health record for
                                                                                     disclosure purposes.




          Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                            Page 118 of 402
                                                                               Brown County Community Treatment Center - SNF Requirements

                                                                                                                  Vendor Capability Legend

                                                                    1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                    2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                    3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #              Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                     Capability
S.2.4.3      Measurement, Analysis,        Health Record Output                      The system SHALL provide the ability to
             Research and Reports                                                    generate reports in both chronological
                                                                                     and specified record elements order.



S.2.4.4      Measurement, Analysis,        Health Record Output                      The system SHALL provide the ability to
             Research and Reports                                                    create hardcopy and electronic report
                                                                                     summary information (procedures,
                                                                                     medications, labs, immunizations,
                                                                                     allergies, vital signs).



S.2.4.5      Measurement, Analysis,        Health Record Output                      The system MAY provide the ability to
             Research and Reports                                                    specify or define reporting groups (i.e.,
                                                                                     print sets) for specific types of disclosure
                                                                                     or information sharing.



S.2.4.6      Measurement, Analysis,        Health Record Output                      The system SHALL provide the ability to
             Research and Reports                                                    customize reports to match mandated
                                                                                     formats as required by jurisdictional law
                                                                                     and/ or regulations.



S.2.5.1      Measurement, Analysis,        Standard Report Generation                The system SHALL provide the ability to           Provide report generation features using
             Research and Reports                                                    generate reports of structured clinical and       tools internal or external to the system,
                                                                                     administrative data using either internal         for the generation of standard reports.
                                                                                     or external reporting tools.                      Providers and administrators need access
                                                                                                                                       to data in the EHR-S for clinical,
                                                                                                                                       administrative, financial decision-making,
                                                                                                                                       audit trail and metadata reporting, as well
                                                                                                                                       as to create reports for patients. Many
                                                                                                                                       systems may use internal or external
                                                                                                                                       reporting tools to accomplish this (such as
                                                                                                                                       Crystal Report). Reports may be based on
                                                                                                                                       structured data and/or unstructured text
                                                                                                                                       from the patient's health record. Users
                                                                                                                                       need




          Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                            Page 119 of 402
                                                                               Brown County Community Treatment Center - SNF Requirements

                                                                                                                  Vendor Capability Legend

                                                                    1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                    2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                    3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                    Vendor
Criteria #              Category                    Category Description                                Criteria                                Discussion / Comments                           Vendor Comments
                                                                                                                                                                                   Capability
                                                                                                                                       to be able to sort and/or filter reports.
                                                                                                                                       For example, the user may wish to view
                                                                                                                                       only the diabetic patients on a report
                                                                                                                                       listing patients and diagnoses.



S.2.5.2      Measurement, Analysis,        Standard Report Generation                The system MAY provide the ability to
             Research and Reports                                                    include information extracted from
                                                                                     unstructured clinical and administrative
                                                                                     data in the report generation process,
                                                                                     using internal or external tools.



S.2.5.3      Measurement, Analysis,        Standard Report Generation                The system SHALL provide the ability to
             Research and Reports                                                    export reports generated.


S.2.5.4      Measurement, Analysis,        Standard Report Generation                The system SHALL provide the ability to
             Research and Reports                                                    specify report parameters, based on
                                                                                     patient demographic and/or clinical data,
                                                                                     which would allow sorting and/or filtering
                                                                                     of the data.



S.2.5.5      Measurement, Analysis,        Standard Report Generation                The system (or an external application,
             Research and Reports                                                    using data from the system) MAY provide
                                                                                     the ability to save report parameters for
                                                                                     generating subsequent reports.




S.2.5.6      Measurement, Analysis,        Standard Report Generation                The system (or an external application,
             Research and Reports                                                    using data from the system) MAY provide
                                                                                     the ability to modify one or more
                                                                                     parameters of a saved report
                                                                                     specification when generating a report
                                                                                     using that specification.




          Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                          Page 120 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                           Vendor
Criteria #              Category                     Category Description                                  Criteria                                Discussion / Comments                               Vendor Comments
                                                                                                                                                                                          Capability
S.2.6.1      Measurement, Analysis,        Provide support for ad hoc query and         The system SHALL provide the ability to           Provide support for ad hoc query and
             Research and Reports          report generation using tools internal or    generate ad hoc query and reports of              report generation using tools internal or
                                           external to the system.                      structured clinical and administrative data       external to the system. Providers and
                                                                                        through either internal or external               administrators need to respond quickly to
                                                                                        reporting tools.                                  new requirements for data measurement
                                                                                                                                          and analysis. This may be as a result of
                                                                                                                                          new regulatory requirements or internal
                                                                                                                                          requirements. This requires that users be
                                                                                                                                          able to define their own query
                                                                                                                                          parameters and retain them. The data
                                                                                                                                          may be found in both structured and
                                                                                                                                          unstructured data. Providers and
                                                                                                                                          administrators also need to query for the
                                                                                                                                          absence of




                                                                                                                                          specific clinical or administrative data. For
                                                                                                                                          example, a quality assurance study may
                                                                                                                                          be reviewing whether or not the protocol
                                                                                                                                          for management of Diabetes Mellitus is
                                                                                                                                          being followed. If the protocol calls for
                                                                                                                                          fasting blood sugars every 3 months at
                                                                                                                                          minimum, the investigator might need to
                                                                                                                                          run an across-patient query locating
                                                                                                                                          patients with diabetes who do not show
                                                                                                                                          an FBS result within the last 3 months.




S.2.6.2      Measurement, Analysis,        Provide support for ad hoc query and         The system MAY provide the ability to
             Research and Reports          report generation using tools internal or    include information extracted from
                                           external to the system.                      unstructured clinical and administrative
                                                                                        data in the report generation process,
                                                                                        using internal or external tools.



S.2.6.3      Measurement, Analysis,        Provide support for ad hoc query and         The system SHALL provide the ability to
             Research and Reports          report generation using tools internal or    export reports generated.
                                           external to the system.



          Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                              Page 121 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #              Category                     Category Description                                  Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                      Capability
S.2.6.4      Measurement, Analysis,        Provide support for ad hoc query and         The system SHALL provide the ability to
             Research and Reports          report generation using tools internal or    specify report parameters, based on
                                           external to the system.                      patient demographic and/or clinical data,
                                                                                        which would allow sorting and/or filtering
                                                                                        of the data.



S.2.6.5      Measurement, Analysis,        Provide support for ad hoc query and         The system MAY provide the ability to
             Research and Reports          report generation using tools internal or    save report parameters for generating
                                           external to the system.                      subsequent reports.


S.2.6.6      Measurement, Analysis,        Provide support for ad hoc query and         The system MAY provide the ability to
             Research and Reports          report generation using tools internal or    modify one or more parameters of a
                                           external to the system.                      saved report specification when
                                                                                        generating a report using that
                                                                                        specification.


S.2.6.7      Measurement, Analysis,        Provide support for ad hoc query and         The system MAY provide the ability to
             Research and Reports          report generation using tools internal or    produce reports, using internal or
                                           external to the system.                      external reporting tools, based on the
                                                                                        absence of a clinical data element (e.g., a
                                                                                        lab test has not been performed in the
                                                                                        last year).


S.2.7.1      Administrative and            Encounter/Episode of Care Management                                                           Support the definition of Manage and
             Financial                                                                                                                    document the health care needed and
                                                                                                                                          delivered during an encounter/episode of
                                                                                                                                          care. Using data standards and
                                                                                                                                          technologies that support
                                                                                                                                          interoperability, encounter management
                                                                                                                                          promotes patient-centered/oriented care
                                                                                                                                          and enables real time, immediate point of
                                                                                                                                          service, point of care by facilitating
                                                                                                                                          efficient work flow and operations
                                                                                                                                          performance to ensure the integrity of:
                                                                                                                                          (1) the health record, (2) public health,
                                                                                                                                          financial and administrative reporting,
                                                                                                                                          and (3) the health care delivery process.




          Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                          Page 122 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #              Category                     Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                      Capability
                                                                                                                                        This support is necessary for direct care
                                                                                                                                        functionality that relies on providing user
                                                                                                                                        interaction and workflows, which are
                                                                                                                                        configured according to clinical protocols
                                                                                                                                        and business rules based on encounter
                                                                                                                                        specific values such as care setting,
                                                                                                                                        encounter type (inpatient, outpatient,
                                                                                                                                        home health, etc.), provider type,
                                                                                                                                        patient's EHR, health status,
                                                                                                                                        demographics, and the initial purpose of
                                                                                                                                        the encounter.



S.2.7.2      Administrative and            Specialized Views                          The system SHALL provide the ability to           Present specialized views based on the
             Financial                                                                define presentation filters that are              encounter-specific values, clinical
                                                                                      specific to the types of encounter, clinical      protocols and business rules. The system
                                                                                      protocols and business rules. These               user is presented with a presentation
                                                                                      specifics may include care provider               view and system interaction appropriate
                                                                                      specialty, location of encounter, date of         to the context with capture of encounter-
                                                                                      encounter, associated diagnosis.                  specific values, clinical protocols and
                                                                                                                                        business rules. This "user view" may be
                                                                                                                                        configurable by the user or system
                                                                                                                                        technicians. Examples include: 1. An
                                                                                                                                        attending physician is presented with a
                                                                                                                                        view that provides the primary functions
                                                                                                                                        used by the physician (physician order
                                                                                                                                        entry, physician progress notes, referrals,
                                                                                                                                        care plan, etc.).




                                                                                                                                        2. A speech pathologist performing a
                                                                                                                                        bedside treatment session, and using a
                                                                                                                                        wireless laptop, would be presented
                                                                                                                                        with rehabilitation specific workflow
                                                                                                                                        synchronized to the patient's current care
                                                                                                                                        plan and tailored to support interventions
                                                                                                                                        appropriate to this patient, including age
                                                                                                                                        and condition-specific guidelines.




          Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                            Page 123 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #              Category                     Category Description                                 Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                      Capability
S.2.7.3      Administrative and            Specialized Views                           The system MAY provide the ability to
             Financial                                                                 define presentation filters that are
                                                                                       specific to the patent demographics.


S.2.7.4      Administrative and            Specialized Views                           The system SHALL provide the ability to
             Financial                                                                 tailor a "user view".

S.2.8.1      Administrative and            Encounter Specific Functionality            The system SHALL provide workflow                 Provide assistance in assembling
             Financial                                                                 support for data collection appropriate           appropriate data, supporting data
                                                                                       for care setting.                                 collection and processing output from a
                                                                                                                                         specific encounter. Workflows, based on
                                                                                                                                         the encounter management settings, will
                                                                                                                                         assist (with triggers, alerts and other
                                                                                                                                         means) in determining and supporting the
                                                                                                                                         appropriate data collection, import,
                                                                                                                                         export, extraction, linkages and
                                                                                                                                         transformation. As an example, neonatal
                                                                                                                                         diagnostic and procedure codes may be
                                                                                                                                         filtered out when presenting codes to
                                                                                                                                         facility clinicians.




                                                                                                                                         Business rules enable automatic
                                                                                                                                         collection of necessary data from the
                                                                                                                                         patient's health record and patient
                                                                                                                                         registry. As the provider enters data,
                                                                                                                                         workflow processes are triggered to
                                                                                                                                         populate appropriate transactions and
                                                                                                                                         documents. For example, data entry
                                                                                                                                         might populate an eligibility verification
                                                                                                                                         transaction or query the immunization
                                                                                                                                         registry.



S.2.8.2      Administrative and            Encounter Specific Functionality            The system SHALL provide the ability to
             Financial                                                                 create and modify data entry workflows.




          Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                           Page 124 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #              Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
S.2.8.3      Administrative and            Encounter Specific Functionality            The system SHALL provide a reduced set
             Financial                                                                 of diagnostic and procedure codes
                                                                                       appropriate for the care setting.



S.2.8.4      Administrative and            Encounter Specific Functionality            The system MAY initiate secondary
             Financial                                                                 reporting workflows as a result of
                                                                                       information entered into the encounter.



