On Wednesday, the Health IT Policy Committee will hold a public hearing on ONC’s Health IT Certification Program to evaluate its performance to date and to get feedback from industry stakeholders on how it can be improved. Specifically, ONC is looking for ways to reduce the burden of the HIT certification while maintaining program integrity.

“Now that the Health IT Certification Program has been operating for almost two years, we want to assess what is working, what isn’t working, and how we can optimize program activities in the future,” says Lee Stevens, policy director for ONC’s state health information exchange program, in a blog.

Under the ONC-managed HIT Certification Program which became fully operational in October 2012, testing activities and certification are performed by separate entities. Testing is performed by Accredited Testing Laboratories and certification is conducted by ONC-Authorized Certification Bodies. Developers and vendors first test their product with an ATL, and if their product meets the requirements, they work with an ONC-ACB to certify the product.

Some stakeholders have suggested that the ATLs and ONC-ACBs should be combined. “The hope is by merging the two there will be clarity and uniformity with respect to requirements and interpretation of the requirements,” says Tom Giannulli, M.D., Chief Medical Information Officer at Kareo, a cloud-based medical office software and services vendor for small practices. “The risks of combining the two, if they exist, are around subjective experience with a vendor that could taint a viewpoint or testing outcome. However, we don't anticipate undue influence if they are joined.”

In March, Kareo EHR was certified by the Drummond Group, an ONC-ACB, and is now fully compliant with Meaningful Use 2014 Edition Stage 1 and 2. Overall, Giannulli says Kareo's experience with Drummond was excellent and could only be improved by simplification and more standardization of requirements and respective test scripts.

Once a product is certified, it is submitted to ONC, which posts approved products to the Certified Health IT Product List. As of April 21, the list of EHR products meeting some or all requirements under the 2014 Edition of meaningful use stood at 1,067--up from 830 in February.

Going forward, Stevens says ONC is seeking input on a new way of developing test procedures--called “open test procedure development”--in which interested stakeholders would be able to contribute their expertise through a collaborative process to assemble test methods (procedures, data, and tools) for the certification program. “Our expectation is that this approach will enable the certification program to incorporate insight into testing scenarios and certification approaches that better reflect clinical workflows and real-world use of health information technology,” he says.

“In many cases, the testing bodies have varied interpretations of requirements and this creates additional work that may be unnecessary for the vendor,” says Giannulli. “As a vendor, we only ask for a consistent protocol with test scripts that are transparent. That way expectations are clear and testing outcomes are more predictable," he adds.

Stakeholders can find details here on the May 7 HIT Policy Committee meeting regarding ONC’s Health IT Certification Program.

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