Jacob Reider to med societies: Be part of the solution to HIT progress

It's time for the American Medical Association and more than 30 other organizations urging change in the electronic health record certification process to be part of the solution, former Deputy National Coordinator for Health IT Jacob Reider said in a blog post.

In a recent letter to National Coordinator Karen DeSalvo, the coalition asserted that Meaningful Use certification had become a priority for physician informaticists and vendors at the expense of "meeting physician customers' needs, patient safety and product innovation."

The letter recommended several changes to the certification program, including:

  • Decoupling EHR certification from the EHR incentive programs 
  • Re-consider alternative software testing methods
  • Incorporate exception handling and Consolidated-Clinical Document Architecture guidance and tests

Reider said the decoupling of EHR certification from the incentive programs is already happening. As far as alternative testing methods, Reider said that ONC has always supported scenario-based testing. The harder part, he said, will be to create a framework that builds and maintains scenario-based test procedures.

ONC has invited everyone to participate," Reider said. "So far, I don't see much [any?] engagement from the AMA or the others who signed the letter. It's relatively easy to write a letter saying someone else is responsible for solving problems. Time to step up to the plate and participate in the solutions, folks!"

Reider added that, regarding incorporation of Consolidated-Clinical Document Architecture guidance and tests, as defined by Congress, ONC's authority is to ensure products conform to standards, not to ensure full end-to-end interoperability tests. That means lobbying Congress to expand ONC's authority and budget, he said.

Former National Coordinator Farzad Mostashari also weighed in with a comment on the post, saying that too many stakeholders are breaking out the torches and pitchforks on ONC.

"It seems that they are happy to join the vendor bandwagon of 'remove onerous regulations' and also slam ONC for not regulating the industry more. …" Mostashari said. "The clinical societies are entirely within their rights to ask for more protections vis a vis vendors who wield a disproportionate advantage over them. But they should then stop bashing the regulator for regulating, and support them in getting sufficient funding and authority to do their job well [which I don't recall seeing]."

ONC has drafted a proposed rule to update the certification process, which is under review at the Office of Management and Budget. Congress, meanwhile, has 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.

To learn more:
- read the blog post