S.2.9.1      Administrative and            Automatic Generation of Administrative      The system SHALL provide the ability to Provide patients clinical data to support
             Financial                     and Financial Data from Clinical Record     define the data required for each external administrative and financial reporting. A
                                                                                       administrative and financial system.       user can generate a bill based on health
                                                                                                                                  record data. Maximizing the extent to
                                                                                                                                  which administrative and financial data
                                                                                                                                  can be derived or developed from clinical
                                                                                                                                  data will lessen provider reporting
                                                                                                                                  burdens and the time it takes to complete
                                                                                                                                  administrative and financial processes
                                                                                                                                  such as claim reimbursement. This may
                                                                                                                                  be implemented by mapping of clinical
                                                                                                                                  terminologies in use to administrative and
                                                                                                                                  financial terminologies.




S.2.9.2      Administrative and            Automatic Generation of Administrative      The system SHALL export appropriate
             Financial                     and Financial Data from Clinical Record     data to administrative and financial
                                                                                       systems.

S.2.9.3      Administrative and            Automatic Generation of Administrative      The system SHALL calculate and report
             Financial                     and Financial Data from Clinical Record     the appropriate Medicare and/or
                                                                                       Medicaid payment calculation score from
                                                                                       the MDS in accordance with the most
                                                                                       recent jurisdictional specifications and
                                                                                       export the calculated scores to
                                                                                       administrative and financial systems.




          Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                         Page 125 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
S.2.10.1     Administrative and             Support Remote Healthcare Services        The system SHALL provide the ability to           Support remote health care services such
             Financial                                                                capture patient data from remote devices          as tele-health and remote device
                                                                                      and integrate that data into the patient's        monitoring by integrating records and
                                                                                      record.                                           data collected by these means into the
                                                                                                                                        patient's record for care management,
                                                                                                                                        billing and public health reporting
                                                                                                                                        purposes. Enables remote treatment of
                                                                                                                                        patients using monitoring devices, and
                                                                                                                                        two way communications between
                                                                                                                                        provider and patient or provider and
                                                                                                                                        provider. Promotes patient
                                                                                                                                        empowerment, self-determination and
                                                                                                                                        ability to maintain health status in the
                                                                                                                                        community.




                                                                                                                                        Promotes personal health, wellness and
                                                                                                                                        preventive care. For example, a diabetic
                                                                                                                                        patient can self-monitor her condition
                                                                                                                                        from home and use web TV to report to
                                                                                                                                        the facility’s community outreach service.
                                                                                                                                        The same TV-internet connectivity allows
                                                                                                                                        her to get dietary and other health
                                                                                                                                        promoting information to assist with
                                                                                                                                        managing diabetes and related risk
                                                                                                                                        factors.




S.2.10.2     Administrative and             Support Remote Healthcare Services        The system SHALL provide authorized
             Financial                                                                users two-way communication between
                                                                                      local practitioner and remote patient, or
                                                                                      local practitioner to remote practitioner.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                           Page 126 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
S.2.11.1     Administrative and             Other Encounter and Episode of Care       The system SHALL provide the ability to           Where not covered above, provide the
             Financial                      Support                                   organize patient data by encounter.               means to manage and organize the
                                                                                                                                        documentation of the health care needed
                                                                                                                                        and delivered during an
                                                                                                                                        encounter/episode of care. Using data
                                                                                                                                        standards and technologies that support
                                                                                                                                        interoperability, encounter management
                                                                                                                                        promotes patient- centered/oriented care
                                                                                                                                        and enables real time, immediate point of
                                                                                                                                        service, point of care by facilitating
                                                                                                                                        efficient work flow and operations
                                                                                                                                        performance to ensure the integrity of:
                                                                                                                                        (1) the health record, (2) public health,
                                                                                                                                        financial




                                                                                                                                        and administrative reporting, and (3) the
                                                                                                                                        health care delivery process. This support
                                                                                                                                        is necessary for direct care functionality
                                                                                                                                        that relies on providing user interaction
                                                                                                                                        and workflows, which are configured
                                                                                                                                        according to clinical protocols and
                                                                                                                                        business rules based on encounter
                                                                                                                                        specific values such as care setting,
                                                                                                                                        encounter type (inpatient, outpatient,
                                                                                                                                        home health, etc.), provider type,
                                                                                                                                        patient's record, health status,
                                                                                                                                        demographics, and the initial purpose of
                                                                                                                                        the encounter.




S.2.11.2     Administrative and             Support Remote Healthcare Services        The system SHALL accept and append
             Financial                                                                patient encounter data from external
                                                                                      systems, such as diagnostic tests and
                                                                                      reports.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                           Page 127 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                    Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
S.2.11.3     Administrative and             Support Remote Healthcare Services         The system SHALL provide the ability to
             Financial                                                                 create encounter documentation by one
                                                                                       or more of the following means: direct
                                                                                       keyboard entry of text; structured data
                                                                                       entry utilizing templates, forms, pick lists
                                                                                       or macro substitution; dictation with
                                                                                       subsequent transcription of voice to text,
                                                                                       either manually or via voice recognition
                                                                                       system.




S.2.11.4     Administrative and             Support Remote Healthcare Services         The system SHALL provide the ability to
             Financial                                                                 define presentation filters that are
                                                                                       specific to the types of encounter. These
                                                                                       specifics may include care provider
                                                                                       specialty, location of encounter, date of
                                                                                       encounter, associated diagnosis.



S.2.12.1     Administrative and             Information Access for Supplemental Use                                                      Support extraction, transformation and
             Financial                                                                                                                   linkage of information from structured
                                                                                                                                         data and unstructured text in the
                                                                                                                                         patient's health record for care
                                                                                                                                         management, financial, administrative,
                                                                                                                                         and public health purposes. Using data
                                                                                                                                         standards and technologies that support
                                                                                                                                         interoperability, information access
                                                                                                                                         functionalities serve primary and
                                                                                                                                         secondary record use and reporting with
                                                                                                                                         continuous record availability and access
                                                                                                                                         that ensure the integrity of: (1) the health
                                                                                                                                         record, (2) public health, financial and
                                                                                                                                         administrative reporting, and (3) the
                                                                                                                                         healthcare delivery process.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 128 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                       Capability
S.2.13.1     Administrative and             Rules-Driven Clinical Coding Assistance     The system SHALL provide the ability to           Make available all pertinent patient
             Financial                                                                  access pertinent patient information              information needed to support coding of
                                                                                        needed to support coding of diagnoses,            diagnoses, procedures and outcomes.
                                                                                        services and outcomes.                            The user is assisted in coding information
                                                                                                                                          for clinical reporting reasons. For
                                                                                                                                          example, a professional coder may have
                                                                                                                                          to code the principal diagnosis in the
                                                                                                                                          current, applicable ICD as a basis for
                                                                                                                                          Medicare Part B reimbursement for
                                                                                                                                          therapy. All diagnoses and services during
                                                                                                                                          the episode may be presented to the
                                                                                                                                          coder or clinician, as well as the
                                                                                                                                          applicable ICD or CPThierarchy containing
                                                                                                                                          these codes.




S.2.13.2     Administrative and             Rules-Driven Clinical Coding Assistance     The system MAY assist with the coding of
             Financial                                                                  diagnoses, procedures and outcomes
                                                                                        based on provider specialty, care setting
                                                                                        and other information that may be
                                                                                        entered into the system during the
                                                                                        encounter.



S.2.14.1     Administrative and             Rules-Driven Financial and Administrative The system SHALL maintain financial and Provide financial and administrative
             Financial                      Coding Assistance                         administrative codes.                   coding assistance based on the structured
                                                                                                                              data and unstructured text available in
                                                                                                                              the encounter documentation. The user
                                                                                                                              is assisted in coding information for billing
                                                                                                                              or administrative reasons. For example,
                                                                                                                              Medicare Part A claims must include
                                                                                                                              HIPPS codes that reflect the payment
                                                                                                                              calculation category and assessment type
                                                                                                                              for MDSs completed during the billing
                                                                                                                              period. To support this transaction, the
                                                                                                                              payment calculation classification and
                                                                                                                              assessment type




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                           Page 129 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                     Category Description                                 Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                     Capability
                                                                                                                                          information would need to be captured
                                                                                                                                          for each MDS completed during a Part A
                                                                                                                                          stay and the information made available
                                                                                                                                          for the billing process.



S.2.14.2     Administrative and             Rules-Driven Financial and Administrative The system SHALL provide the ability to
             Financial                      Coding Assistance                         retrieve data from the electronic health
                                                                                      record as required to simplify the coding
                                                                                      of financial and administrative
                                                                                      documentation.



S.2.14.3     Administrative and             Rules-Driven Financial and Administrative The system MAY support rules driven
             Financial                      Coding Assistance                         prompts to facilitate the collection of data
                                                                                      in the clinical workflow that is required
                                                                                      for administrative and financial coding.




S.2.14.4     Administrative and             Rules-Driven Financial and Administrative The system MAY assist with the coding of
             Financial                      Coding Assistance                         required administrative and financial
                                                                                      documents based on provider specialty,
                                                                                      care setting and other information that
                                                                                      may be entered into the system during
                                                                                      the encounter.



S.2.14.5     Administrative and             Rules-Driven Financial and Administrative The system MAY internally generate
             Financial                      Coding Assistance                         administrative and financial coding such
                                                                                      as place of service, type of facility, tax
                                                                                      rates, etc.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                         Page 130 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                         Capability
S.2.15.1     Administrative and             Integrate Cost/Financial Information        The system MAY provide the ability to             Support interactions with other systems,
             Financial                                                                  retrieve formularies, preferred providers,        applications, and modules to enable the
                                                                                        and other information, from internal or           use of cost management information
                                                                                        external sources, that are associated with        required to guide users and workflows.
                                                                                        a patient’s health care plan and coverage         The provider is alerted or presented with
                                                                                        so that the provider can offer cost               the most cost-effective services, referrals,
                                                                                        effective alternatives to patients.               devices and etc., to recommend to the
                                                                                                                                          patient. This may be tailored to the
                                                                                                                                          patient's health insurance/plan coverage
                                                                                                                                          rules. Medications may be presented in
                                                                                                                                          order of cost, or the cost of specific
                                                                                                                                          interventions may be presented at the
                                                                                                                                          time of ordering.




S.2.15.2     Administrative and             Integrate Cost/Financial Information        The system MAY provide the ability to
             Financial                                                                  retrieve or request information about
                                                                                        exemptions on coverage limitations and
                                                                                        guidelines.


S.2.15.3     Administrative and             Integrate Cost/Financial Information        The system MAY provide the ability to
             Financial                                                                  retrieve and provide expected patient out-
                                                                                        of- pocket cost information for
                                                                                        medications, diagnostic testing, and
                                                                                        procedures, from internal or external
                                                                                        sources, that are associated with a
                                                                                        patients health care plan and coverage.



S.2.15.4     Administrative and             Integrate Cost/Financial Information        The system SHALL alert the provider of
             Financial                                                                  care where formularies, preferred
                                                                                        provider and other information indicate
                                                                                        the health plan requires an alternative.


