ONC's new EHR certification criteria: What's behind the better mouse trap?

What if someone built a better mouse trap and no one used it? What if people opted to continue using the existing available mouse traps because they were just as effective and cheaper than the upgraded mouse trap, and there was no obligation to use the newer one?

That's my initial concern with the Office of the National Coordinator's newly proposed 2015 Edition of EHR certification criteria.

It's a laudable idea. According to the rule, the 2015 Edition introduces the beginning of ONC's new approach to health IT certification regulations. The agency now will update the certification criteria every 12 to 18 months, rather than waiting years; provide more incremental regulatory changes and policy proposals; provide greater and earlier visibility before compliance with certification criteria is required; give more time for public input; and enable certification processes to more quickly adopt newer industry standards. The new approach is intended to spur innovation and fix bugs faster.   

Plus, it's voluntary. An electronic health record developer whose software meets the certification criteria for the 2014 Edition does not need to adopt the 2015 Edition and recertify; providers don't have to switch to 2015 Edition technology.

"EHR technology developers and EPs, EHs, and CAHs would have the opportunity to move ahead to the 2015 Edition at their own pace and on their own terms," ONC says in the proposed rule.

Fair enough.

But will it be worth it for vendors and providers to move to the 2015 Edition? It's nice in theory, but that's an extra burden on them, especially since almost two-thirds (60 percent) of the certification criteria in the 2014 Edition remain the same in the 2015 Edition. The rest clarifies revisions, provides standards updates, engages in restructuring make the certification criteria clearer, and offers new certification criteria proposals, according to the rule.

Then there's the cost of this voluntary effort. ONC states that the expenses are "not economically significant" with overall costs "less than $100 million in any one year."

That's not exactly chump change.

ONC even admits that it does not expect a lot of takers. So can we take this rule at face value? What's really going on here behind the scenes?

Is ONC trying to appease critics, who already say that the Meaningful Use program is full of technological and other flaws? Is it a subtle way to separate the wheat from the chaff in the developer community, testing who's in it for the long haul,  giving those (more established, experienced  and financially healthy) vendors to better position themselves for Stage 3 of Meaningful Use and beyond and forcing the others to drop out by default?

Is it a quiet way to give everyone more breathing room, so that the Meaningful Use program can be phased in more gently and slowly?

What is apparent is that ONC wants feedback on its 242-page proposed rule, which it was not required to promulgate and which also solicits comments on Stage 3.

So if you have comments, submit them. Providing comments when the government asks for input is one of the best ways for stakeholders to be heard. The comment period on this proposed rule ends April 28.

If ONC is going to build a better mouse trap, it doesn't hurt to help design it. - Marla (@MarlaHirsch @FierceHealthIT)

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