Health IT Stakeholders Have Different Takes on Changes to EHR Certification Program | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Health IT Stakeholders Have Different Takes on Changes to EHR Certification Program

September 25, 2017
by Heather Landi
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The Office of the National Coordinator for Health IT (ONC) announced on Thursday updates to the Health IT Certification Program with the aim of making it easier for health IT vendors to get their products certified.

As previously reported by Healthcare Informatics, the changes signal that ONC it will relax its oversight of how well electronic health records (EHRs) meet government standards. In making these changes, ONC, which is a part of the U.S. Department of Health and Human Services (HHS), aims to improve the program’s efficiency and reduce burden on health IT developers and users. The goal, the agency said, is to enable health IT developers to devote more of their resources and focus on the remaining interoperability-oriented criteria, aligning with the tenets of the 21st Century Cures Act, ONC officials said.

Providers are required to use a certified EHR in order to be compliant with meaningful use regulations.

The agency said it will allow health IT companies to “self-declare” that their products meet 30 of the 55 criteria needed in order to get their products certified. The second change will ease requirements for random surveillance of health IT by ONC-Authorized Certification Bodies (ACBs).

An ONC webpage outlining 2015 Certification testing and test methods features an updated chart indicating exactly which criteria no longer require a test tool.

“This means that health IT developers will self-declare their product’s conformance to these criteria without having to spend valuable time testing with an ONC-Authorized Testing Laboratories. This testing typically included either a visual demonstration of the product’s functionality or submission of documentation confirming the required functionality,” Elise Sweeney Anthony, director of ONC’s Office of Policy, and Steven Posnack, director of ONC’s Office of Standards and Technology, wrote in an ONC Health IT Buzz blog post.

The ONC officials note that self-declaration is not a new approach and is used among other industry testing programs. The test procedures for health IT products now designated as “self-declaration” are for functionality-based certification criteria.

Many health IT vendors voiced support for the program changes and hope that it signals a broader reform of the Health IT Certification program. Sasha TerMaat, chair of the EHR Association and director at Epic Systems, said in a statement, “We have encouraged ONC to look for ways to make the certification process less expensive and more efficient. We therefore appreciate the direction and intent of the proposed changes, and look forward to reviewing the details of this new approach.”

Stephanie Zaremba, athenahealth's director of government and regulatory affairs, says, “At a high level, we were happy to see ONC doing some things to reduce the burden that the certification process places on developers, but more so on the providers.” Zaremba says a highly-prescribed certification process results in health IT functionality “that is clunkier" for provider end-users. And, she added, “For every extra hour we put into testing of certification, that’s an hour that we’re not putting into something that our customer has specifically asked for. We’re happy to see them taking steps in the right direction on this. We’re also looking forward to seeing these changes as just one piece of a strategy in a broader reform of the certification program.”

Zaremba said ONC has an opportunity to support “good business and good technology processes that align even more closely with the constantly evolving government payment programs.” Also, she added, “More can be done in the certification program to really encourage innovation in service of providers and patients.”

Many health IT industry stakeholders said they still reviewing the changes, but many voiced concerns about ONC scaling back its oversight of EHR certification and the potential impact to patient safety. At the same time, some health IT stakeholders worried that the relaxing of oversight of certification requirements would pass the responsibility onto providers to uncover deficiencies.

Robert Tennant, director of health information technology policy at the Medical Group Management Association, notes that MGMA “strongly supports a robust oversight process from ONC” and that the ONC decision to relax its oversight comes on the heels of the eClinicalWorks settlement of a False Claims Act lawsuit. Back in May, the U.S. Department of Justice announced a settlement that holds eClinicalWorks, and the company’s founders and executives, liable for payment of $155 million to resolve a False Claims Act lawsuit. The complaint alleges eClinicalWorks falsely attested to its certifying body that it met certification requirements under the Meaningful Use program, and in turn caused its healthcare provider customers to make false claims for incentive payments under the Meaningful Use program.

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