S.2.15.5     Administrative and             Integrate Cost/Financial Information        The system SHALL integrate support of
             Financial                                                                  prior authorization processes.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 131 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                      Capability
S.2.16.1     Administrative and             Administrative Transaction Processing                                                        Support the creation (including using
             Financial                                                                                                                   external data sources, if necessary),
                                                                                                                                         electronic interchange, and processing of
                                                                                                                                         transactions listed below that may be
                                                                                                                                         necessary for encounter management
                                                                                                                                         during an episode of care. Support the
                                                                                                                                         creation (including using external data
                                                                                                                                         sources, if necessary), electronic
                                                                                                                                         interchange, and processing of
                                                                                                                                         transactions listed below that may be
                                                                                                                                         necessary for encounter management
                                                                                                                                         during an episode of care. The EHR
                                                                                                                                         system shall capture the patient health-
                                                                                                                                         related information needed for




                                                                                                                                         administrative and financial purposes
                                                                                                                                         including reimbursement. Captures the
                                                                                                                                         episode and encounter information to
                                                                                                                                         pass to administrative or financial
                                                                                                                                         processes (e.g., triggers transmissions of
                                                                                                                                         charge transactions as by-product of on-
                                                                                                                                         line interaction including order entry,
                                                                                                                                         order statusing, result entry,
                                                                                                                                         documentation entry, medication
                                                                                                                                         administration charting). Automatically
                                                                                                                                         retrieves information needed to verify
                                                                                                                                         coverage and medical necessity. As a
                                                                                                                                         byproduct




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                           Page 132 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
                                                                                                                                         of care delivery and documentation:
                                                                                                                                         captures and presents all patient
                                                                                                                                         information needed to support coding.
                                                                                                                                         Ideally performs coding based on
                                                                                                                                         documentation. Clinically automated
                                                                                                                                         revenue cycle -- examples of reduced
                                                                                                                                         denials and error rates in claims; 1.
                                                                                                                                         Clinical information needed for billing is
                                                                                                                                         available on the date of service. 2.
                                                                                                                                         Physicians and clinicians do not perform
                                                                                                                                         additional data entry/ tasks exclusively to
                                                                                                                                         support administrative or financial
                                                                                                                                         processes.




S.2.17.1     Administrative and             Enrollment of Patients                     The system SHALL provide the ability to           Support interactions with other systems,
             Financial                                                                 retrieve subsidized and unsubsidized              applications, and modules to facilitate
                                                                                       health plan options from internal or              enrollment of uninsured patients into
                                                                                       external sources to allow for presentation        subsidized and unsubsidized health plans,
                                                                                       of alternatives for health care coverage to       and enrollment of patients who are
                                                                                       patients subject to jurisdictional law.           eligible on the basis of health and/or
                                                                                                                                         financial status in social service and other
                                                                                                                                         programs, including clinical trials.
                                                                                                                                         Expedites determination of health
                                                                                                                                         insurance coverage. The provider may be
                                                                                                                                         alerted that uninsured patients may be
                                                                                                                                         eligible for subsidized health insurance or
                                                                                                                                         other health programs because they meet




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 133 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                  Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                         Capability
                                                                                                                                           eligibility criteria based on demographics
                                                                                                                                           and/or health status. For example: a
                                                                                                                                           provider is presented with information
                                                                                                                                           about eligibility for subsidy for a patient
                                                                                                                                           who has recently immigrated. Links may
                                                                                                                                           be provided to online enrollment forms.
                                                                                                                                           When enrollment is determined, the
                                                                                                                                           health coverage information needed for
                                                                                                                                           processing administrative and financial
                                                                                                                                           documentation, reports or transactions is
                                                                                                                                           captured.




S.2.17.2     Administrative and             Enrollment of Patients                       The system MAY provide the ability to
             Financial                                                                   retrieve health plan enrollment criteria to
                                                                                         match patients health and financial
                                                                                         status.

S.2.18.1     Administrative and             Eligibility Verification and Determination    The system SHALL provide the ability to          Retrieves information needed to support
             Financial                      of Coverage                                  input patient health plan eligibility             verification of coverage at the
                                                                                         information for date(s) of service.               appropriate juncture in the encounter
                                                                                                                                           workflow. Improves patient access to
                                                                                                                                           covered care and reduces claim denials.
                                                                                                                                           When eligibility is verified, the system
                                                                                                                                           would capture eligibility information
                                                                                                                                           needed for processing administrative and
                                                                                                                                           financial documentation, reports or
                                                                                                                                           transactions -- updating or flagging any
                                                                                                                                           inconsistent data. In addition to health
                                                                                                                                           insurance eligibility, this function would
                                                                                                                                           support verification of registration in
                                                                                                                                           programs and




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                            Page 134 of 402
                                                                                   Brown County Community Treatment Center - SNF Requirements

                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                     Category Description                                  Criteria                                Discussion / Comments                           Vendor Comments
                                                                                                                                                                                       Capability
                                                                                                                                           registries, such as chronic care case
                                                                                                                                           management and immunization
                                                                                                                                           registries. A system would likely verify
                                                                                                                                           health insurance eligibility prior to the
                                                                                                                                           encounter, but would verify registration
                                                                                                                                           in case management or immunization
                                                                                                                                           registries during the encounter. When
                                                                                                                                           consistency checks are conducted they
                                                                                                                                           may check for consistency
                                                                                                                                           between internal data entered by a user
                                                                                                                                           in multiple places, consistency between
                                                                                                                                           internal data and data received
                                                                                                                                           externally, or consistency between data
                                                                                                                                           elements received externally.




S.2.18.2     Administrative and             Eligibility Verification and Determination   The system SHOULD provide the ability to
             Financial                      of Coverage                                  exchange electronic eligibility information
                                                                                         (e.g., health plan coverage dates) with
                                                                                         internal and external systems, THEN the
                                                                                         system SHALL provide authorized users
                                                                                         the ability to input and maintain patient
                                                                                         health plan coverage dates.




S.2.18.3     Administrative and             Eligibility Verification and Determination   The system SHOULD provide the ability to
             Financial                      of Coverage                                  input general benefit coverage
                                                                                         information for patients.

S.2.18.4     Administrative and             Eligibility Verification and Determination   The system SHOULD provide for the
             Financial                      of Coverage                                  retention of eligibility date(s) of service,
                                                                                         coverage dates, general benefits and
                                                                                         other benefit coverage documentation
                                                                                         for service rendered.




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                          Page 135 of 402
                                                                                    Brown County Community Treatment Center - SNF Requirements

                                                                                                                       Vendor Capability Legend

                                                                         1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                         2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                         3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #                Category                     Category Description                                  Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                       Capability
S.2.18.6      Administrative and             Eligibility Verification and Determination   The system SHOULD provide the ability to
              Financial                      of Coverage                                  exchange electronic eligibility information
                                                                                          (e.g., health plan coverage dates)
                                                                                          with internal and external systems.



S.2.18.7      Administrative and             Eligibility Verification and Determination   The system MAY provide the ability to
              Financial                      of Coverage                                  access information received through
                                                                                          electronic prescription eligibility checking.



S.2.18.8      Administrative and             Eligibility Verification and Determination   The system MAY provide authorized users
              Financial                      of Coverage                                  the ability to collect and retain patient
                                                                                          registration in special programs such as
                                                                                          but not limited to: registries and case
                                                                                          management.



S.2.18.9      Administrative and             Eligibility Verification and Determination   The system SHOULD alert the user to
              Financial                      of Coverage                                  inconsistencies present in eligibility and
                                                                                          coverage information (e.g., coverage
                                                                                          dates, patient identity data, coverage
                                                                                          status).



S.2.18.10     Administrative and             Eligibility Verification and Determination   IF the system provides the ability to
              Financial                      of Coverage                                  exchange eligibility information with
                                                                                          external systems, THEN the system SHALL
                                                                                          conduct the information exchange in
                                                                                          accordance with ASC X12N 270/271
                                                                                          (Healthcare Eligibility Benefits Inquiry and
                                                                                          Response) version 004010X092A1 or
                                                                                          higher.




            Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                         Page 136 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
S.2.19.1     Administrative and             Service Authorizations                     IF the system is unable to obtain service         Support interactions with other systems,
             Financial                                                                 authorization data through exchange with          applications, and modules to enable the
                                                                                       an external source, the system MAY                creation of requests, responses and
                                                                                       provide the ability to exchange electronic,       appeals related to service authorization,
                                                                                       computer readable data on service                 including prior authorizations, referrals,
                                                                                       authorization information, including              and pre-certification. Retrieves
                                                                                       specific data if mandated by local                information needed to support
                                                                                       authority, THEN the system SHALL                  verification of medical necessity and prior
                                                                                       provide the ability to input service              authorization of services at the
                                                                                       authorizations relevant to the service            appropriate juncture in the encounter
                                                                                       provided including the source, dates, and         workflow. Improves timeliness of patient
                                                                                       service(s) authorized.                            care and reduces claim denials.




S.2.19.2     Administrative and             Service Authorizations                     The system MAY provide the ability to
             Financial                                                                 exchange electronic, computer readable
                                                                                       data on service authorization information,
                                                                                       including specific data if mandated by
                                                                                       local authority.



S.2.20.1     Administrative and             Support of Service Requests and Claims     The system SHALL provide the ability to           Support interactions with other systems,
             Financial                                                                 view available, applicable clinical               applications, and modules to support the
                                                                                       information to support service requests.          creation of health care attachments for
                                                                                                                                         submitting additional clinical information
                                                                                                                                         in support of service requests and claims.
                                                                                                                                         Retrieves structured and unstructured
                                                                                                                                         data, including but not limited to lab data,
                                                                                                                                         imaging data, device monitoring data, and
                                                                                                                                         text based data, based on rules or
                                                                                                                                         requests for additional clinical
                                                                                                                                         information, in support of service
                                                                                                                                         requests or claims, at the appropriate
                                                                                                                                         juncture in the encounter workflow.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 137 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
S.2.20.2     Administrative and             Support of Service Requests and Claims     The system SHALL provide the ability to
             Financial                                                                 view available, applicable clinical
                                                                                       information to support claims.



S.2.20.3     Administrative and             Support of Service Requests and Claims     The system SHOULD provide available,
             Financial                                                                 applicable clinical information to support
                                                                                       service requests in computer readable
                                                                                       formats.



S.2.20.4     Administrative and             Support of Service Requests and Claims     The system SHOULD provide available,
             Financial                                                                 applicable clinical information to support
                                                                                       claims in computer readable formats.



S.2.21.1     Administrative and             Claims and Encounter Reports for           The system SHALL provide the ability to           Support interactions with other systems,
             Financial                      Reimbursement                              view available, applicable information            applications, and modules to enable the
                                                                                       needed to enable the creation of claims           creation of claims and encounter reports
                                                                                       and encounter reports for                         for reimbursement. Retrieves
                                                                                       reimbursement.                                    information needed to support claims and
                                                                                                                                         encounter reporting. This reporting
                                                                                                                                         occurs at the appropriate juncture in the
                                                                                                                                         encounter workflow in a manual or
                                                                                                                                         automated fashion. For example this
                                                                                                                                         could occur at an initial, interim or final
                                                                                                                                         billing. The system may also present the
                                                                                                                                         information that is provided for audit and
                                                                                                                                         review by local authorities.




S.2.21.2     Administrative and             Claims and Encounter Reports for           The system SHALL provide the ability to
             Financial                      Reimbursement                              capture and present available, applicable
                                                                                       data as required by local authority for
                                                                                       audit and review.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                            Page 138 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                       Capability
S.2.21.3     Administrative and             Claims and Encounter Reports for            The system SHOULD provide available,
             Financial                      Reimbursement                               applicable data in a computer readable
                                                                                        form when needed to enable the creation
                                                                                        of claims and encounter reports for
                                                                                        reimbursement.



S.2.22.1     Administrative and             Health Service Reports at the Conclusion    The system SHOULD prompt providers for            Support the creation of health service
             Financial                      of an Episode of Care                       data needed for end of care reporting             reports at the conclusion of an episode of
                                                                                        during the continuum of care to reduce            care. Support the creation of health
                                                                                        the need for end of care data collection.         service reports to authorized health
                                                                                                                                          entities, for example public health, such
                                                                                                                                          as notifiable condition reports,
                                                                                                                                          immunization, cancer registry and
                                                                                                                                          discharge data that a provider may be
                                                                                                                                          required to generate at the conclusion of
                                                                                                                                          an episode of care. Effective use of this
                                                                                                                                          function means that providers do not
                                                                                                                                          perform additional data entry to support
                                                                                                                                          health management programs and
                                                                                                                                          reporting. Nursing




                                                                                                                                          Homes are required by federal
                                                                                                                                          regulations to complete a discharge
                                                                                                                                          summary. The proposed CARE
                                                                                                                                          Instrument developed by CMS is an
                                                                                                                                          example of an end of episode report.
                                                                                                                                          State regulations may also include
                                                                                                                                          discharge summary requirements.



