170.314.a.

4 Vital Signs, BMI, Growth Chart PS

Test Criteria: 170.314.a.4 Vital Signs, BMI, Growth

Chart
Testing Result
Participant and Product-withversion
Setting (Ambulatory or Inpatient)
Test Proctor
Test Date
Results (PASS/FAIL/
DID NOT ATTEMPT)
If Fail, describe error.
EHR Supports Optional Growth
Charts (YES / NO)
Additional Software Used In
Demonstration
Modifications to Product Under
Test
Additional Proctor Notes

Scope of Proctoring Sheet

The ONC test method associated with this criterion is the only approved test method for
EHR Meaningful Use certification. This Proctoring Sheet is not a replacement test
method but a test procedure document for performing the ONC test method and recording
the results. Proctoring Sheet describe test data, test criteria and expected results. It is
assumed the Vendor or Participant Under Test is familiar with the associated ONC test
method.

Test Data
Source: ONC Supplied
Load Time: At the time of testing but ONLY at direction of Test Proctor except for
Growth Chart height/weight which can be pre-loaded

Test Tools
None

Version of ONC Test Methods

1.3
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170.314.a.4 Vital Signs, BMI, Growth Chart PS

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Critical Rules for Test Event

Strict time allotment for testing

o Supplemental Retest: 1 hour
o 1-9 Modules: 2 hours
o 10-18 Modules: 4 hours
o 19-24 Modules: 6 hours
o 25-32 Modules: 8 hours
o 33-39 Modules: 10 hours
o 40+ Modules: 12 hours
When a test error is encountered, the module is recorded as failed, and the participant
is instructed to move to the next module for testing.
If a module cannot be tested due to the participant failing to pre-load the required pretest patient setup data, the module is recorded as failed, and the participant is
instructed to move to the next module for testing.
If time permits, the participant will be allowed to retest failed modules after all other
modules have been tested.
No code changes or error fixes are allowed without Proctor permission and until all
registered modules are tested once. Only minor code changes are allowed.
Only one code change is allowed on specific module functionality during a test event.
For example, a code change/modification is only allowed once on the problem list
functionality within a given test day.
You must supply patient test data that is fictitious and contrived by the participant for
test purposes.
No recording of audio or video by the participant is allowed during the test event.

Robustness and Reliability Requirement

To satisfy the module criteria, it is expected that the Product-Under-Test is able to
complete the testing requirements reliably, including repeat testing with the same result
without error, and with a satisfactory level of robustness. This includes unexpected error
messages produced through normal operation, multiple unintended restarts of the
application or any other buggy facets of the product displayed while testing. These
errors are record in the Additional Proctor Notes of the proctor sheet. Lack of reliability
and robustness of design will result in failure of the module.

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Test Proctor Instructions

Prior to administering the test proctor sheet, the test proctor will confirm the current
version of the proctor sheet is being used per the controlled document log of the testing
quality system.
The test proctor instructs and observes the product-under-test performing the required test
procedure steps for each test requirement. The test proctor shall record pass/fail/no
attempt results and observations for each test requirement section as well as test
verification audit information in the appropriate sections. If all test requirements pass the
expected test results per the test procedures steps, the entire module test will be marked
as PASS in the Testing Result section. If one or more test requirements are not met, the
entire module test is marked as FAIL. Other test event information is recorded as
dictated in the Testing Results section.
If an error occurs in the product software during the course of testing, the error may be
resolved and module retested once in the course of the test event if time permits, but only
under the supervision of the test proctor. The test proctor records the modification made
to the product either in the Modifications to Product Under Test section or the Test Result
Verification section.
The test proctor shall record relevant free form notes regarding the module testing as
necessary in the Additional Proctor Notes section. This includes records of errors or bugs
observed outside the specific scope of the module test requirement, such as privacy and
security failures, which could be relevant in granting certification or unusual activities of
the product-under-test revealed in the course of testing which could impact certification
confidence.

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Test Requirement: DTR 170.314.a.4.i-1: Electronically Record Patient

Vital Signs
To Be Completed by Test Proctor
Test Requirement RESULT (Pass/Fail/No Attempt)

Test Procedures
1. Proctor will instruct Vendor to select patient record.
2. Proctor will instruct Vendor to attempt to enter non-numerical vital signs for
patients height/length, weight and blood pressure. EHR should not allow for
non-numerical vitals to be recorded.
3. Proctor will instruct Vendor to enter numerical vital signs from the selected
data set of the ONC supplied data set but also copied below into the vitals of
the patient record.
4. Proctor will confirm Expected Test Results were achieved.
5. Proctor will audit test results by completing Test Result Verification checklist.

