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ONC Health IT Costs and Limitations Disclosures

This Virtuoso 2.0 is 2014 Edition compliant and has been certified by ICSA Labs in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services.

Certification Details

  • Vendor Name: LeonardoMD
  • Date Certified: Oct 31, 2013
  • Product Name: Virtuoso
  • Product Version: 2.0
  • Certification ID: 130093R00

For list of certification criteria and clinical quality measures for which Virtuoso is tested and certified, please visit the Virtuoso Certified Health IT Product Page.

Additional software to achieve certification compliance

The additional software Virtuoso relied upon to demonstrate compliance includes iPatientCare PHR, iPatientCare EIA (Enterprise Integration Adaptors), iPatientCare HISP, MedlinePlus Connect, and Meinberg NTP Time Server Monitor.


An eligible provider would expect to pay the following costs for using Virtuoso whether to meet meaningful use objectives and measures, or to achieve any other use within the scope of the health IT's certification:

  • Upfront License/Setup Costs: An upfront initial setup fee per provider
  • Monthly Subscription Costs: Monthly subscription costs that include cloud-based data hosting, customer service, drug reference and interaction database subscription, and subscription to attend weekly staff training classes
  • Data Migration Costs: Fees for migrating data into and our of the Virtuoso database and/or third-party vendor integration and implementation costs
  • Lab Interface Costs: Depending on the customer’s selected lab/imaging company and their current transactional volume, this certified product-version may require one-time costs to establish interfaces to electronically exchange results. (170.314(b)(5)(a) – Incorporate laboratory tests and values/results, 170.314(a)(12) – Image Results)
  • Provider Connectivity Costs: Connecting to providers on other HISPs which are part of the Direct Trust Bundle may require ongoing service fees per provider. This is in regards to criteria 170.314(b)(1) – Transitions of care – receive, display and incorporate transition of care/referral summaries and 170.314(b)(2) – Transitions of care – create and transmit transition of care/referral summaries.
  • Patient Communication Costs: Depending on the patient’s preferred mode of communication, transactional costs may apply per SMS/voice message sent. (170.314(a)(14) Patient List Creation)
  • EPCS Costs: Optional one-time and yearly subscription fees are required for EPCS and interfaces with any third-party vendor and/or service provider.
  • Patient Education: A third-party partner that provides patient-specific education (170.314(a)(15) Patient-specific education resources). Costs are a monthly cost per provider and the costs vary depending on the selected third-party partner.
  • Reporting Interface Costs: This certified product-version may require one-time costs and/or re-occurring costs to establish interfaces for reporting to immunization public health agencies or any specialized registry. (170.314(f)(3) – Transmission to Public Health Agencies – Syndromic Surveillance)
  • Connectivity Costs: Support and maintenance for integration of this certified product-version with other ONC certified systems may require additional one-time and/or re-occurring costs.
  • Payer Quality Costs: Generating and/or transmitting QRDA (170.314(c)(3) Clinical Quality measures – Electronic Submission) or other format file(s) required for participation in payer quality initiatives/programs may require one-time costs, ongoing service fees, and/or transaction-based fees.
  • Custom Consultation/Services Costs: Depending on the customer’s needs, there may be costs for any additional services outside the standard agreement (such as additional implementation services, business analysis services, additional training services, etc.).
  • Optional one-time initial and either annually or monthly recurring costs from third-party products and services providers introduced by LeonardoMD for providing any value-added products and services. These costs vary by vendor and are quoted additionally.

The Eligible Provider must sign a LeonardoMD Virtuoso Subscription Order Form and a Business Associate Agreement, and the term of the agreement is typically a monthly, quarterly, or annual subscription which may vary depending on the customer’s needs.

There may be additional agreements that an Eligible Provider must enter with a third-party vendor (such as a clearinghouse company, lab company, etc.) depending on the customer’s needs.


  • Direct Messaging: A few practices have had difficulty finding other practices in their area that use Direct Messaging. This can make it difficult for some to meet the electronic summary of care requirement.
  • Registry Interface: A few practices have had a difficult time getting certain registries to interface with Virtuoso due to resource limitations.

There are no other known limitations that a user may encounter in the course of implementing and using Virtuoso capabilities, whether to meet meaningful use objectives and measures or to achieve any other use within the scope of the health IT's certification.

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