A Health IT Policy Committee workgroup on May 8 recommended major changes to the electronic health records certification program, one day after getting stakeholder feedback during a contentious public hearing. 

Paul Tang, M.D., the HIT Policy Committee vice chair who led the Certification Hearing Workgroup, called the recommendations a "massive change" to the current certification program. One recommendation is to take a “holistic” and “end-to-end" approach to the process of certification, starting with meaningful use objectives through the definition of testing to auditing at the end of the process. The workgroup's second recommendation is to limit the "scope" of the HIT Certification Program to three areas: interoperability, clinical quality measures, and privacy and security.

"To summarize, we have two major conclusions. They're made up of many component parts but they're all based on what we heard yesterday," he told the workgroup at the end of its three-hour discussion on May 8. Tang argued that the goal is to create a "more streamlined, more coordinated, and more timely process, as well as have ongoing feedback so that it can be continuously improved--at least in the regulatory environment."

The workgroup's recommendations are an attempt to respond to stakeholders’ feelings of being "overwhelmed" by the certification process, he said. "Those are two very potent recommendations" from the workgroup, concluded Tang.

However, Jeff Smith, director of public policy for the College of Healthcare Information Management Executives, criticized the workgroup's recommendations during the public comment period. "For the vast majority of providers, the certification is a requirement of meaningful use and nothing more," said Smith. "It does not provide assurance of interoperability. It does not pretend better usability or quality. And, may I be so bold as to suggest, it says very little of security. It is a requirement of meaningful use.”

"I would suggest that ONC focus its certification only on Stage 3 meaningful use requirements, whatever those end up being," he added. "This means no 2015 Edition and a much more teased out 2017 Edition. This could include an incubation period or a gap year for broad vendor-provider beta testing. Beyond 2017, I would suggest that ONC dedicate more resources toward building a certification program focused on much more foundational elements of health IT such as data integrity for patient safety, quality measurement, and security components."  

The workgroup will present its recommendations at the next HIT Policy Committee meeting.

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