S.2.22.2     Administrative and             Health Service Reports at the Conclusion    The system SHOULD create service
             Financial                      of an Episode of Care                       reports at the completion of an episode
                                                                                        of care such as but not limited to; public
                                                                                        health reports, etc. using data collected
                                                                                        during the encounter.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                           Page 139 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                       Capability
S.2.23.1     Administrative and             Manage Practitioner/Patient               The system SHALL provide the ability to Identify relationships among providers
             Financial                      Relationships                             identify all providers by name associated treating a single patient, and provide the
                                                                                      with a specific patient encounter.        ability to manage patient lists assigned to
                                                                                                                                a particular provider. This function
                                                                                                                                addresses the ability to access and update
                                                                                                                                current information about the
                                                                                                                                relationships between caregivers and the
                                                                                                                                patients. This information should be able
                                                                                                                                to flow seamlessly between the different
                                                                                                                                components of the system, and between
                                                                                                                                the EHR system and other systems.
                                                                                                                                Business rules may be reflected in the
                                                                                                                                presentation of, and the access to this
                                                                                                                                information.




                                                                                                                                        The relationship among providers treating
                                                                                                                                        a single patient will include any necessary
                                                                                                                                        chain of authority/responsibility.
                                                                                                                                        Examples: 1) In a care setting with
                                                                                                                                        multiple providers, where the patient can
                                                                                                                                        only see certain kinds of providers (or an
                                                                                                                                        individual provider); allow the selection of
                                                                                                                                        only the appropriate providers. 2)
                                                                                                                                        Designating relationships such as
                                                                                                                                        attending physician, dentist, podiatrist,
                                                                                                                                        ophthalmologist, etc.




S.2.23.2     Administrative and             Manage Practitioner/Patient               The system SHALL provide the ability to
             Financial                      Relationships                             specify the role of each provider
                                                                                      associated with a patient such as
                                                                                      attending physician, ophthalmologist,
                                                                                      psychologist, dentist, podiatrist, geriatric
                                                                                      nurse practitioner, physician assistant, or
                                                                                      consultant.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                             Page 140 of 402
                                                                                Brown County Community Treatment Center - SNF Requirements

                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
S.2.23.3     Administrative and             Manage Practitioner/Patient               The system SHALL provide the ability to
             Financial                      Relationships                             identify all providers who have been
                                                                                      associated with any encounter for a
                                                                                      specific patient.


S.2.23.4     Administrative and             Manage Practitioner/Patient               The system SHALL provide authorized
             Financial                      Relationships                             users the ability to add and update
                                                                                      information on the relationship of
                                                                                      provider to patient.


S.2.23.5     Administrative and             Manage Practitioner/Patient               The system SHOULD provide the ability to
             Financial                      Relationships                             view patient lists by provider.



S.2.23.6     Administrative and             Manage Practitioner/Patient               The system SHALL provide the ability to
             Financial                      Relationships                             specify primary or principal provider(s)
                                                                                      responsible for the care of a patient
                                                                                      within a care setting.



S.2.24.1     Administrative and             Related by Genealogy                      The system SHALL provide the ability to           Provide information on relationships by
             Financial                                                                collect and maintain genealogical                 genealogy. Relationships by genealogy
                                                                                      relationships.                                    may include next of kin, and/or family
                                                                                                                                        members. Appropriate consents must be
                                                                                                                                        acquired prior to the collection or use of
                                                                                                                                        this information.




S.2.24.2     Administrative and             Related by Genealogy                      The system SHALL provide the ability to
             Financial                                                                identify persons related by genealogy.


S.2.24.3     Administrative and             Related by Genealogy                      The system MAY provide the ability to
             Financial                                                                collect and maintain patient consents
                                                                                      required to allow patient records to be
                                                                                      accessed.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                           Page 141 of 402
                                                                                     Brown County Community Treatment Center - SNF Requirements

                                                                                                                        Vendor Capability Legend

                                                                          1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                          2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                          3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                    Criteria                                Discussion / Comments                           Vendor Comments
                                                                                                                                                                                         Capability
S.2.25.1     Administrative and             Related by Insurance                           The system MAY SHALL provide the ability Support interactions with other systems,
             Financial                                                                     to identify persons related by insurance applications, and modules to provide
                                                                                           plan.                                    information on relationships by insurance
                                                                                                                                    (domestic partner, spouse, and
                                                                                                                                    guarantor).



S.2.26.1     Administrative and             Related by Living Situation                    The system SHALL provide the ability to           Provide information on relationships by
             Financial                                                                     identify patients related by living               living situation (in same household).
                                                                                           situation.

S.2.27.1     Administrative and             Related by Other Means                         The system MAY provide the ability to             Provide information on relationships by
             Financial                                                                     identify patients related by employer and         other means. Other relationships that
                                                                                           work location for purposes of                     may need to be recorded would include
                                                                                           epidemiological exposure and public               but not be limited to, power of attorney/
                                                                                           health analysis and reporting.                    conservator/guardian, a person
                                                                                                                                             authorized to see health records, health
                                                                                                                                             care surrogate, persons who may be
                                                                                                                                             related by epidemiologic exposure, etc.




S.2.27.2     Administrative and             Related by Other Means                         The system SHALL provide the ability to
             Financial                                                                     identify persons with Power of Attorney
                                                                                           for Health Care or other persons with the
                                                                                           authority to make medical decisions on
                                                                                           behalf of the patient.



S.2.27.3     Administrative and             Related by Other Means                         The system MAY provide the ability to
             Financial                                                                     identify persons related to the patient by
                                                                                           other means.




           Dixon Hughes PLLC Confidential                                                                                        8/15/2010                                                                          Page 142 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
S.2.28.1     Administrative and             Acuity and Severity                        The system SHALL provide the ability to           Provide the data necessary to support
             Financial                                                                 collect appropriate existing data to              and manage patient acuity/ severity for
                                                                                       support the patient case                          illness/risk-based adjustment of resource.
                                                                                       mix/acuity/severity processes for                 Research has been done on nurse staffing
                                                                                       illness/risk-based adjustment of                  and patient outcomes; the impact of
                                                                                       resources.                                        organizational characteristics on nurse
                                                                                                                                         staffing patterns, patient outcomes, and
                                                                                                                                         costs; and the impact of nurses’
                                                                                                                                         experience on patient outcomes. The
                                                                                                                                         research indicates that nurse staffing has
                                                                                                                                         a definite and measurable impact on
                                                                                                                                         patient outcomes, medical errors, length
                                                                                                                                         of stay, nurse turnover, and patient




                                                                                                                                         mortality. Case mix/acuity data helps
                                                                                                                                         determine what is, indeed, appropriate
                                                                                                                                         staffing--as modified by the nurses’ level
                                                                                                                                         of experience, the organization’s
                                                                                                                                         characteristics, and the quality of clinical
                                                                                                                                         interaction between and among
                                                                                                                                         physicians, nurses, and administrators.
                                                                                                                                         Also, case mix, acuity and severity data is
                                                                                                                                         routinely the evidential basis most
                                                                                                                                         frequently cited by staff when
                                                                                                                                         recommending clinical staffing changes.




S.2.28.2     Administrative and             Acuity and Severity                        The system MAY provide the ability to
             Financial                                                                 export appropriate data to support the
                                                                                       patient acuity/severity processes for
                                                                                       illness/risk-based adjustment of
                                                                                       resources.


S.2.28.3     Administrative and             Acuity and Severity                        The system MAY prompt the user to
             Financial                                                                 provide key data needed to support
                                                                                       acuity/severity processes.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 143 of 402
                                                                                  Brown County Community Treatment Center - SNF Requirements

                                                                                                                     Vendor Capability Legend

                                                                       1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                       2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                       3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                         Capability
S.2.28.4     Administrative and             Acuity and Severity                         The system MAY provide the ability to
             Financial                                                                  calculate patient acuity and/or severity
                                                                                        levels.


S.2.29.1     Administrative and             Clinical Decision Support System            IF providing decision support, THEN the           Facilitate and/or perform updates of
             Financial                      Guidelines Updates                          system SHALL provide the ability to               clinical decision support system
                                                                                        update the clinical content or rules              guidelines and associated reference
                                                                                        utilized to generate clinical decision            material. Clinical decision support rules
                                                                                        support reminders and alerts.                     may be applied to the system using a
                                                                                                                                          manual process. As standards are
                                                                                                                                          developed to represent these rules, an
                                                                                                                                          automated update will be recommended.
                                                                                                                                          Any process to update decision support
                                                                                                                                          rules should include the verification of the
                                                                                                                                          appropriateness of the rules to the
                                                                                                                                          system. This may include but




                                                                                                                                          not be limited to authenticity of the
                                                                                                                                          source, the currency of the version, and
                                                                                                                                          any necessary approvals before updates
                                                                                                                                          can take place.



S.2.29.2     Administrative and             Clinical Decision Support System            IF providing decision support, THEN the
             Financial                      Guidelines Updates                          system SHOULD validate that the most
                                                                                        applicable version is utilized for the
                                                                                        update, and capture the date of update.



S.2.29.3     Administrative and             Clinical Decision Support System            IF multiple versions exist, THEN the
             Financial                      Guidelines Updates                          system SHALL track and retain the version
                                                                                        used when guidelines are provided in a
                                                                                        stay/encounter.




           Dixon Hughes PLLC Confidential                                                                                     8/15/2010                                                                             Page 144 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                    Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
S.2.30.1     Administrative and             Patient Education Material Updates         The system SHALL provide the ability to           Receive and validate formatted inbound
             Financial                                                                 capture and update patient education              communications to facilitate and/or
                                                                                       material.                                         perform updating of patient education
                                                                                                                                         material. Materials may include
                                                                                                                                         information about a diagnosis,
                                                                                                                                         recommended diets, associated patient
                                                                                                                                         health organizations, or web links to
                                                                                                                                         similar educational information. These
                                                                                                                                         materials may be provided electronically
                                                                                                                                         and may require validation prior to
                                                                                                                                         inclusion in the system. For example, First
                                                                                                                                         Databank for drug information.




S.2.30.2     Administrative and             Patient Education Material Updates         The system MAY provide the ability to
             Financial                                                                 validate the material prior to update.



S.2.31.1     Administrative and             Patient Reminder Information Updates       The system MAY provide the ability to             Receive and validate formatted inbound
             Financial                                                                 add patient reminders for patients based          communications to facilitate updating of
                                                                                       on the recommendations of public health           patient reminder information from
                                                                                       authorities or disease specific                   external sources such as Cancer or
                                                                                       associations.                                     Immunization Registries. Information
                                                                                                                                         from outside groups, such as
                                                                                                                                         immunization groups, public health
                                                                                                                                         organizations, etc. may periodically send
                                                                                                                                         updates to patient care providers. The
                                                                                                                                         system should be capable of generating
                                                                                                                                         patient reminders based on the
                                                                                                                                         recommendations of these organizations.
                                                                                                                                         Patient reminders could be provided to
                                                                                                                                         patients by a number of means including
                                                                                                                                         phone calls, or mail.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                            Page 145 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                    Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
                                                                                                                                         A record of such reminders may become
                                                                                                                                         part of a patient’s record. Examples of
                                                                                                                                         reminders could include a recommended
                                                                                                                                         immunization, prophylactic guidelines for
                                                                                                                                         MVP, patient self-testing for disease, etc.




S.2.31.2     Administrative and             Patient Reminder Information Updates       The system MAY provide the ability to
             Financial                                                                 automatically associate patient reminders
                                                                                       with patients meeting specific phenotypic
                                                                                       criteria such as age, gender, diagnosis,
                                                                                       etc.

S.2.31.3     Administrative and             Patient Reminder Information Updates       The system SHALL provide the ability to
             Financial                                                                 display patient reminders, manually
                                                                                       process, and record associated contacts.