Test Data
Test data is copied from ONC Test Method Test Data.
If different test data is used, test proctor must note this test data in the Test Result
Verification section.
Vital Signs/BMI Data Set #1
Height: 5 ft 5 in OR 65 in OR 1.65 meters OR 165 centimeters
Weight: 139 lbs OR or 139lbs 2 oz OR 63 kg OR 63049 gm
Blood pressure: 110/90

Expected Testing Results

[IN170.314.a.4.i-1.01 / IN170.314.a.4.i-1.03] Patient vital signs, including

height, weight, and blood pressure, are entered correctly and without omission
into the patients record.
[IN170.314.a.4.i-1.02] Units of measure appropriate for the height and weight
are displayed or are selected at the time each vital sign is entered.

Test Result Verification

INSERT SCREEN SHOT Non-numeric vital signs cannot be recorded

INSERT SCREEN SHOT Recorded vital signs

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Test Requirement: DTR 170.314.a.4.i-2: Electronically Change Patient

Vital Signs
To Be Completed by Test Proctor
Test Requirement RESULT (Pass/Fail/No Attempt)

Test Procedures
1. Proctor will instruct Vendor to select patient record.
2. Proctor will instruct Vendor to modify patient vital signs as described in the
ONC supplied data set but also copied below. Changes from original list are
highlighted in bold.
3. Proctor will confirm Expected Test Results were achieved.
4. Proctor will audit test results by completing Test Result Verification checklist.

Test Data
Test data is copied from ONC Test Method Test Data.
If different test data is used, test proctor must note this test data in the Test Result
Verification section.
Vital Signs #1
Height: 5 ft 6 in OR 66 in OR 1.68 m OR 168 cm
Weight: 136 lbs OR 136 lbs 3 oz OR 62 kg OR 61,689 g
Blood pressure: 120/80

Expected Testing Results

[IN170.314.a.4.i-1.01 / IN170.314.a.4.i-1.03] Patient vital signs, including

height, weight, and blood pressure, are changed correctly and without
omission into the patients record.
[IN170.314.a.4.i-1.02] Units of measure appropriate for the height and weight
are displayed or are selected at the time each vital sign is changed.

Test Result Verification

INSERT SCREEN SHOT Modified vital signs

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Test Requirement: DTR 170.314.a.4.i-3: Electronically Access Patient

Vital Signs
Test Requirement: DTR 170.314.a.4.ii-1: Automatically Calculate and
Electronically Display Body Mass Index
To Be Completed by Test Proctor
Test Requirement RESULT (Pass/Fail/No Attempt)

Test Procedures
1. Proctor will instruct Vendor to select patient record.
2. Proctor will instruct Vendor to retrieve patient vital signs as described in the
ONC supplied data set but also copied below.
3. Proctor will confirm Expected Test Results were achieved.
4. Proctor will audit test results by completing Test Result Verification checklist.

Test Data
Test data is copied from ONC Test Method Test Data.
If different test data is used, test proctor must note this test data in the Test Result
Verification section.
Vital Signs/BMI Data Set #1
Height: 5 ft 6 in OR 66 in OR 1.68 m OR 168 cm
Weight: 136 lbs OR 136 lbs 3 oz OR 62 kg OR 61,689 gm
Blood pressure: 120/80
Calculated BMI: 21.9

Expected Testing Results

[IN170.314.a.4.i-3.01 / IN170.314(a)(4)(ii) 1.01] Patient vital signs,

including height, weight, and blood pressure, are accessed correctly and
without omission into the patients record.
[IN170.314.a.4.i-3.02 / IN170.314(a)(4)(ii) 1.02] Units of measure
appropriate for the height and weight are displayed or are selected.
[IN170.314(a)(4)(ii) 1.03] Patient BMI is calculated correctly.

Test Result Verification

INSERT SCREEN SHOT Retrieved vital signs

INSERT SCREEN SHOT Recorded BMI

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Test Requirement: DTR 170.314.a.4.3-1: Electronically Plot and

Display Growth Charts (Optional)
To Be Completed by Test Proctor
Test Requirement RESULT (Pass/Fail/No Attempt)

Test Procedures
1. Proctor will instruct Vendor to select patient record for both a male adolescent
and female adolescent.
2. If height and weight are not pre-loaded, Proctor will instruct Vendor to enter
height and weight measurements for a male and female patients from the ONC
supplied data set but also copied below.
3. Proctor will instruct Vendor to generate both height and weight growth charts
for both the male adolescent and female adolescent patient which plots and
displays their weight and height per age. Only the most recent or current
height and weight are required to be plotted upon the chart. However, the
EHR may include the height and weight from the previous two encounters on
the age graph to show a historical progression. Weight and height may be
plotted and displayed on a single growth chart or separate charts.
4. Proctor will confirm Expected Test Results were achieved.
5. Proctor will audit test results by completing Test Result Verification checklist.

