AMA, others support expanded ONC role in oversight
Representatives of physician groups are offering support for a final rule that gives the Office of the National Coordinator for Health Information Technology increased responsibility in ensuring the accountability and transparency of certified healthcare IT.
ONC is taking on a larger role in reviewing products that are to be certified for use in federal programs, such as the emerging Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program.
The nation’s largest physician organization, the American Medical Association, offered support for broadening the role of ONC in monitoring and testing certified electronic health records.
"These rules will promote health IT developers' accountability for the performance, reliability and safety of certified health IT," says Steven J. Stack, MD, immediate past president of the AMA.
A stronger role in monitoring applications is important in ensuring that applications provide value to the nation’s physicians, Stack contends.
"Physicians are captive to the IT products, and these steps will give regulatory certainty to them.” Increasing the accountability and transparency of health IT certification will give assurances to physicians as they modernize their practices. While we do not expect a large number of non-conformity instances or adjustments to vendors' health IT certification, we agree more emphasis must be placed on supporting the physician as an end-user and furthering their consumer power."
MACRA will dominate changes to physician reimbursement under Medicare; certified electronic health records will be required for participation in new payment programs in coming years.
The rule expands ONC's ability to identify issues with EHRs in the field. ONC will determine if EHRs comply with certification standards, and if not, the agency will require vendors to follow comprehensive corrective action plans. The public availability of these results will provide physicians with valuable information about the continued conformity of certified health IT.
AMA says it will continue to work with the Centers for Medicare and Medicaid Services and ONC to refine policies on the use and implementation of certified health IT.
In addition, DirectTrust CEO/President David C. Kibbe, MD, says he favors ONC’s broader role in testing certified EHR technology. Kibbe is a former leader of the American Academy of Family Physicians. DirectTrust is a secure messaging vendor supported via a collaboration of industry stakeholders.
“In general, and not speaking for all of our very diverse members, I am in favor of the new final rule, in part because it has maintained the oversight function I feel is of value, and also scaled back from the proposal in March,” Kibbe adds.
“There truly needs to be continuing oversight by ONC’s certification program to protect against the very few but potentially very damaging instances in which vendor conduct turns out to be improper after initial certification, or when vendors fail to perform their responsibilities as agreed to as part of the certification process. We don’t get our cars and trucks inspected just once; we’re required to get inspections annually. The same notion of keeping the technology healthy, capable and safe for patients and users ought to apply to these increasingly very complicated software systems.”
Oversight is important in ensuring that HIT remains current to meet emerging needs and standards, he contends. “In no area of health IT is it more important for vendors and their EHRs to stay in step than in conformity with the infrastructure that allows for electronic exchanges of health information. This is because it is through the interoperable exchange of health information—across different organizations using different EHR vendors’ products—that we can eventually make the most progress in closing the gap between our healthcare system’s potential for quality improvements and the recognizably disappointing results to date.”