This document summarizes a Cypress Tech Talk presentation about version 3 of the Cypress tool. Key points include: - Cypress v3 supports 2015-2016 certification for electronic clinical quality measures. - Updates include a new test plan for ONC 2015 Edition certification, support for updated standards versions, and a refreshed user interface. - Guidance was provided on issues related to data criteria substitution, diagnosis/procedure ordinality, and measure inclusion in patient records for manual entry tests. - Future versions and tech talks were announced.

1. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
Cypress
Cypress Tech Talk
August 16, 2016

2. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
Agenda
 Cypress 3 Overview
– Certification Updates
– Pre-certification testing support
– Standards Support
– UI Updates
 Cypress Versions
 Issues with Guidance
– CYPRESS-706
– CYPRESS-717
– CYPRESS-729
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3. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
Cypress V3 Released
 Cypress v3 is now available to support 2015 certification for
electronic clinical quality measures (eCQM). Cypress v3
supports testing for the June 2015 and April 2016 updates to the
Meaningful Use (MU) Stage 2 Eligible Hospital eCQMs and the
MU Stage 2 Eligible Professional eCQMs. The new v3 release
and release notes are available on the Cypress website
https://healthit.gov/cypress/.
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4. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
Certification Updates
■ New eCQM Test Plan to
support Office of the National
Coordinator for Health
Information Technology
(ONC) 2015 Edition
Certification Testing
 Cypress evaluates C1, C2, C3, C4
independently of each other
 C4 eCQM Filter Certification Criteria
testing ability of electronic health
records (EHR) systems to filter, export,
and view patient data
 C1 Only testing without automated
import that demonstrates the validation
of well-formed QRDA Category 1
patient record required for
interoperable exchange across
systems
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5. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
Pre-Certification testing support
 Certification Application Programming Interface (API) to
automate and expedite pre-certification testing
 Ability to turn off document duplication and record
randomization to use a stable set of test patients
 Ability for vendors to test their own data, with the addition
of the Cypress Validation Utility
■ Ability to view test patients and measure calculation
■ Ability to download HTML patient records
■ Ability to download ‘Known Good Result’ test specific
sample QRDA I and III files
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6. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
Standards Support
 Support for Health Quality Measure Format (HQMF) R2.1 and
Quality Reporting Document Architecture (QRDA) R3.1
 Support for both the 2015 and 2016 Annual Measure Updates
– Cypress v3 includes the updated specifications introduced for
Eligible Hospital Measures and Eligible Professional Measures in
June 2015 and April 2016 by the Centers for Medicare & Medicaid
Services (CMS)
 With the 2015 eCQMs, validation of 2016 CMS QRDA
Implementation Guide (IG) is available
 With the 2016 eCQMs, validation of 2017 CMS QRDA IG for
Hospital Quality Reporting (informational) is available.
– Note: For the 2016 eCQMs, the 2017 CMS QRDA IG for Eligible
Clinicians is not yet available, but will be added in a future release
of Cypress.
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7. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
UI Updates
■ Refreshed design providing a more responsive and
accessible user interface
 Cypress v3 complies with Section 508 and Web Content
Accessibility Guidelines (WCAG) 2.0 AA conformance level
requirements
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8. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
Cypress Versions
Version Dates Measures Supported
V2.6.1 Ongoing – frozen;
only major issues
addressed moving
forward
Measures released in 2014 for the 2015 reporting year
V3 (final
release)
7/28/16 Measures released in 2015 for the 2016 reporting year
Measures released in 2016 for the 2017 reporting year
If you plan on certifying using the Cypress API, please contact your ATL ASAP
and let them know your intent.
Cypress v2.6.1 Demo server scheduled for sunset on 9/1/2016

9. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
C1 Manual Entry – Synonymous Data Criteria
Substitution (CYPRESS-706)
 Some measures include ‘Unions’ of clinically equivalent data
criteria of different data types
 Cypress current chooses one of these criteria, and does not allow
substitution
 ATLs will be provided guidance on cases where substitutions are
allowable (and therefore error messages ignored)
– Substituted data criteria must be clinically equivalent
– The data criteria must be able to be substituted in every measure it
appears
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Not clinically equivalent
CMS145

10. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
C1 Manual Entry – Diagnosis and Procedure
Ordinality (CYPRESS-717)
 Some C1 Manual Entry test require the entry of a “Diagnosis,
Active” or “Procedure, Performed” with ordinality
 Cypress currently looks in the wrong place to verify the
existence of the ordinality attribute for 2015 measures
 The following error messages can be ignored for 2015 measures
when the ordinality attribute is required
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11. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
Manual Entry requires all measures in patient
XML (CYPRESS-729)
 C1 Manual Test are created to test the manual entry of patient
data for multiple measures
 The C1 Manual Test validators expect the uploaded files to
include ids for all measures the in C1 Manual Test
 However, the uploaded files may not fall into the IPP for all C1
Manual measures, and therefore should not need to ‘report’ on
measures they are not a part of
 The following error messages can be ignored for C1 Manual Tests
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12. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
cypress
OPEN DISCUSSION
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13. © 2016 The MITRE Corporation. All rights reserved. For MITRE/Government use only
Next Cypress Tech Talk
 Tuesday August 23th at 1pm EDT
 Register at
https://attendee.gotowebinar.com/register/8110364277730751489
 Completed Webinars will be posted on the Cypress Website on
the Timeline Tab.
– http://projectcypress.org/timeline.html
 Send questions and feedback to the Cypress Talk List at
– project-cypress-talk@googlegroups.com
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