The headline for the ONC’s new proposed rule standards and certification criteria for EHRs 2014 edition, which was rolled out at HIMSS this year, has been all about flexibility. The ONC has envisioned the new certification criteria also giving clearer definitions of certification requirements, promoting progress toward interoperability, and reducing regulatory burden.

The illustration ONC is using to illustrate this tiered Certified EHR Technology (CERT) certification looks like a bull's–eye with concentric layers of certification, with the core as Base EHR certification, surrounded by layers certifying meaningful use core objectives and meaningful use menu set objectives.
 

Steven Posnack, MHS, director, Federal Policy Division, ONC, was explaining at a National eHealth Collaborative webinar last week that unlike the 2011-13 certification requirements, which required vendors to meet all meaningful use core and  menu items, that is not the case for the 2014 edition.

“If you’re an eligible provider and you can meet exclusion that is in the core objectives and measures for either Stage1 or Stage 2, you wouldn’t necessarily need to have an EHR technology that was certified for the associated 2014 certification criteria, nor would you EHR technology developer need to go through the additional burden to get certified for that either,” said. “So that is really where regulatory flexibility and burden reduction that we’ve introduced to this proposal really benefit both sides.”

But will the new certification rules really benefit both sides? How much will eligible providers and hospitals have to pay for vendors to meet meaningful use requirements and for these the outer levels of certification? I can only imagine since providers faced additional fees for meaningful use Stage 1 upgrades, that meaningful use Stage 2 packages might be even more expensive in this tiered certification model.

And on the flip side, what will all this mean for vendors? Will there be some vendors that decide that most of their customer base might not be eligible for meaningful use attestation, so they just not support the outer certification levels beyond the base EHR? Needless to say, I’m very curious what the comment period will bring.