Federal Workgroup Critical of EHR Decertification

Data blocking and decertification of electronic health records continue to be a hot topic of debate in federal policy circles. Some see decertification of EHR products that block data sharing as a lever for promoting interoperability of health information technology industry-wide. Others worry of unintended consequences.

Congress has urged the Office of the National Coordinator for Health IT to use its authority to certify only those EHR products that clearly meet current meaningful use program standards and that do not block health information exchange. In addition, lawmakers are pressing ONC to take steps to decertify EHR products that proactively block the sharing of information.

Also See: EHR Decertification in 21st Century Cures Act Raises Concerns

At Friday’s Health IT Policy Conference meeting, the Implementation, Usability, and Safety Workgroup of industry stakeholders offered recommendations on the proposed 2015 Edition EHR certification criteria published March 30, which included a request for comment on the concept of decertification.

When it comes to data blocking and EHR decertification, workgroup co-chair Larry Wolf told the HIT Policy Committee that “decertification is a very blunt instrument and needs to be used judiciously” and “needs better definition of how providers would manage if their software were decertified.” As a result, the workgroup believes that if decertification were implemented it would be a major burden to providers that “would almost certainly result in unintended consequences” and that “planning for consequences must be outlined before the workgroup could support this element.”

Overall, Wolf said the workgroup is “not opposed to decertification as a deterrent” to data blocking but rather is “opposed to implementing a process that would create more issues than it would solve.”

In April, ONC sent a report to Congress on electronic health information blocking and how both provider and vendor “bad actors” are interfering with data exchange. While the workgroup did not review the report to Congress, Wolf pointed out that ONC’s report does provide definitions of data blocking and some specific examples but “we had concerns about what exactly is the meaning of data blocking,” noting that there is no generally accepted definition.

Data blocking is “one of those tough areas,” he said. “One person’s data blocking is another person’s data protection and good stewardship,” observing that the process needs to be able to detect and differentiate when sharing is blocked due to legitimate factors such as regulation due to sensitive nature of data or limitations in technology. According to Wolf, ONC is beginning to gather information on examples of data blocking and must also “gather information on process and planning for consequences” for providers that might arise should EHR decertification be implemented.

The Health IT Policy Committee on May 22 voted to approve the Implementation, Usability, and Safety Workgroup’s recommendations regarding the proposed 2015 Edition rule, including its comments on decertification.