AAFP Guides ONC Toward Solutions to Problematic Health IT Certification Issues

May 05, 2014 09:49 am News Staff

The AAFP continues to work to ease family physicians' transition to -- and efficient use of -- electronic health records (EHRs), and that work includes constant vigilance regarding federal rules and regulations promulgated by the Office of the National Coordinator for Health Information Technology (ONC).

[Doctor entering information on computer tablet]

Case in point: In an April 24 letter(3 page PDF), AAFP Board Chair Jeff Cain, M.D., of Denver, corresponded with ONC head Karen DeSalvo, M.D., M.P.H., about a proposed rule on EHR certification criteria(www.gpo.gov) published in the March 19 Federal Register.

The rule, according to Cain, "initiates the ONC's more frequent approach to health information technology certification regulations," and he noted that the AAFP appreciates the ONC's efforts to establish a process for more frequent, visible and incremental changes to EHR certification criteria.

"Providing EHR developers with advanced notification of future mandatory certification criteria is useful for developers and physicians alike, as it provide all stakeholders with time to prepare and test software upgrades before the standards are mandatory and associated with punitive financial penalties for noncompliance," said Cain.

However, Cain voiced the AAFP's concern that the proposed rule "outlines 2015 edition EHR certification criteria as voluntary," meaning that EHR technology developers who certified to the 2014 edition would not need to recertify to the 2015 edition to enable their customers to participate in the Medicare and Medicaid EHR Incentive programs.

Story highlights
  • The AAFP recently responded to new electronic health record (EHR) certification rules proposed by the Office of the National Coordinator of Health Information Technology (ONC).
  • AAFP Board Chair Jeff Cain, M.D., voiced the AAFP's concern about the proposed "voluntary" nature of 2015 EHR certification criteria.
  • Cain also urged the ONC to follow through with its proposal to discontinue complete EHR system certification and instead certify each product according to its ability to meet individual meaningful use criteria.

Thus, the proposed rule, as written, could create confusion for family physicians regarding what level of certification actually would be required for their EHRs to qualify to attest to meaningful use, Cain said. It also would allow vendors to potentially market and sell an update as required even though it may not be required.

"The 2015 voluntary edition might be seen as a forecast of future requirements for the next mandatory certification, yet that is not guaranteed by ONC," Cain noted. He pointed to the already daunting complexity of the ONC's EHR meaningful use program and urged DeSalvo "not to add another layer of complexity to this program by creating a new and voluntary certification level."

The AAFP expressed support for the ONC's proposal to discontinue "complete EHR" certification. In its place, "the AAFP recommends that each product being certified contain a listing of all meaningful use certification criteria and an indication of 'passed,' 'failed,' or 'not tested' for each criterion," said Cain.

He also urged the ONC to improve the tool it created to help physicians determine exactly which products are certified.

"The usability of the website continues to be a challenge for our members," said Cain. "The AAFP is available to meet with ONC staff to provide further recommendations on much-needed improvements."

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