NIST asks for help vetting Health IT Standards

The process for certifying Electronic Health Records (EHR) systems is still quite a work-in-progress. Reading tea leaves is an image that comes to mind.

The Office of the National Coordinator (ONC) for Health IT is advised by two Federal Advisory Committees: the Health IT Policy Committee and the Health IT Standards Committee.

The Policy Committee has determined that multiple agencies will likely be commissioned to grant HHS Certification – after all, individual physicians will need to demonstrate “meaningful use” of a “certified” EHR by 2011 in order to be eligible for up to $44,000 in incentive payments as part of ARRA/HITECH. To date, both CCHIT and Drummond have expressed interest in pursuit of becoming designated as HHS certifying organizations.

According to the direction set forth by the Policy Committee, certification criteria need to follow from Meaningful Use criteria. Based on this, the Standards Committee has been deliberating on how to implement these as a collection of Standards Criteria. Their set of principles were reviewed earlier, and represent an inclusive rather than exclusive orientation, which is welcomed.

The Standards Committee is advised by the National Institute of Standards and Technology (NIST), which sets standards for many different agencies. The NIST has thus been charged with determining the nuts-and-bolts of Health IT standards definition. As part of this effort, on December 18th, the NIST published a request for input from research organizations who could help vet the standards coming from the Standards Committee – its request states that “this project does not seek to select the standards… it seeks to analyze those standards… by objectively determining the maturity, robustness, testability and suitability of a particular standard for use.” In other words, it desires to select an implementation of standards that will actually work in the real world.

Given that this request for input from the NIST went out on December 18th, and given that its findings will be instrumental in creating “appropriate test material, data and standard-specific test tools” needed for carrying out HHS certification activity, it is likely that designation of certifying agencies (or at least, coming up with a standardized set of testing scripts that such certifying agencies would use) will not take place at least until January.

On the one hand, the process is proceeding appropriately and is inclusive of as many stakeholders as possible, and is doing so in a way that should work in real-life given the state of standards adoption (or lack thereof) across the landscape. However, as we have pointed out before, time is short before the 2011 timeframe contained in ARRA/HITECH.

We anxiously look forward to rapid progress on this front, so that EHR vendors like Practice Fusion will have a clear path by which to become HHS Certified, and can deliver its product to physicians in a way that facilitates demonstration of Meaningful Use, and access to HITECH stimulus incentive payments as soon as they become available.


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