Cypress Helps Healthcare IT Vendors Make the Grade

March 2015
Topics: Informatics, Software Testing, Data Management
The quality and consistency of patient care nationwide is rising, thanks to an automated tool developed by MITRE. Cypress modernizes underlying health information technology, ensuring that healthcare providers are adhering to national standards.
Sam Sayer, a software systems engineer who helped develop the Cypress tool, reviews the latest measurement data.

A typical patient with diabetes often receives vision screenings, foot circulation evaluations, and regular cholesterol tests. But how do we ensure that the patient in Portland, Maine, is receiving the same quality of care as someone with the same condition in San Francisco?

MITRE is helping make that kind of healthcare comparison possible. Our researchers have created a tool that enables repeatable and rigorous testing of Electronic Health Records' (EHRs) ability to calculate a series of electronic measures established by the government. These measures certify whether the EHR technology meets the national standards.

Through the development of an open-source "Cypress" Electronic Health Records Certification Testing and Certification tool, MITRE's health information technology and systems engineering experts are working hand-in-hand with our government sponsors to improve the quality, safety, and efficiency of the nation's healthcare system.

"The premise is to measure quality using data stored in EHRs," explains Rob McCready, a MITRE healthcare Information Technology (IT) program manager. "Some people think of an Electronic Health Record as just a tool for a care provider to capture information and transmit between electronic devices. However, the data captured in EHRs are powerful and can do much more."

In the future, all diabetes patients—and other patient groups such as expectant mothers— will be tracked to ensure they receive the appropriate battery of tests for their specific conditions and the system will reveal when they are not receiving the appropriate standard of care. This defined process not only ensures that EHRs meet new standards, but also that they are meaningfully used to take advantage of every opportunity to provide the high quality care that leads to the best possible outcome. (See "What's the Meaning of Meaningful Use? " below.)

The First Testing Tool of Its Kind

Cypress is an automated testing tool that enables healthcare providers and hospitals to better determine whether their EHR system meets the quality measurement requirements of Meaningful Use. "Think of the computer used at your vehicle inspection station when you bring your car in for its annual inspection," says McCready. "Cypress is the testing tool healthcare vendors use to certify that their systems and products meet quality standards established by the U.S. Department of Health and Human Services [HHS]."

MITRE developed Cypress, the first certification testing tool of its kind, for the Office of the National Coordinator for Health Information Technology. Jeffrey Hammer, who heads the MITRE project for MITRE's Centers for Medicare & Medicaid Services Alliance to Modernize Healthcare (CAMH), adds, "Cypress paves the way towards interoperability. That produces cost savings for the healthcare provider community, patients, and ultimately, the nation."

Cypress works by evaluating the computation and reporting of Clinical Quality Measures (CQMs) by EHR vendor systems. MITRE's previous work in medical data formats via Project Laika and the design of the popHealth open source EHR testing framework—combined with deep knowledge of healthcare industry standards—strengthened the team’s approach to Cypress.

"We also applied software engineering expertise and knowledge from other domains across MITRE to develop the tool," says Hammer.

Why Does the Healthcare Community Need Cypress?

As the medical community increasingly moves towards sharing data via electronic medical records, more healthcare organizations, from hospitals to specialists, are adopting electronic systems.

Ultimately, the goal is for meaningful use-compliant EHRs to act as a critical support for a healthier population, thanks to increased data transparency and efficiency. Systems that capture robust research data on health systems will be especially valuable towards that end.

MITRE released Cypress under an open-source software distribution license. This lets EHR vendors and authorized testing labs make use of Cypress, learn from its programming code, and ensure that it conforms to nationally recognized data standards established by HHS.

The Cypress tool is freely available for use or adoption by the health IT community. "MITRE was responsible for designing, developing, and fielding the tool,” says McCready. "It’s a real capability that accurately calculates and reports measures of healthcare quality."

MITRE's healthcare specialists believe that solutions such as Cypress will lead the way in revolutionizing the nation's health care system by modernizing its underlying IT, making healthcare ultimately more affordable, and its patients healthier.

—by Cheryl Scaparrotta


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