FREE EMR ACCEPTANCE RECORD
Version: 2026-10-13
Companion: https://www.veroscribe.com/blog/free-emr-guide

Use synthetic data. Keep real records, credentials and confidential evidence in the clinic's controlled workspace.
This template is not a product test result. Status starts as NOT RUN.

CONFIGURATION
Candidate / edition:
Software version / build / modules:
Operator / hosting region:
Browser / device / server stack:
Roles / permissions:
Interface configuration / third parties:
Run date / time zone:
Clinical owner:
Health-IT owner:
Privacy / contracting owner:
Scope / required workflows:
Local recovery-time and data-loss limits:
Private evidence folder reference:

FM-01 - Encounter and cover
Required owner: Clinical operations
Fixture: Synthetic F-101 / E-101, report dated October 6, received October 13; primary clinician absent next day.
Action: Attach to the correct encounter, leave review pending, then remove the primary clinician from the active queue.
Expected result: Correct patient, original date, receipt date and pending status remain; covering clinician receives the work.
Required evidence: Reopened encounter, queue, named cover and audit event.
Status: NOT RUN [choose Pass / Fail / Not run / Not applicable]
Applicability reason:
Actual finding:
Configuration deviations:
Evidence references (private):
Remediation / owner / due date:
Recheck date / result / evidence:
Approver / scope / date:
Remaining conditions:

FM-02 - Least privilege
Required owner: Access lead
Fixture: Reception account with a documented role; separate administrator.
Action: Attempt a restricted edit/export, then a permitted scheduling action.
Expected result: Restricted action denied; permitted scheduling works.
Required evidence: Role configuration, denial and successful allowed-action logs.
Status: NOT RUN [choose Pass / Fail / Not run / Not applicable]
Applicability reason:
Actual finding:
Configuration deviations:
Evidence references (private):
Remediation / owner / due date:
Recheck date / result / evidence:
Approver / scope / date:
Remaining conditions:

FM-03 - Interface recovery
Required owner: Interface owner
Fixture: One synthetic report, a duplicate delivery and a corrected version with distinct payload identifiers.
Action: Send original twice, then corrected version.
Expected result: No duplicate clinical task; correction and source dates remain distinguishable.
Required evidence: Payload IDs, acknowledgments, displayed versions and task count.
Status: NOT RUN [choose Pass / Fail / Not run / Not applicable]
Applicability reason:
Actual finding:
Configuration deviations:
Evidence references (private):
Remediation / owner / due date:
Recheck date / result / evidence:
Approver / scope / date:
Remaining conditions:

FM-04 - Patient copy
Required owner: Records lead
Fixture: F-101 chart with corrected text and attachment; defined release scope.
Action: Generate the readable patient copy.
Expected result: Corrected text, attachment and encounter identity match the approved scope.
Required evidence: Source-to-copy comparison and release decision.
Status: NOT RUN [choose Pass / Fail / Not run / Not applicable]
Applicability reason:
Actual finding:
Configuration deviations:
Evidence references (private):
Remediation / owner / due date:
Recheck date / result / evidence:
Approver / scope / date:
Remaining conditions:

FM-05 - Migration export
Required owner: Technical and records leads
Fixture: Two synthetic charts, two encounters and three PDFs with original and receipt dates.
Action: Export with attachments and reconstruct associations in an isolated target.
Expected result: Two charts, two encounters, three PDFs; associations and dates retained; unsupported fields listed.
Required evidence: Manifest, counts, hashes, associations and exception list.
Status: NOT RUN [choose Pass / Fail / Not run / Not applicable]
Applicability reason:
Actual finding:
Configuration deviations:
Evidence references (private):
Remediation / owner / due date:
Recheck date / result / evidence:
Approver / scope / date:
Remaining conditions:

FM-06 - Restore
Required owner: Operations owner
Fixture: Known backup timestamp and synthetic transactions created afterward.
Action: Restore in isolation and reconcile the post-backup transactions.
Expected result: Recovery time and data gap measured against locally approved requirements; discrepancy list resolved or held.
Required evidence: Backup ID, timed restore log and reconciliation record.
Status: NOT RUN [choose Pass / Fail / Not run / Not applicable]
Applicability reason:
Actual finding:
Configuration deviations:
Evidence references (private):
Remediation / owner / due date:
Recheck date / result / evidence:
Approver / scope / date:
Remaining conditions:

FM-07 - Offboarding
Required owner: Access lead
Fixture: Test user with an active session and authorized API token where applicable.
Action: Disable the user, revoke sessions/tokens using the supported process and retry access.
Expected result: Access blocked through all tested routes; untested routes listed.
Required evidence: Revocation record, access attempts and logs.
Status: NOT RUN [choose Pass / Fail / Not run / Not applicable]
Applicability reason:
Actual finding:
Configuration deviations:
Evidence references (private):
Remediation / owner / due date:
Recheck date / result / evidence:
Approver / scope / date:
Remaining conditions:

FM-08 - Exit agreement
Required owner: Contracting and records leads
Fixture: Proposed dated agreement and synthetic export package.
Action: Rehearse request, approval, download and reconstruction before contractual cutoff.
Expected result: Named staff can obtain scoped records within the agreed access window.
Required evidence: Terms version, request route, response, package and access deadline.
Status: NOT RUN [choose Pass / Fail / Not run / Not applicable]
Applicability reason:
Actual finding:
Configuration deviations:
Evidence references (private):
Remediation / owner / due date:
Recheck date / result / evidence:
Approver / scope / date:
Remaining conditions:

COMPLETED FICTIONAL ROW - NOT AN OBSERVED PRODUCT RESULT
FM-05 / tabletop date October 13, 2026
Candidate: fictional installation using documented OpenEMR 8.4.0 export workflow.
Configuration: exporter enabled; administrator; document inclusion initially unchecked.
Fixture: two synthetic charts, two encounters, three attached PDFs.
Expected: all records and PDFs reconstruct with associations, original dates and receipt dates.
Finding: first package includes two charts and two encounters, zero PDFs.
Initial status: FAIL.
Evidence: EX-FM05-01 (fictional manifest reference).
Remediation: export administrator enables document inclusion and repeats export.
Recheck: fictional package contains all three PDFs; records lead verifies both dates and associations in isolated target.
Recheck evidence: EX-FM05-02 (fictional reference).
Approver: fictional records lead / FM-05 fixture only / October 13, 2026.
Decision: FM-05 fixture passes after repair. FM-06 restore remains NOT RUN.
Production decision: HOLD. A completed export job alone is insufficient.

FINAL DECISION (complete for your actual evaluation)
Decision: Hold / Re-test / Approve bounded pilot / Approve scoped deployment
Scope approved:
Critical failures and unresolved conditions:
Named remediation owners and deadlines:
Clinical approval / date:
Health-IT approval / date:
Privacy / contracting approval / date:
Cutover, downtime and rollback plan reference:
Recheck triggers: version, module, interface, role, host or contract change; significant failure.