Test Data
Test data is copied from ONC Test Method Test Data.
If different test data is used, test proctor must note this test data in the Test Result
Verification section.
Test data can be preloaded prior to testing or loaded at the time of testing.
Male Patient 1
Age: 2
Height: 3 ft 1 in OR 37 in OR 0.94 m OR 94 cm
Weight: 33 lbs OR 32 lbs 14 oz OR 15 kg OR 14,969 gm
Male Patient 2
Age: 12
Height: 5 ft 1 in OR 61 in OR 1.55 m OR 155 cm
Weight: 99 lbs OR 98 lbs 11 oz OR 45 kg OR 44,906 gm
Female Patient 3
Age: 5
Height: 3 ft 4 in OR 40 in OR 1.02 m OR 102 cm
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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Weight: 40 lbs OR 40 lbs 2 oz OR 18 kg OR 18,144 gm
Female Patient 4
Age: 14
Height: 5 ft 3 in OR 63 in OR 1.60 m OR 160 cm
Weight: 110 lbs OR 110 lbs 1 oz OR 50 kg OR 49,895 gm

Expected Testing Results

[IN170.314(a)(4)(iii) 1.01-1.09] Each height and weight measurement of

both male patient and female patient is accurately plotted against their age and
then displayed on gender-based growth charts (2-20 years).

Test Result Verification

INSERT SCREEN SHOT Male patient growth chart

INSERT SCREEN SHOT Female patient growth chart

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Appendix A: Testing Guide

This appendix contains more details and background on the testing requirements,
including explanation on underlying standards, notable issues and best practice
suggestions.
Rev 01-Mar-2013 Additions
A numerical vital sign is precise and unambiguous, can be converted to other units
and plotted on a graph or chart. For example, 57, 176 lbs, and 120/80 mmHg
are all acceptable numerical vital signs that are captured. When such units are
recorded, they must be done in an unambiguous, precise manner that could be
converted to other units and/or plotted on a graph or chart.
Rev 20-Dec-2012 Additions
For height and weight, any unit of measurement listed in the test data is permitted,
and it is not required that all units of measurement be supported.
Blood pressure may be entered as a single value into one blood pressure field or as
two separate values systolic and diastolic each entered into its own part of a twopart blood pressure field.
The CDC BMI Calculator used for this test data is available at:
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/b
mi_calculator.html. Use of the CDC BMI Calculator is not required. It is recognized
that other BMI calculators may have slightly different algorithms and the derived
BMI may not be exactly the same as the test data below.
Growth charts are not required to include a comparison reference to the national
norms, but ONC does encourage Complete EHR and EHR Module developers to
include this feature. CDC provides growth chart templates here:
http://www.cdc.gov/growthcharts/clinical_charts.htm
Only growth charts of heights and weights of 2-20 year olds are required. BMI
growth chart is not required nor charts for additional ages.
The patient height and weight for each of the 3 age dates can be plotted together on
the same chart or separately on 3 distinct charts.

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Appendix B: ONC Criteria and Standards

This appendix contains copy of the relevant ONC criteria and standards for this proctor
sheet as a reference. In the event of a discrepancy with the ONC Final Rule, the ONC
Final Rule takes precedence.
170.314(a)(4) Vital signs, body mass index, and growth charts.
(i)
Vital signs. Enable a user to electronically record, change, and access, at a
minimum, a patients height/length, weight, and blood pressure.
Height/length, weight, and blood pressure must be recorded in numerical
values only.
(ii)
Calculate body mass index. Automatically calculate and electronically
display body mass index based on a patients height and weight.
(iii)
OptionalPlot and display growth charts. Plot and electronically display,
upon request, growth charts for patients.

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

Change Log
Revision
01-Apr-2013
01-Mar-2013
20-Dec-2012

Change Description
Added screenshot requirement verifying non-numerical values
cannot be recorded.
Added clarification on how data is recorded in the Testing Guide
appendix.
Initial Release.

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170.314.a.4 Vital Signs, BMI, Growth Chart PS

About Drummond Group Inc.

Drummond Group Inc. is a global software test and certification lab that serves a wide
range of vertical industries. In healthcare, Drummond Group tests and certifies
Controlled Substance Ordering Systems (CSOS), Electronic Prescription of Controlled
Substances (EPCS) software and processes, and Electronic Health Records (EHRs)
designating the trusted test lab as the only third-party certifier of all three initiatives
designed to move the industry toward a digital future. Founded in 1999, and accredited
for the Office of the National Coordinator HIT Certification Program as an Authorized
Certification Body (ACB) and an Authorized Test Lab (ATL), Drummond Group
continues to build upon its deep experience and expertise necessary to deliver reliable
and cost-effective services. For more information, please visit
http://www.drummondgroup.com or email DGI@drummondgroup.com.

END OF DOCUMENT

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