EHR Certification Shortcomings Get Spotlight during June HITPC Meeting
Key Takeaway: The Health IT Policy Committee conducted its June meeting this past week; members received the latest Meaningful Use numbers and discussed proposals to amend ONC’s (Office of the National Coordinator) Certification Program.
Why it Matters: Discussions about how to amend a lynchpin of federal health IT policymaking – ONC’s Certification Program – continue in earnest. With a backdrop of low numbers of MU attestations, patient safety concerns and ongoing interoperability challenges, this may prove to be a timely opportunity to reassess how health IT products are certified.
In what turned out to be a slightly contentious meeting of the Health IT Policy Committee, officials learned that fewer than 10 hospitals had met enough objectives to qualify for Meaningful Use Stage 2 through June 1, and a key member of the committee called on ONC to suspend its Certification Program. New data released by CMS indicated that only eight hospitals, out of a scheduled 2000 hospitals, had managed to meet the requirements of Stage 2 Meaningful Use in 2014. Such numbers are not surprising and lend credence to the rationale for a recent NPRM to provide new pathways to meet MU this year. (Click here for access to an archived CHIME briefing on the proposed changes to MU, and click here for presentation slides.) The next mile marker for Stage 2 performance will come next month, as the third quarter of federal fiscal year 2014 comes to a close and the last reporting period for eligible hospitals and critical access hospitals begins.
The committee also heard a report detailing a recent ONC hearing on certification. The hearing included members of numerous stakeholder organizations, including CHIME members Cletis Earle (CIO, St. Luke’s Cornwall) and Colin Banas (CMIO, Virginia Commonwealth University Health System), and testimony produced several shared concerns, including:
- Insufficient time for product development and testing
- Immature testing tools and protocols
- Inconsistent application of certification criteria among testing labs, certification bodies and auditors
These complaints led to two recommendations: the formation of a “kaizen” to study end-to-end certification processes and establish a certification “roadmap and timelines;” and a commitment to limit the scope of future certification efforts to “interoperability, clinical quality measures and privacy and security.” Paul Egerman, a long-time committee member and software entrepreneur, called for the suspension of the certification program. ONC chief Karen DeSalvo was quick to dismiss the idea, but acknowledged that the program needs to be modified. While it is unlikely that ONC will halt its certification program, the convergence of several factors could give the ONC the perfect window to reconsider the parameters of its certification program. Meaningful Use Stage 3 policies are being drafted now; ONC has broad aspirations to lead health IT patient safety efforts, and a handful of wide-ranging reports have identified interoperability as a major challenge. Certification touches all these issues and could hold great promise for their eventual resolution.
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