John Halamka: Limit EHR certification process to standards adoption, interoperability

The certification process for Meaningful Use is in need of a "radical" overhaul, Beth Israel Deaconess Medical Center CIO John Halamka says in his most recent blog post. Halamka (pictured right), who also serves on FierceHealthIT's Editorial Advisory Board, says that while attestation should be maintained as a demonstration of performance, certification should be limited to rigorous standards adoption and interoperability.

To explain, Halamka likens the current certification process to the government hypothetically mandating the use of USB thumb drives.

"Not only would [the government] specify a USB 3.0 standard, they would require it is black, rectangular and weighs 2 ounces," Halamka says. "Such prescriptive requirements would stifle innovation since today's USB drives might be in the shape of a key or even mimic a sushi roll."

Instead, Halamka says, traits like interoperability and addressing gaps in data sharing need to be the real focus.

"If certification focused entirely on interoperability, EHRs would be a bit more like USB drives," he says. "They might be big or small, black or red, key shaped or sushi shaped. However, they'll work with any device you plug them into."

Doing so, he adds, would ensure happiness from patients, vendors and Congress.

The issue of interoperability, or lack thereof, across healthcare organizations was the focus of a discussion panel hosted by West Health last month at the Innovate, Design, Engage, and Advance event in San Diego. According to FierceHealthIT Editor in Chief Gienna Shaw, who moderated the discussion, interoperability remains "tantalizingly out of reach" despite "enormous incentives" to ensure that it gets done.

In September, officials from the Office of the National Coordinator for Health IT, in a blog post, outlined five elements ONC believes are critical to achieving health IT interoperability. Among the five elements were standards to support implementation and certification, and privacy and security.

To learn more:
- read Halamka's post