S.2.32.1     Administrative and             Public Health Related Updates              The system SHALL provide the ability to
             Financial                                                                 capture and update public health
                                                                                       reporting guidelines.


S.2.32.2     Administrative and             Public Health Related Updates              The system MAY provide the ability to    Receive and validate formatted inbound
             Financial                                                                 automatically generate patient reminders communications to facilitate updating of
                                                                                       for delivery to patients.                public health reporting guidelines. As
                                                                                                                                standards become available, information
                                                                                                                                and reporting requirements from outside
                                                                                                                                groups, such as public health
                                                                                                                                organizations, may be made available to
                                                                                                                                patient care providers. Examples may
                                                                                                                                include requirements to report on new
                                                                                                                                disease types, or changes to reporting
                                                                                                                                guidelines. The information in these
                                                                                                                                public health updates may be applied to
                                                                                                                                the system so that appropriate data can
                                                                                                                                be collected and reported to comply with
                                                                                                                                requirements.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                            Page 146 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                    Category Description                                 Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
S.2.32.3     Administrative and             Public Health Related Updates              The system MAY provide the ability to
             Financial                                                                 validate the material prior to update.



IN.1.1       Security                                                                                                                    Secure the access to an EHR-S and EHR
                                                                                                                                         information. Manage the sets of access
                                                                                                                                         control permissions granted within an
                                                                                                                                         EHR-S. Prevent unauthorized use of data,
                                                                                                                                         data loss, tampering and destruction. To
                                                                                                                                         enforce security, all EHR-S applications
                                                                                                                                         must adhere to the rules established to
                                                                                                                                         control access and protect the privacy of
                                                                                                                                         EHR information. Security measures assist
                                                                                                                                         in preventing unauthorized use of data
                                                                                                                                         and protect against loss, tampering and
                                                                                                                                         destruction. An EHR-S must be capable of
                                                                                                                                         including or interfacing with standards-




                                                                                                                                         conformant security services to ensure
                                                                                                                                         that any Principal (user, organization,
                                                                                                                                         device, application, component, or
                                                                                                                                         object) accessing the system or its data is
                                                                                                                                         appropriately authenticated, authorized
                                                                                                                                         and audited in conformance with local
                                                                                                                                         and/or jurisdictional policies. An EHR-S
                                                                                                                                         should support Chains of Trust in respect
                                                                                                                                         of authentication, authorization, and
                                                                                                                                         privilege management, either intrinsically
                                                                                                                                         or by interfacing with relevant external
                                                                                                                                         services.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                            Page 147 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                         Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                        Capability
IN.1.1.1     Security                       Entity Authentication                      The system SHALL authenticate principals Authenticate EHR-S users and/or entities
                                                                                       prior to accessing an EHR-S application or before allowing access to an EHR-S. Both
                                                                                       EHR-S data.                                users and applications are subject to
                                                                                                                                  authentication. The EHR-S must provide
                                                                                                                                  mechanisms for users and applications to
                                                                                                                                  be authenticated. Users will have to be
                                                                                                                                  authenticated when they attempt to use
                                                                                                                                  the application, the applications must
                                                                                                                                  authenticate themselves before accessing
                                                                                                                                  EHR information managed by other
                                                                                                                                  applications or remote EHR-S’. In order
                                                                                                                                  for authentication to be




                                                                                                                                         established a Chain of Trust agreement is
                                                                                                                                         assumed to be in place. Examples of
                                                                                                                                         entity authentication include: 1)
                                                                                                                                         username/ password; 2) digital
                                                                                                                                         certificate; 3) secure token; 4) biometrics.




IN.1.1.2     Security                       Entity Authentication                      The system SHALL prevent access to EHR-
                                                                                       S applications or EHR-S data by all non-
                                                                                       authenticated principals.


IN.1.1.3     Security                       Entity Authentication                      The system SHOULD provide the ability to
                                                                                       implement a Chain of Trust agreement.



IN.1.1.4     Security                       Entity Authentication                      IF other appropriate authentication
                                                                                       mechanisms are absent, THEN the system
                                                                                       SHALL authenticate principals using at
                                                                                       least one of the following authentication
                                                                                       mechanisms: username/password, digital
                                                                                       certificate, secure token or biometrics.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                             Page 148 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                      Capability
IN.1.2.1     Security                       Entity Authorization                       The system SHALL provide the ability to           Manage the sets of access-control
                                                                                       create and update sets of access-control          permissions granted to entities that use
                                                                                       permissions granted to principals.                an EHR-S (EHR-S Users). Enable EHR-S
                                                                                                                                         security administrators to grant
                                                                                                                                         authorizations to users, for roles, and
                                                                                                                                         within contexts. A combination of these
                                                                                                                                         authorization categories may be applied
                                                                                                                                         to control access to EHR-S functions or
                                                                                                                                         data within an EHR-S, including at the
                                                                                                                                         application or the operating system level.
                                                                                                                                         EHR-S Users are authorized to use the
                                                                                                                                         components of an EHR-S according to
                                                                                                                                         their identity, role, work-




                                                                                                                                         assignment, location and/or the patient’s
                                                                                                                                         present condition and the EHR-S User’s
                                                                                                                                         scope of practice within a legal
                                                                                                                                         jurisdiction. User based authorization
                                                                                                                                         refers to the permissions granted or
                                                                                                                                         denied based on the identity of an
                                                                                                                                         individual. An example of User based
                                                                                                                                         authorization is a patient defined denial
                                                                                                                                         of access to all or part of a record to a
                                                                                                                                         particular party for privacy related
                                                                                                                                         reasons. Another user based
                                                                                                                                         authorization is for a tele-monitor device
                                                                                                                                         or robotic access to an EHR-S for
                                                                                                                                         prescribed




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                           Page 149 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
                                                                                                                                         directions and other input. Role based
                                                                                                                                         authorization refers to the responsibility
                                                                                                                                         or function performed in a particular
                                                                                                                                         operation or process. Example roles
                                                                                                                                         include: an application or device (tele-
                                                                                                                                         monitor or robotic); or a nurse, dietician,
                                                                                                                                         administrator, legal guardian, and
                                                                                                                                         auditor. Context-based Authorization is
                                                                                                                                         defined by ISO 10181-3 Technical
                                                                                                                                         Framework for Access Control Standard
                                                                                                                                         as security-relevant properties of the
                                                                                                                                         context in which an access request
                                                                                                                                         occurs, explicitly time, location,




                                                                                                                                         route of access, and quality of
                                                                                                                                         authentication. For example, an EHR-S
                                                                                                                                         might only allow supervising providers’
                                                                                                                                         context authorization to attest to entries
                                                                                                                                         proposed by residents under their
                                                                                                                                         supervision. In addition to the ISO
                                                                                                                                         standard, context authorization for an
                                                                                                                                         EHR-S is extended to satisfy special
                                                                                                                                         circumstances such as, work assignment,
                                                                                                                                         patient consents and authorizations, etc.
                                                                                                                                         Example: 1) Patient-granted authorization
                                                                                                                                         to a specific third party for a limited
                                                                                                                                         period to view




                                                                                                                                         specific EHR records. 2) Right granted for
                                                                                                                                         a limited period to view those, and only
                                                                                                                                         those, EHR records connected to a
                                                                                                                                         specific topic of investigation.


IN.1.2.2     Security                       Entity Authorization                       The system SHALL record all authorization
                                                                                       actions.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                            Page 150 of 402
                                                                                 Brown County Community Treatment Center - SNF Requirements

                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                     Vendor
Criteria #               Category                     Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                                    Capability
IN.1.2.3     Security                       Entity Authorization                       The system SHALL provide EHR-S security [NEED TO STATE JURISDICTIONAL
                                                                                       administrators with the ability to grant     REGULATIONS AND FACILITY POLICY]
                                                                                       authorizations to principals according to
                                                                                       scope of practice, organizational policy, or
                                                                                       jurisdictional law.



IN.1.2.4     Security                       Entity Authorization                       The system SHALL provide EHR-S security
                                                                                       administrators with the ability to grant
                                                                                       authorizations for roles according to
                                                                                       scope of practice, organizational policy, or
                                                                                       jurisdictional law.



IN.1.2.5     Security                       Entity Authorization                       The system SHALL provide EHR-S security
                                                                                       administrators with the ability to grant
                                                                                       authorizations within contexts according
                                                                                       to scope of practice, organizational policy,
                                                                                       or jurisdictional law.



IN.1.2.6     Security                       Entity Authorization                       The system SHALL provide the ability to
                                                                                       define context for the purpose of
                                                                                       principal authorization based on identity,
                                                                                       credential, role, work assignment, and
                                                                                       location, in accordance with scope of
                                                                                       practice, organizational policy or
                                                                                       jurisdictional law.



IN.1.2.7     Security                       Entity Authorization                       The system MAY provide the ability to
                                                                                       define context based on legal
                                                                                       requirements or disaster conditions.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                         Page 151 of 402
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                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
IN.1.3.1     Security                       Entity Access Control                      The system SHALL provide the ability to           Verify and enforce access control to all
                                                                                       define system and data access rules.              EHR-S components, EHR information and
                                                                                                                                         functions for end-users, applications,
                                                                                                                                         sites, etc., to prevent unauthorized use of
                                                                                                                                         a resource. Entity Access Control is a
                                                                                                                                         fundamental function of an EHR-S. To
                                                                                                                                         ensure that access is controlled, an EHR-S
                                                                                                                                         must perform authentication and
                                                                                                                                         authorization of users or applications for
                                                                                                                                         any operation that requires it and enforce
                                                                                                                                         the system and information access rules
                                                                                                                                         that have been defined.




IN.1.3.2     Security                       Entity Access Control                      The system SHALL enforce system and
                                                                                       data access rules for all EHR-S resources
                                                                                       (at component, application, or user level,
                                                                                       either local or remote).



IN.1.4.1     Security                       Patient Access Management                  The system SHALL manage a patient’s               Enable a health care delivery organization
                                                                                       access to his or her healthcare                   to allow and manage a patient’s access to
                                                                                       information.                                      the patient’s personal health information.
                                                                                                                                         A health care delivery organization will be
                                                                                                                                         able to manage a patient’s ability to view
                                                                                                                                         his or her EHR based on scope of practice,
                                                                                                                                         organization policy or jurisdictional law.
                                                                                                                                         Typically, a patient has the right to view
                                                                                                                                         his or her EHR and the right to place
                                                                                                                                         restrictions on who can view parts or the
                                                                                                                                         whole of that EHR. For example, in some
                                                                                                                                         jurisdictions, minors have the right to
                                                                                                                                         restrict




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                            Page 152 of 402
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                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
                                                                                                                                        access to their data by parents/
                                                                                                                                        guardians. One example of managing a
                                                                                                                                        patient’s access to his or her data is by
                                                                                                                                        extending user access controls to
                                                                                                                                        patients.

IN.1.4.2     Security                       Patient Access Management                 The system SHALL conform to the HITSP
                                                                                      Consumer Empowerment Interoperability
                                                                                      Specification (version 2 or later), as it
                                                                                      applies to patient access management.



IN.1.4.3     Security                       Patient Access Management                 The system SHALL conform to the HITSP
                                                                                      Consumer Empowerment Interoperability
                                                                                      Specification (version 2 or later), as it
                                                                                      applies to patient access management.



