Client Introduction

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 in the absence of a relational database. 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.

Structured and Secured Data

Enhanced Interoperability

Higher Quality Patient Care

Technology Stack

MS WinForms
C++, MFC
C-Tree SQL

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