ONC Certification for Behavioral Health EHR

Vicert improved the client's system, adding new features which allowed the client to acquire the ONC certification and avoid penalties.


ONC Certification for Behavioral Health EHR

Interoperability and Data Quality Management

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FHIR, Firely, Duende IDP

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1 year

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We built a series of features for the client’s behavioral health EHR system to make them eligible for ONC certification.


Our client is a leading EHR solution designed for behavioral health. They were obliged to comply with the ONC’s Cures Act to implement and certify for the FHIR standard. The main challenge was acquiring ONC certification quickly to resume operations without our client acquiring penalties.

The CMS Interoperability and Patient Access Final Rule mandates using ONC certified EHR software to participate in certain Medicare programs and initiatives. Noncompliance with these programs and initiatives can result in reduced Medicare payments or exclusion from certain programs.

Case Study, FHIR Server and ONC-certified EHR technology, Diagram


Vicert was hired to create the missing software feature for data exchange (interop) in FHIR format. The implementation had to compile to the FHIR standard extended with the US Core Implementation Guide. The first step in this solution was to determine if the client’s database contained all the necessary information for each FHIR resource we had to provide to get the ONC certification.

To enable FHIR, we needed to develop a server from scratch, a time and budget-consuming process. We chose one of the available solutions from the many available vendors.

Firely was chosen as the server provider along with Firely facade, a fully customizable plugin for the server. We have successfully enabled the interpretation of our client’s data from their MS SQL database into the specified format.

To create ONC certified EHR software, we also needed to make it support the SMART on FHIR protocols, which required obtaining a fully customized Identity Server, which was not in place before. Vicert chose and configured Duende Identity Server to integrate into the client’s FHIR system. We had to test our solution to see if it met the ONC certification requirements. To do that, we used a tool called Inferno, which is a test simulator made by ONC. It was important to complete this step and ensure certification would pass smoothly and without delays.


  • Successful ONC certification and continuation of conducting business operations as usual, without penalties
  • By certifying for FHIR, the client can easily exchange data with other systems
  • Our client was able to offer their patients and partners the benefit of improved interoperability and data-sharing,
  • improving outcomes and patient satisfaction
  • Our client now occupies a more competitive place in the market
  • Our software that granted the client ONC certification made them more adaptable to future changes