IN.1.5.1     Security                       Non-Repudiation                           The system SHALL time stamp initial               [NEED TO STATE JURISDICTIONAL
                                                                                      entry, modification, or exchange of data,         REGULATIONS AND FACILITY POLICY]
                                                                                      and identify the actor/principal taking the       Limit an EHR-S user’s ability to deny
                                                                                      action as required by users' scope of             (repudiate) the origination, receipt, or
                                                                                      practice, organizational policy, or               authorization of a data exchange by that
                                                                                      jurisdictional law.                               user. An EHR-S allows data entry and
                                                                                                                                        data access to a patient's electronic
                                                                                                                                        health record and it can be a sender or
                                                                                                                                        receiver of healthcare information. Non-
                                                                                                                                        repudiation guarantees that the source of
                                                                                                                                        the data record can not later deny that it
                                                                                                                                        is the source; that the sender or receiver
                                                                                                                                        of a message cannot later deny having
                                                                                                                                        sent or received the message. For




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                           Page 153 of 402
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                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                     Capability
                                                                                                                                        example, non-repudiation may be
                                                                                                                                        achieved through the use of a: 1) Digital
                                                                                                                                        signature, which serves as a unique
                                                                                                                                        identifier for an individual (much like a
                                                                                                                                        written signature on a paper document),
                                                                                                                                        2) Confirmation service, which utilizes a
                                                                                                                                        message transfer agent to create a digital
                                                                                                                                        receipt (providing confirmation that a
                                                                                                                                        message was sent and/or received) and 3)
                                                                                                                                        Timestamp, which proves that a
                                                                                                                                        document existed at a certain date and
                                                                                                                                        time. Date and Time stamping implies the
                                                                                                                                        ability to indicate the time zone where it
                                                                                                                                        was recorded (time zones are described
                                                                                                                                        in ISO 8601 Standard Time Reference).




IN.1.5.2     Security                       Non-Repudiation                           The system SHALL provide additional non-
                                                                                      repudiation functionality where required
                                                                                      by users' scope of practice, organizational
                                                                                      policy, or jurisdictional law.




IN.1.5.3     Security                       Non-Repudiation                           The system SHALL prevent repudiation of
                                                                                      data origination, receipt, or access.



IN.1.5.4     Security                       Non-Repudiation                           The system SHOULD ensure the integrity
                                                                                      of data exchange and thus prevent
                                                                                      repudiation of data origination or receipt.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                           Page 154 of 402
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                                                                                                                   Vendor Capability Legend

                                                                     1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                     2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                     3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #               Category                    Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                      Capability
IN.1.6.1     Security                       Secure Data Exchange                      The system SHALL secure all modes of              Secure all modes of EHR data exchange.
                                                                                      EHR data exchange.                                Whenever an exchange of EHR
                                                                                                                                        information occurs, it requires
                                                                                                                                        appropriate security and privacy
                                                                                                                                        considerations, including data
                                                                                                                                        obfuscation as well as both destination
                                                                                                                                        and source authentication when
                                                                                                                                        necessary. For example, it may be
                                                                                                                                        necessary to encrypt data sent to remote
                                                                                                                                        or external destinations. A secure data
                                                                                                                                        exchange requires that there is an overall
                                                                                                                                        coordination regarding the information
                                                                                                                                        that is exchanged between EHR-S entities
                                                                                                                                        and how that exchange is expected to
                                                                                                                                        occur.




                                                                                                                                        The policies applied at different locations
                                                                                                                                        must be consistent or compatible with
                                                                                                                                        each other in order to ensure that the
                                                                                                                                        information is protected when it crosses
                                                                                                                                        entity boundaries within an EHR-S or
                                                                                                                                        external to an EHR-S.



IN.1.6.2     Security                       Secure Data Exchange                      The system MAY provide the ability to
                                                                                      obfuscate data.

IN.1.6.3     Security                       Secure Data Exchange                      The system SHALL encrypt and decrypt
                                                                                      EHR data that is exchanged over a non-
                                                                                      secure link.

IN.1.6.4     Security                       Secure Data Exchange                      The system SHALL support standards-
                                                                                      based encryption mechanisms when
                                                                                      encryption is used for secure data
                                                                                      exchange.




           Dixon Hughes PLLC Confidential                                                                                   8/15/2010                                                                            Page 155 of 402
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                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                       Capability
IN.1.7.1     Security                       Information Attestation                    The system SHALL provide the ability to           Manage electronic attestation of
                                                                                       associate any attestable content added or         information including the retention of the
                                                                                       changed to an EHR with the content's              signature of attestation (or certificate of
                                                                                       author.                                           authenticity) associated with incoming or
                                                                                                                                         outgoing information. The purpose of
                                                                                                                                         attestation is to show authorship and
                                                                                                                                         assign responsibility for an act, event,
                                                                                                                                         condition, opinion, or diagnosis. Every
                                                                                                                                         entry in the health record must be
                                                                                                                                         identified with the author and should not
                                                                                                                                         be made or signed by someone other
                                                                                                                                         than the author. (Note: A transcriptionist
                                                                                                                                         may transcribe an author's notes and a




                                                                                                                                         senior clinician may attest to the accuracy
                                                                                                                                         of another's statement of events.)
                                                                                                                                         Attestation is required for (paper or
                                                                                                                                         electronic) entries such as narrative or
                                                                                                                                         progress notes, assessments, flow sheets,
                                                                                                                                         and orders. Electronic signatures may be
                                                                                                                                         used to implement document attestation.
                                                                                                                                         For an incoming document, the record of
                                                                                                                                         attestation is retained if included.
                                                                                                                                         Attestation functionality must meet
                                                                                                                                         applicable legal, regulatory and other
                                                                                                                                         applicable standards or requirements.
                                                                                                                                         For the LTC profile,




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                            Page 156 of 402
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                                                                                                                    Vendor Capability Legend

                                                                      1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                      2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                      3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                       Vendor
Criteria #               Category                     Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                                      Capability
                                                                                                                                         the term "digital signature" is replaced
                                                                                                                                         with "electronic signature”. Electronic
                                                                                                                                         signature is defined as, "any
                                                                                                                                         representation of the signature in digital
                                                                                                                                         form including image of handwritten
                                                                                                                                         signature”. This term refers to the
                                                                                                                                         process of attestation and proof of
                                                                                                                                         identity at the time of data entry in the
                                                                                                                                         EHR.



IN.1.7.2     Security                       Information Attestation                    The system SHALL provide the ability for
                                                                                       attestation of EHR content by the
                                                                                       content's author.

IN.1.7.3     Security                       Information Attestation                    The system SHALL indicate the status of
                                                                                       attestable data which has not been
                                                                                       attested.

IN.1.7.4     Security                       Information Attestation                    The system SHOULD provide the ability
                                                                                       for attestation of EHR content by properly
                                                                                       authenticated and authorized users
                                                                                       different from the author as required by
                                                                                       users’ scope of practice, organizational
                                                                                       policy, or jurisdictional law.




           Dixon Hughes PLLC Confidential                                                                                    8/15/2010                                                                           Page 157 of 402
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                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                     Category Description                                  Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                         Capability
IN.1.8.1     Security                       Patient Privacy and Confidentiality          The system SHALL provide the ability to           Enable the enforcement of the applicable
                                                                                         fully comply with the requirements for            jurisdictional and organizational patient
                                                                                         patient privacy and confidentiality in            privacy rules as they apply to various
                                                                                         accordance with a user's scope of                 parts of an EHR-S through the
                                                                                         practice, organizational policy, HIPAA            implementation of security mechanisms.
                                                                                         Privacy Rules, Federal Conditions of              Patients’ privacy and the confidentiality
                                                                                         Participation for Medicare/ Medicaid              of EHRs are violated if access to EHRs
                                                                                         Providers, or jurisdictional law.                 occurs without authorization. Violations
                                                                                                                                           or potential violations can impose
                                                                                                                                           tangible economic or social losses on
                                                                                                                                           affected patients, as well as less tangible
                                                                                                                                           feelings of vulnerability and pain. Fear of
                                                                                                                                           potential violations discourages




                                                                                                                                           patients from revealing sensitive personal
                                                                                                                                           information that may be relevant to
                                                                                                                                           diagnostic and treatment services. Rules
                                                                                                                                           for the protection of privacy and
                                                                                                                                           confidentiality may vary depending upon
                                                                                                                                           the vulnerability of patients and the
                                                                                                                                           sensitivity of records. Strongest
                                                                                                                                           protections should apply to the records of
                                                                                                                                           minors and the records of patients with
                                                                                                                                           stigmatized conditions. Authorization to
                                                                                                                                           access the most sensitive parts of an EHR
                                                                                                                                           is most definitive if made by the explicit
                                                                                                                                           and specific consent of the patient.




IN.1.8.2     Security                       Patient Privacy and Confidentiality          The system SHALL provide the ability to
                                                                                         maintain varying levels of confidentiality
                                                                                         in accordance with users' scope of
                                                                                         practice, organizational policy, HIPAA
                                                                                         Privacy Rules or jurisdictional law.




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                            Page 158 of 402
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                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                        Vendor
Criteria #               Category                     Category Description                                  Criteria                                Discussion / Comments                           Vendor Comments
                                                                                                                                                                                       Capability
IN.1.8.3     Security                       Patient Privacy and Confidentiality          The system SHALL provide the ability to
                                                                                         mask parts of the electronic health record
                                                                                         (e.g., medications, conditions, sensitive
                                                                                         documents) from disclosure.



IN.1.8.4     Security                       Patient Privacy and Confidentiality          The system SHALL provide the ability to
                                                                                         override a mask in emergency or other
                                                                                         specific situations.



IN.1.9.1     Security                       Secure Data Routing (LTC)                    The system SHALL automatically route              Route electronically exchanged EHR data
                                                                                         electronically exchanged EHR data only            only to/from known, registered, and
                                                                                         from and to known sources and                     authenticated destinations/sources
                                                                                         destinations using either secure networks         according to applicable health care-
                                                                                         or properly encrypted.                            specific rules and relevant standards. An
                                                                                                                                           EHR-S needs to ensure that it is
                                                                                                                                           exchanging EHR information with the
                                                                                                                                           entities (applications, institutions,
                                                                                                                                           directories) it expects. This function
                                                                                                                                           depends on entity authorization and
                                                                                                                                           authentication to be available in the
                                                                                                                                           system. For example, a physician practice
                                                                                                                                           management application in an EHR-S
                                                                                                                                           might send claim attachment




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                          Page 159 of 402
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                                                                                                                      Vendor Capability Legend

                                                                        1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                        2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                        3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                          Vendor
Criteria #               Category                    Category Description                                   Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                         Capability
                                                                                                                                           information to an external entity. To
                                                                                                                                           accomplish this, the application must use
                                                                                                                                           a secure routing method, which ensures
                                                                                                                                           that both the sender and receiving sides
                                                                                                                                           are authorized to engage in the
                                                                                                                                           information exchange. Known sources
                                                                                                                                           and destinations can be established in a
                                                                                                                                           static setup or they can be dynamically
                                                                                                                                           determined. Examples of a static setup
                                                                                                                                           are recordings of IP addresses or
                                                                                                                                           recordings of DNS names. For dynamic
                                                                                                                                           determination of known sources and
                                                                                                                                           destinations systems can use
                                                                                                                                           authentication mechanisms. For example,
                                                                                                                                           the



                                                                                                                                           sending of a lab order from the EHRS to a
                                                                                                                                           lab system within the same organization
                                                                                                                                           usually uses a simple static setup for
                                                                                                                                           routing. In contrast sending a lab order to
                                                                                                                                           a reference lab outside of the
                                                                                                                                           organization will involve some kind of
                                                                                                                                           authentication process.



IN.1.9.2     Security                       Secure Data Routing (LTC)                    The system SHOULD route electronically
                                                                                         exchanged EHR data only to and from
                                                                                         authenticated sources and destinations.



IN.1.9.3     Security                       Secure Data Routing (LTC)                    The system SHOULD provide audit
                                                                                         information about additions and changes
                                                                                         to the status of destinations and sources.




