A coalition of 35 medical societies led by the American Medical Association sent a letter on Wednesday to National Coordinator for Health IT Karen DeSalvo, M.D., arguing that the Meaningful Use electronic health record certification program is not working.

“Among physicians there are documented challenges and growing frustration with the way EHRs are performing,” states the nine-page letter to DeSalvo. “Many physicians find these systems cumbersome, do not meet their workflow needs, decrease efficiency, and have limited, if any, interoperability. Most importantly, certified EHR technology can present safety concerns for patients. 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.”

Specifically, the group charges that the MU certification requirements are contributing to EHR system problems with “downstream effects” on patient safety and that MU certification “has become the priority in health IT design at the expense of meeting physician customers’ needs, patient safety, and product innovation.” The coalition also expresses its concern with the “lack of oversight ONC places on authorized testing and certification bodies for ensuring testing procedures and standards are adequate to secure and protect electronic patient information contained in EHRs.” In addition to patient safety concerns, they say the certification process lacks necessary security measures to protect patient information.

The letter strongly recommends seven changes to improve EHR certification: decoupling EHR certification from the MU program; re-considering alternative software testing methods; establishing greater transparency and uniformity on user centered design (UCD) testing and process results; incorporating exception handling into EHR certification; developing consolidated clinical document architecture (C-CDA) guidance and testing to support exchange; seeking further stakeholder feedback; and increasing education on EHR implementation.


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