The federal government will not finalize a rule that would adopt criteria for an optional 2015 Edition of electronic health records meaningful use certification. Rather, a new final rule adopts a smaller subset of criteria from the original proposal, now called 2014 Edition Release 2.
The Office of the National Coordinator for Health IT issued the 2014 Edition Release 2 final rule today. The rule will be published Sept. 11 in the Federal Register. The Department of Health and Human Services and ONC use these optional editions of meaningful use to inform further decision making for the program.
Ten criteria in 2014 Edition Release 2 are optional and include two existing criteria have been revised. The view/download/transmit criteria is revised to provide more optionality in transport methods, and the safety-enhanced design criteria is revised to reflect adoption of three separate CPOE criteria covering medications, laboratory and radiology/imaging orders.
The 10 optional criteria include the separation of three CPOE types plus transitions of care, clinical information reconciliation and incorporation, ambulatory setting transmission to public health agencies of syndromic surveillance, automated numerator recording, an applicability statement for secure health transport, an applicability statement for secure health transport and XDR/XDM for Direct Messaging, and a SOAP transport and security specification and XDR/XDM for Direct Messaging.
We note that EHR technology developers do not have to update and recertify their products to the 2014 Edition Release 2 nor do eligible professionals, eligible hospitals and critical access hospitals have to upgrade to EHR technology certified to the 2014 Edition Release 2, the agencies note in the final rule. However, we encourage EHR technology developers and the EPs, EHs and CAHs that they support to consider whether the 2014 Edition Release 2 offers any opportunities that they might want to pursue.
So, for now, the 2015 Edition has been scaled down and renamed. However, the government intends in 2015 to publish a new edition of certification criteria that will be called the 2015 Edition under the new naming procedure. If the government subsequently issues a final rule in 2016 with certification criteria to support another HHS program or make changes to the 2015 Edition, the new rule in 2016 will be known as 2015 Edition Release 2.
Importantly, this provides stakeholders with a consistent and predictable naming approach for future editions and also supports ONCs broader interests to have the ONC HIT Certification Program be generally accessible to other programs either within or outside government, according to the rule. Stakeholders that seek to leverage the ONC HIT Certification Program would then be able to choose which edition of certification criteria (or subset of criteria within an edition) is most relevant and appropriate for their program needs.
The final rule also discontinues use of the certification term Complete EHR following the current 2014 Edition of certification to reflect expanded flexibility in becoming certified and to respond to a situation where some EHR vendors only plan to offer a certified Complete EHR to customers.
While we recognize EHR technology developers may choose to pursue various approaches for designing and marketing their products, we are in a position to modify our policy so that it does not encourage EHR developers to offer only a single certified solution, according to the rule. In general, we believe the decision to seek certification only for a Complete EHR serves to defeat the flexibility provided by the 2014 Edition CEHRT definition. Consequently, by discontinuing the availability of the Complete EHR certification, the EHR technology market could be driven by EHR technology developers competing on the capabilities included in their EHR technology rather than on the type of certification issued (Complete EHR or EHR Module).
The final rule is available here.
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