Meaningful Use Certification for a Chiropractic focused EHR and practice management system


Client Challenge

Meaningful Use certification was sought for their ambulatory Chiro EHR, built on C++ where the data was stored in .dat files. Developing modules like the Clinical Quality Measures (CQMs), Clinical Document Architectures (CDAs) and implementing DIRECT messaging was a challenge as the data could not be searched easily as there was no relational database used. DIRECT messaging will help reduce dependency on third party solutions and make the solution more affordable by getting rid of partner associated costs.


To speed up the development for some of the complex requirements such as CQMs, the data model was migrated into a relational database using C-Tree SQL where all the data operations could be performed. A loosely coupled design was adopted to build CCDA and QRDA generators that work dynamically through configurations. DIRECT server was setup at the customer location which can be accessed using the cloud hosted service which enables access from anywhere.


A Healthcare Technology Company who offers a complete EHR and a Practice Management System used by over 7000 Chiropractic, physical therapy and medical practices across the US needed a much needed upgrade to their EHR and achieve Meaningful Use Certification.

Nalashaa’s prior experience with MU certifications resulted in a successful MU2 certification in just 8 months. Without any handholding, the entire development and certification was orchestrated and led by experts from Nalashaa to achieve a successful certification with Drummond.

Technology Stack

  • MS WinForms
  • C++, MFC
  • C-Tree SQL