The American Medical Informatics Association (AMIA) wants federal officials to take a much more aggressive role in measuring EHR performance data.
Responding to the Office of the National Coordinator for Health IT’s request for information (RFI) regarding the creation of an EHR Reporting Program, AMIA criticized the agency’s “constrained scope” that closely resembles a “government-sponsored ‘Consumer Reports’” approach.
ONC issued its RFI in August asking for public input about the 21st Century Cures-mandated platform. Some, like AMIA Vice President of Public Policy Jeff Smith, quickly questioned whether the program, as outlined by ONC, met its legislative purpose.
In his comments (PDF), AMIA President and CEO Douglas B. Fridsma, M.D., Ph.D., highlighted an opportunity to lean on real-time data to supplement the program that serves as more than just a resource for “acquisition decision maker.” The Certified EHR Technology (CEHRT) program used to ensure vendors meet minimum standards could be leveraged to feed valuable data into the reporting program, he added.
“Although the current program focuses on complaint-driven, nonconformities of CEHRT, it would be greatly enhanced by focusing on real-world production data related to interoperability, usability, and security to better understand CEHRT performance in a live environment,” Fridsma wrote.
HIMSS also pushed (PDF) for a more robust reporting program that includes a “snapshot of the number of open and closed non-conformities per vendor” through the Certified Health IT Product List, along with a way to rank the severity of those issues.
Most groups were also concerned about creating a program that added any additional work for either providers or vendors. The American Hospital Association (AHA) urged (PDF) ONC to work with vendors to automate data submitted to ONC, noting that any requirement that forced providers to submit data on their EHR interactions would “distract from their focus on patient care and would increase existing regulatory burdens.”
Similarly, Epic argued (PDF) that the program as written would be “prohibitively expensive and of minimal use to the industry.” Cerner (PDF) and Allscripts (PDF) joined their EHR counterpart in downplaying the value of user-submitted reviews, categorizing the approaches as highly subjective.
“Rather, we recommend ONC avoid duplicating current industry initiatives, focus narrowly on any gaps that can be effectively served by this program, and only introduce reporting metrics that have been carefully vetted to ensure their value exceeds the burden of additional data capture,” Epic Director Sasha TerMaat wrote, adding that very few providers use the Certified Health IT Product List.
On the other side of the spectrum, Kaiser Permanente suggested (PDF) that ONC allow users to voluntarily submit reviews about usability, safety and interoperability.
“There should also be an effort to ensure that EHR vendor contracts do not include restrictive provisions that prohibit end users from reporting these data,” Jamie Ferguson, Kaiser's vice president of health IT strategy and policy, wrote.