           Dixon Hughes PLLC Confidential                                                                                      8/15/2010                                                                            Page 160 of 402
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                                                                                                                 Vendor Capability Legend

                                                                   1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                   2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                   3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                      Vendor
Criteria #               Category                 Category Description                                 Criteria                                Discussion / Comments                              Vendor Comments
                                                                                                                                                                                     Capability
IN.2.1       Health Record Information                                                                                                Manage EHR information across EHR-S
             and Management                                                                                                           applications by ensuring that clinical
                                                                                                                                      information entered by providers is a
                                                                                                                                      valid representation of clinical notes; and
                                                                                                                                      is accurate and complete according to
                                                                                                                                      clinical rules and tracking amendments to
                                                                                                                                      clinical documents. Ensure that
                                                                                                                                      information entered by or on behalf of
                                                                                                                                      the patient is accurately represented.
                                                                                                                                      Since EHR information will typically be
                                                                                                                                      available on a variety of EHR-S
                                                                                                                                      applications, an EHR-S must provide the
                                                                                                                                      ability to access,




                                                                                                                                      manage and verify accuracy and
                                                                                                                                      completeness of EHR information,
                                                                                                                                      maintain the integrity and reliability of
                                                                                                                                      the data, and provide the ability to audit
                                                                                                                                      the use of and access to EHR information.



IN.2.1.1     Health Record Information Data Retention, Availability and             The system SHALL provide the ability to           Retain, ensure availability, and destroy
             and Management            Destruction                                  store and retrieve health record data and         health record information. This includes:
                                                                                    clinical documents for the legally                1) Retaining all EHR-S data and clinical
                                                                                    prescribed time.                                  documents for the time period
                                                                                                                                      designated by policy or legal requirement;
                                                                                                                                      2 ) Retaining inbound documents as
                                                                                                                                      originally received (unaltered); 3)
                                                                                                                                      Ensuring availability of information for the
                                                                                                                                      legally prescribed period of time to users
                                                                                                                                      and patients; and 4) Providing the ability
                                                                                                                                      to destroy EHR data/records in a
                                                                                                                                      systematic way according to policy and
                                                                                                                                      after the legally prescribed retention
                                                                                                                                      period. Discrete and structured EHR-S
                                                                                                                                      data, records and reports must be: 1)




           Dixon Hughes PLLC Confidential                                                                                 8/15/2010                                                                             Page 161 of 402
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                                                                                                                 Vendor Capability Legend

                                                                   1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                   2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                   3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                   Vendor
Criteria #               Category                 Category Description                                 Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                  Capability
                                                                                                                                      Made available to users in a timely
                                                                                                                                      fashion; 2) Stored and retrieved in a
                                                                                                                                      semantically intelligent and useful
                                                                                                                                      manner (for example, chronologically,
                                                                                                                                      retrospectively per a given disease or
                                                                                                                                      event, or in accordance with business
                                                                                                                                      requirements, local policies, or legal
                                                                                                                                      requirements); 3) Retained for a legally
                                                                                                                                      prescribed period of time; and 4)
                                                                                                                                      Destroyed in a systematic manner in
                                                                                                                                      relation to the applicable retention
                                                                                                                                      period. An EHR-S must also allow an
                                                                                                                                      organization to identify data/ records to
                                                                                                                                      be destroyed, and to review and approve.




IN.2.1.2     Health Record Information Data Retention, Availability and             The system SHALL provide the ability to
             and Management            Destruction                                  retain inbound data or documents
                                                                                    (related to health records) as originally
                                                                                    received (unaltered, inclusive of the
                                                                                    method in which they were received) for
                                                                                    the legally organizationally prescribed
                                                                                    time.



IN.2.1.3     Health Record Information Data Retention, Availability and             The system SHALL retain the content of
             and Management            Destruction                                  inbound data (related to health records)
                                                                                    as originally received for the legally
                                                                                    prescribed time.



IN.2.1.4     Health Record Information Data Retention, Availability and             The system SHOULD provide the ability to
             and Management            Destruction                                  retrieve both the information and
                                                                                    business context data within which that
                                                                                    information was obtained.




           Dixon Hughes PLLC Confidential                                                                                 8/15/2010                                                                          Page 162 of 402
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                                                                                                                 Vendor Capability Legend

                                                                   1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                   2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                   3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                   Vendor
Criteria #               Category                 Category Description                                 Criteria                               Discussion / Comments                            Vendor Comments
                                                                                                                                                                                  Capability
IN.2.1.5     Health Record Information Data Retention, Availability and             The system SHOULD provide the ability to
             and Management            Destruction                                  retrieve all the elements included in the
                                                                                    definition of a legal medical record.



IN.2.1.6     Health Record Information Data Retention, Availability and             The system SHOULD provide the ability to
             and Management            Destruction                                  identify specific EHR data/records for
                                                                                    destruction, review and confirm
                                                                                    destruction before it occurs.



IN.2.1.7     Health Record Information Data Retention, Availability and             The system MAY provide the ability to
             and Management            Destruction                                  destroy EHR data/records so that all
                                                                                    traces are irrecoverably removed
                                                                                    according to policy and legal retentions
                                                                                    periods.

IN.2.1.8     Health Record Information Data Retention, Availability and             The system SHOULD pass along record
             and Management            Destruction                                  destruction date information (if any)
                                                                                    along with existing data when providing
                                                                                    records to another entity.



IN.2.2.1     Health Record Information Auditable Records                            The system SHALL provide audit                    Provide audit capabilities for system
             and Management                                                         capabilities for recording access and             access and usage indicating the author,
                                                                                    usage of systems, data, and                       the modification (where pertinent), and
                                                                                    organizational resources.                         the date and time at which a record was
                                                                                                                                      created, modified, viewed, extracted, or
                                                                                                                                      deleted. Date and Time stamping implies
                                                                                                                                      the ability to indicate the time zone
                                                                                                                                      where it was recorded (time zones are
                                                                                                                                      described in ISO 8601 Standard Time
                                                                                                                                      Reference). Auditable records extend to
                                                                                                                                      information exchange, to audit of consent
                                                                                                                                      status management (to support DC.1.3.3)
                                                                                                                                      and to entity authentication




           Dixon Hughes PLLC Confidential                                                                                 8/15/2010                                                                          Page 163 of 402
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                                                                                                        Vendor Capability Legend

                                                          1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                          2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                          3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                           Vendor
Criteria #             Category           Category Description                                Criteria                                Discussion / Comments                            Vendor Comments
                                                                                                                                                                          Capability
                                                                                                                             attempts. Audit functionality includes the
                                                                                                                             ability to generate audit reports and to
                                                                                                                             interactively view change history for
                                                                                                                             individual health records or for an EHR-S.
                                                                                                                             Audit functionality extends to security
                                                                                                                             audits, data audits, audits of data
                                                                                                                             exchange, and the ability to generate
                                                                                                                             audit reports. Audit capability settings
                                                                                                                             should be configurable to meet the needs
                                                                                                                             of local policies. Examples of audited
                                                                                                                             areas include: 1) Security audit, which
                                                                                                                             logs access attempts and resource usage
                                                                                                                             including user log-in, file access, other
                                                                                                                             various




                                                                                                                             activities, and whether any actual or
                                                                                                                             attempted security violations occurred.
                                                                                                                             2) Data audit, which records who, when,
                                                                                                                             and by which system an EHR record was
                                                                                                                             created, updated, translated, viewed,
                                                                                                                             extracted, or (if local policy permits)
                                                                                                                             deleted. Audit-data may refer to system
                                                                                                                             setup data or to clinical and patient
                                                                                                                             management data. 3) Information
                                                                                                                             exchange audit, which records data
                                                                                                                             exchanges between EHR-S applications
                                                                                                                             (for example, sending application; the
                                                                                                                             nature, history, and content of the
                                                                                                                             information




         Dixon Hughes PLLC Confidential                                                                          8/15/2010                                                                           Page 164 of 402
                                                                           Brown County Community Treatment Center - SNF Requirements

                                                                                                              Vendor Capability Legend

                                                                1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                  Vendor
Criteria #               Category               Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                 Capability
                                                                                                                                   exchanged); and information about data
                                                                                                                                   transformations (for example, vocabulary
                                                                                                                                   translations, reception event details,
                                                                                                                                   etc.). 4) Audit reports should be flexible
                                                                                                                                   and address various users' needs. For
                                                                                                                                   example, a legal authority may want to
                                                                                                                                   know how many patients a given health
                                                                                                                                   care provider treated while the provider's
                                                                                                                                   license was suspended. Similarly, in some
                                                                                                                                   cases a report detailing all those who
                                                                                                                                   modified or viewed a certain patient
                                                                                                                                   record. 5) Security audit trails and data
                                                                                                                                   audit trails are used to verify enforcement
                                                                                                                                   of business, data




                                                                                                                                   integrity, security, and access-control
                                                                                                                                   rules. There is a requirement for system
                                                                                                                                   audit trails for the following events: 1)
                                                                                                                                   Loading new versions of, or changes to,
                                                                                                                                   the clinical system; 2) Loading new
                                                                                                                                   versions of codes and knowledge bases;
                                                                                                                                   3) Taking and restoring of backup; 4)
                                                                                                                                   Changing the date and time where the
                                                                                                                                   clinical system allows this to be done; 5)
                                                                                                                                   Archiving any data; 6) Re-activating of an
                                                                                                                                   archived patient record; 7) Entry to and
                                                                                                                                   exiting from the clinical system; 8)
                                                                                                                                   Remote access connections including
                                                                                                                                   those for system support and
                                                                                                                                   maintenance activities.




IN.2.2.2     Health Record Information Auditable Records                         The system SHALL provide audit
             and Management                                                      capabilities indicating the time stamp for
                                                                                 an object or data creation.




           Dixon Hughes PLLC Confidential                                                                              8/15/2010                                                                            Page 165 of 402
                                                                            Brown County Community Treatment Center - SNF Requirements

                                                                                                               Vendor Capability Legend

                                                                 1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                 2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                 3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                Vendor
Criteria #                Category               Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                               Capability
IN.2.2.3      Health Record Information Auditable Records                         The system SHALL provide audit
              and Management                                                      capabilities indicating the time stamp for
                                                                                  an object or data modification


IN.2.2.4      Health Record Information Auditable Records                         The system SHALL provide audit
              and Management                                                      capabilities indicating the time stamp for
                                                                                  an object or data extraction.


IN.2.2.5      Health Record Information Auditable Records                         The system SHALL provide audit
              and Management                                                      capabilities indicating the time stamp for
                                                                                  an object or data exchange.


IN.2.2.6      Health Record Information Auditable Records                         The system SHALL provide audit
              and Management                                                      capabilities indicating the time stamp for
                                                                                  an object or data view.

IN.2.2.7      Health Record Information Auditable Records                         The system SHALL provide audit
              and Management                                                      capabilities indicating the time stamp for
                                                                                  an object or data deletion.



IN.2.2.8      Health Record Information Auditable Records                         The system SHALL provide audit
              and Management                                                      capabilities indicating the viewer of a data
                                                                                  set.

IN.2.2.9      Health Record Information Auditable Records                         The system SHALL provide audit
              and Management                                                      capabilities indicating the data value
                                                                                  before a change.

IN.2.2.10     Health Record Information Auditable Records                         The system MAY provide audit
              and Management                                                      capabilities to capture system events at
                                                                                  the hardware and software architecture
                                                                                  level.


IN.2.2.11     Health Record Information Auditable Records                         The system SHALL limit access to audit
              and Management                                                      record information to appropriate
                                                                                  entities.




            Dixon Hughes PLLC Confidential                                                                              8/15/2010                                                                         Page 166 of 402
                                                                            Brown County Community Treatment Center - SNF Requirements

                                                                                                               Vendor Capability Legend

                                                                 1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                 2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                 3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                Vendor
Criteria #                Category               Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                               Capability
IN.2.2.12     Health Record Information Auditable Records                         The system SHALL provide the ability to
              and Management                                                      generate an audit report.

IN.2.2.13     Health Record Information Auditable Records                         The system SHALL provide the ability to
              and Management                                                      view change history for a particular
                                                                                  record or data set.

IN.2.2.14     Health Record Information Auditable Records                         The system SHOULD provide the ability to
              and Management                                                      record system maintenance events for
                                                                                  loading new versions of, or changes to,
                                                                                  the clinical system.



IN.2.2.15     Health Record Information Auditable Records                         The system SHOULD provide the ability to
              and Management                                                      record system maintenance events for
                                                                                  loading new versions of codes and
                                                                                  knowledge bases.



