EHR Certification Recommendations

Checklist-VectorUnder the 2009 economic stimulus package, medical providers who demonstrate meaningful use of certified Electronic Health Record (EHR) systems can qualify for Medicaid and Medicare incentive payments.  The American Medical Association (AMA) is leading a coalition of 35 medical societies and this group recently sent a letter to the National Coordinator for Health IT recommending major changes to the certification program.

Among other things, the letter recommends that EHR certification is separated from the meaningful use program, that there is exception handling in EHR testing, that alternate software testing methods are assessed, and that a new architectural guide to support information exchange is developed.  The coalition feels that “certification has become the priority in [health IT] design at the expense of meeting physician customers’ needs, patient safety and product innovation.”  The letter stated, “We believe there is an urgent need to change the current certification program to better align end-to-end testing to focus on EHR usability, interoperability, and safety.”

This is not the first time the AMA has voiced concerns. In the fall of 2014 the AMA released a letter to the Office of the National Coordinator (ONC) Karen B. DeSalvo and Centers for Medicare & Medicaid Services (CMS) Administrator, Marilyn B. Tavenner. The 30 page letter states, “After three-and-a-half years of provider participation, we are at a critical crossroad where we believe it is important and necessary to pause and fully assess what is working and what needs improvement before moving ahead to Stage 3 of the program.”  At that time they provided a blueprint that they felt would improve the program.

The AMA recently published a list of “Top 10 issues for physicians to watch in 2015” and top ranking on the list were Electronic Health Records as they feel a “one size fits all” approach is not prudent, and ICD-10 regulations with high administrative load as it pulls time away from patient care.  In their recent letter, the AMA also voiced concerns about the security of electronic health records and would like to see enhanced security criterion in EHR certification.

A separate group of 10, which included the American Association of Orthopaedic Surgeons and the American Joint Replacement Registry recently sent a letter to Health and Human Services (HHS) Secretary Sylvia Mathews Burwell urging unique device identifier fields to be included in upcoming electronic health record certification criteria. They wrote, “We are asking that the Office of the National Coordinator for Health Information Technology and the Centers for Medicare & Medicaid Services include provisions to enable and encourage providers to document the specific medical devices implanted in patients as part of forthcoming rules on the electronic health record certification and meaningful use programs.”

As certification criteria grows and changes, there will surely be recommendations for many additions, subtractions and revisions. MedisoftLytec and Greenway Primesuite electronic health record and practice management software are all working hard to make sure the products are compliant and able to meet all the necessary changes.