The debate over EHR certification

As the national Health IT Policy committee continues to develop a policy around “meaningful use,” the debate on what criteria should be used to deem an EHR as “certified” has been heating up. The Certification/Adoption workgroup held hearings on July 14 and 15, and testimony there illustrated significant debate on the role that CCHIT (the legacy certification body for EHRs) should play in the new era.

CCHIT developed certification criteria in a national policy vacuum, and (not surprisingly) created criteria that were largely feature-focused. Large legacy EHR vendors, via their trade organization (HIMSS), created and spun off CCHIT, and developed a criteria-set in 3 domains: functionality (what specific features were included in the software), interoperability (which was about fairly low-level data exchange capabilities between systems) and security (a superset of HIPAA). It did not address anything about usability, or outcomes.

In the current era, where ARRA moneys are earmarked for health IT adoption (HITECH), the Office of the National Coordinator for Health IT (ONCHIT, or ONC for short) has developed policy focused on results – on “meaningful use” of technology. In its July 16 meeting, the HIT Policy Committee has defined its views around certification a little more. They propose a new term: “HHS Certification,” which is to mean a system that is able to achieve government requirements for security, privacy and interoperability, and would enable the Meaningful Use results that the government expects. Certification should flow from the Meaningful Use criteria, and be carried out in a way that is much more flexible than has occurred in the past.

At Practice Fusion, we applaud the direction being charted by ONCHIT. The emerging certification criteria, focused around achieving Meaningful Use, gives us an opportunity to build systems that have true value. This year presents a unique window of opportunity to “get it right” and create tools that can actually facilitate a transformed healthcare delivery system.

Robert Rowley, MD
Chief Medical Officer
Practice Fusion, Inc.