IN.2.2.16     Health Record Information Auditable Records                         The system SHALL provide the ability to
              and Management                                                      record changing the date and time where
                                                                                  the clinical system allows this to be done.



IN.2.2.17     Health Record Information Auditable Records                         The system SHALL NOT provide the
              and Management                                                      capability to alter the time stamp of an
                                                                                  existing event.

IN.2.2.18     Health Record Information Auditable Records                         The system SHOULD provide the ability to
              and Management                                                      record system maintenance events for
                                                                                  creating and restoring of backup.



IN.2.2.19     Health Record Information Auditable Records                         The system SHOULD provide the ability to
              and Management                                                      record system maintenance events for
                                                                                  archiving any data.




            Dixon Hughes PLLC Confidential                                                                              8/15/2010                                                                         Page 167 of 402
                                                                            Brown County Community Treatment Center - SNF Requirements

                                                                                                               Vendor Capability Legend

                                                                 1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                 2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                 3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                Vendor
Criteria #                Category               Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                               Capability
IN.2.2.20     Health Record Information Auditable Records                         The system SHOULD provide the ability to
              and Management                                                      record system maintenance events for re-
                                                                                  activating of an archived patient record.




IN.2.2.21     Health Record Information Auditable Records                         The system SHALL provide the ability to
              and Management                                                      record system maintenance events for
                                                                                  entry to and exit from the EHR system.



IN.2.2.22     Health Record Information Auditable Records                         The system SHALL provide the ability to
              and Management                                                      record system maintenance events for
                                                                                  remote access connections including
                                                                                  those for system support and
                                                                                  maintenance activities.



IN.2.2.23     Health Record Information Auditable Records                         The system SHOULD provide the ability to
              and Management                                                      record and report upon audit information
                                                                                  using a standards-based audit record
                                                                                  format (for example RFC 3881).

IN.2.2.24     Health Record Information Auditable Records                         The system SHALL NOT provide the
              and Management                                                      capability to modify audit data.

IN.2.2.25     Health Record Information Auditable Records                         The system MAY provide the capability to
              and Management                                                      manually append information to audit
                                                                                  data.




            Dixon Hughes PLLC Confidential                                                                              8/15/2010                                                                         Page 168 of 402
                                                                           Brown County Community Treatment Center - SNF Requirements

                                                                                                              Vendor Capability Legend

                                                                1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                Vendor
Criteria #               Category               Category Description                                Criteria                                Discussion / Comments                           Vendor Comments
                                                                                                                                                                               Capability
IN.2.3.1     Health Record Information Synchronization                           The system SHOULD provide the ability to Maintain synchronization involving: 1)
             and Management                                                      link entities to external information.   Interaction with entity directories; 2)
                                                                                                                          Linkage of received data with existing
                                                                                                                          entity records; 3) Location of each health
                                                                                                                          record component; and 4)
                                                                                                                          Communication of changes between key
                                                                                                                          systems. An EHR-S may consist of a set of
                                                                                                                          components or applications; each
                                                                                                                          application manages a subset of the
                                                                                                                          health information. Therefore it is
                                                                                                                          important that, through various
                                                                                                                          interoperability mechanisms, an EHR-S
                                                                                                                          maintains all the relevant information
                                                                                                                          regarding the health record in synchrony.
                                                                                                                          For example, if



                                                                                                                                   a physician orders an MRI, a set of
                                                                                                                                   diagnostic images and a radiology report
                                                                                                                                   will be created. The patient
                                                                                                                                   demographics, the order for MRI, the
                                                                                                                                   diagnostic images associated with the
                                                                                                                                   order, and the report associated with the
                                                                                                                                   study must all be synchronized in order
                                                                                                                                   for the clinicians to view the complete
                                                                                                                                   record.



IN.2.3.2     Health Record Information Synchronization                           The system SHOULD store the location of
             and Management                                                      each known health record component in
                                                                                 order to enable authorized access to a
                                                                                 complete logical health record if the EHR
                                                                                 is distributed among several applications
                                                                                 within the EHR-S.




           Dixon Hughes PLLC Confidential                                                                              8/15/2010                                                                          Page 169 of 402
                                                                             Brown County Community Treatment Center - SNF Requirements

                                                                                                                Vendor Capability Legend

                                                                  1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                  2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                  3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                    Vendor
Criteria #               Category                 Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                   Capability
IN.2.4.1     Health Record Information Extraction of Health Record Information     The system SHALL provide the ability to           Manage data extraction in accordance
             and Management                                                        extract health record information.                with analysis and reporting requirements.
                                                                                                                                     The extracted data may require use of
                                                                                                                                     more than one application and it may be
                                                                                                                                     pre-processed (for example, by being de-
                                                                                                                                     identified) before transmission. Data
                                                                                                                                     extractions may be used to exchange data
                                                                                                                                     and provide reports for primary and
                                                                                                                                     ancillary purposes. An EHR-S enables an
                                                                                                                                     authorized user, such as a clinician, to
                                                                                                                                     access and aggregate the distributed
                                                                                                                                     information, which corresponds to the
                                                                                                                                     health record or records that




                                                                                                                                     are needed for viewing, reporting,
                                                                                                                                     disclosure, etc. An EHR-S must support
                                                                                                                                     data extraction operations across the
                                                                                                                                     complete data set that constitutes the
                                                                                                                                     health record of an individual and provide
                                                                                                                                     an output that fully chronicles the health
                                                                                                                                     care process. Data extractions are used as
                                                                                                                                     input to patient care coordination
                                                                                                                                     between facilities, organizations and
                                                                                                                                     settings. In addition, data extractions can
                                                                                                                                     be used for administrative, financial,
                                                                                                                                     research, quality analysis, and public
                                                                                                                                     health purposes.




IN.2.4.2     Health Record Information Synchronization                             The system SHALL provide secure data
             and Management                                                        exchange capabilities.


IN.2.4.3     Health Record Information Synchronization                             The system SHOULD provide the ability to
             and Management                                                        de-identify extracted information.




           Dixon Hughes PLLC Confidential                                                                                8/15/2010                                                                            Page 170 of 402
                                                                            Brown County Community Treatment Center - SNF Requirements

                                                                                                               Vendor Capability Legend

                                                                 1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                 2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                 3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                Vendor
Criteria #                Category               Category Description                                Criteria                               Discussion / Comments                           Vendor Comments
                                                                                                                                                                               Capability
IN.2.4.4      Health Record Information Synchronization                           The system SHALL enable data extraction
              and Management                                                      in standard-based formats.


IN.2.4.5      Health Record Information Synchronization                           The system SHALL provide the ability to
              and Management                                                      perform extraction operations across the
                                                                                  complete data set that constitutes the
                                                                                  health record of an individual within the
                                                                                  system.



IN.2.4.6      Health Record Information Synchronization                           The system SHALL provide the ability to
              and Management                                                      perform extraction operations whose
                                                                                  output fully chronicles the healthcare
                                                                                  process.


IN.2.4.7      Health Record Information Synchronization                           The system SHALL provide the ability to
              and Management                                                      extract data for administrative purposes.



IN.2.4.8      Health Record Information Synchronization                           The system SHOULD provide the ability to
              and Management                                                      extract data for financial purposes.



IN.2.4.9      Health Record Information Synchronization                           The system SHOULD provide the ability to
              and Management                                                      extract data for research purposes.



IN.2.4.10     Health Record Information Synchronization                           The system SHOULD provide the ability to
              and Management                                                      extract data for quality analysis purposes.



IN.2.4.11     Health Record Information Synchronization                           The system SHOULD provide the ability to
              and Management                                                      extract data for public health purposes.




            Dixon Hughes PLLC Confidential                                                                              8/15/2010                                                                         Page 171 of 402
                                                                           Brown County Community Treatment Center - SNF Requirements

                                                                                                              Vendor Capability Legend

                                                                1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                  Vendor
Criteria #               Category               Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                 Capability
IN.2.5.1     Health Record Information Store and Manage Health Record                                                              Store and manage health record
             and Management            Information                                                                                 information as structured and
                                                                                                                                   unstructured data. Unstructured health
                                                                                                                                   record information is information that is
                                                                                                                                   not divided into discrete fields AND not
                                                                                                                                   represented as numeric, enumerated or
                                                                                                                                   codified data. General examples of
                                                                                                                                   unstructured health record information
                                                                                                                                   include: text, word processing document,
                                                                                                                                   image, multimedia. Specific examples
                                                                                                                                   include: text message to physician,
                                                                                                                                   patient photo, letter from family, scanned
                                                                                                                                   image of insurance card, dictated report




                                                                                                                                   (voice recording). Structured health
                                                                                                                                   record information is divided into discrete
                                                                                                                                   fields, and may be enumerated, numeric
                                                                                                                                   or codified. Examples of structured
                                                                                                                                   health information include: 1) patient
                                                                                                                                   address (non-codified, but discrete field);
                                                                                                                                   2) diastolic blood pressure (numeric); 3)
                                                                                                                                   coded result observation; 4) coded
                                                                                                                                   diagnosis; 5) patient risk assessment
                                                                                                                                   questionnaire with multiple-choice
                                                                                                                                   answers. Context may determine
                                                                                                                                   whether or not data are unstructured
                                                                                                                                   (e.g., a progress note might be
                                                                                                                                   standardized), and




           Dixon Hughes PLLC Confidential                                                                              8/15/2010                                                                            Page 172 of 402
                                                                           Brown County Community Treatment Center - SNF Requirements

                                                                                                              Vendor Capability Legend

                                                                1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                                  Vendor
Criteria #               Category               Category Description                                Criteria                                Discussion / Comments                             Vendor Comments
                                                                                                                                                                                 Capability
                                                                                                                                   structured in some EHR-S (e.g.,
                                                                                                                                   Subjective/Objective/ Assessment/ Plan)
                                                                                                                                   but unstructured in others. Managing
                                                                                                                                   health care data includes capture,
                                                                                                                                   retrieval, deletion, correction,
                                                                                                                                   amendment, and augmentation.
                                                                                                                                   Augmentation refers to providing
                                                                                                                                   additional information regarding the
                                                                                                                                   healthcare data, which is not part of the
                                                                                                                                   data itself (e.g., linking patient consents
                                                                                                                                   or authorizations to the health care data
                                                                                                                                   of the patient).




IN.2.6.1     Health Record Information Manage Unstructured Health Record         The system SHALL capture unstructured             Create, capture, and maintain
             and Management            Information                               health record information as part of the          unstructured health record information.
                                                                                 patient EHR.



IN.2.6.2     Health Record Information Manage Unstructured Health Record         The system SHALL retrieve unstructured
             and Management            Information                               health record information as part of the
                                                                                 patient EHR.



IN.2.6.3     Health Record Information Manage Unstructured Health Record         The system SHALL provide the ability to           Create, capture, and maintain
             and Management            Information                               update unstructured health record                 unstructured health record information.
                                                                                 information.


IN.2.6.4     Health Record Information Manage Unstructured Health Record         The system SHALL provide the ability to           Create, capture, and maintain
             and Management            Information                               inactivate, obsolete, or destroy                  unstructured health record information.
                                                                                 unstructured health record information.



IN.2.6.5     Health Record Information Manage Unstructured Health Record         The system SHOULD provide the ability to Create, capture, and maintain
             and Management            Information                               output unstructured health record        unstructured health record information.
                                                                                 information to a report.




           Dixon Hughes PLLC Confidential                                                                              8/15/2010                                                                            Page 173 of 402
                                                                           Brown County Community Treatment Center - SNF Requirements

                                                                                                              Vendor Capability Legend

                                                                1 - Supported as delivered “out of the box”       4 - Planned in future release
                                                                2 - Supported with ‘workaround’                   5 - Supported with customization (changes to source code)
                                                                3 - Supported via 3rd Party solution              6 - Not Supported



                                                                                                                                                                               Vendor
Criteria #               Category               Category Description                                Criteria                               Discussion / Comments                           Vendor Comments