Docs to ONC: Change the EHR certification process

An American Medical Association-led coalition of 35 medical societies, stressing "elevated concern" about the certification of electronic health record systems, has sent a letter to National Coordinator for Health IT Karen DeSalvo urging ONC to reevaluate its "current trajectory" and recommending changes to the certification process.

The letter, dated Jan. 21, identifies a myriad of problems with the current EHR certification process, including: the lack of necessary security measures to protect patient information; the lack of oversight on the authorized testing and certification bodies; concern that test methods are no guarantee that the systems will perform as expected in production; and fear that the administration is "pushing too quickly" for use of certified EHRs beyond the Meaningful Use program.

EHR certification has been receiving increased attention in recent weeks. ONC has drafted a proposed rule to update the certification process, which currently is under review at the Office of Management and Budget. Congress, as part of the 2015 omnibus appropriations bill passed in December, asked ONC to use its authority to certify only products that meet the current Meaningful Use program standards and don't block health information exchange.

ONC has indicated that it is examining the issue carefully.

Stressing that certification should "prioritize testing EHR functionality over isolated MU criteria," the societies recommend that ONC make seven changes to the certification program:

  1. Decouple EHR certification from the Meaningful Use program
  2. Re-consider alternative software testing methods
  3. Establish greater transparency and uniformity on UCD testing and process results
  4. Incorporate exception handling into EHR certification
  5. Develop C-CDA guidance and tests to support exchange
  6. Seek further stakeholder feedback
  7. Increase education on EHR implementation

"Unfortunately, we believe the Meaningful Use certification requirements are contributing to EHR system problems, and we are worried about the downstream effects on patient safety," the coalition warns. "Physician informaticists and vendors have reported to us that MU certification has become the priority in health information technology design at the expense of meeting physician customers' needs, patient safety and product innovation."

The College of Healthcare Information Management Executives is part of the coalition.

To learn more:
- read the letter (.pdf)