With the final rule on meaningful use of electronic health-record systems out, there's one fewer item on the federal government's checklist for implementing the EHR subsidy program under the American Recovery and Reinvestment Act of 2009.
Certification issues remain, providers say
One looming potential problem for health information technology executives, though, is the government's long delay in establishing a procedure to recognize organizations to test and certify EHRs and their modular components.
The Office of the National Coordinator for Health Information Technology didn't publish final rules on a first-round process to name "temporary" testing and certification programs until June 18 and didn't start taking applications from organizations seeking to qualify as testing and certification organizations until July 1.
Certification is a "necessary evil," given the multibillion-dollar public commitment to EHR subsidies, said Ray Scott, CEO of Axolotl Corp., a provider of EHR systems and health information exchange software and services. But at this stage of the program, he added, not having a single government-approved testing and certification authority in place and at the same time having hundreds of IT vendors needing to get their systems tested and certified under the new guidelines "might be a road block" to making certification happen.
Chad Greeno, managing director of the healthcare reform business unit at Cerner Corp., a developer of EHRs for hospitals and physician offices, concurred. "There is probably a bit of disappointment," he said. "It has taken a lot longer than anyone, particularly someone as naive as me, thought it would take.”
Farzad Mostashari, deputy national coordinator for programs and policy within the ONC, said he has faith in the market the government has helped create to enable multiple providers of EHR testing and accreditation services as opposed to the de facto monopoly HHS created in the previous decade by anointing the not-for-profit Certification Commission for Health Information Technology.
"I believe in the market," Mostashari said. "One thing we did was to create a competitive marketplace for certification. It's an open field." Providers, he said, can compete on service, speed and costs.
"We have gotten a lot of interest, a lot of requests for applications; we're committed that within 30 days of receiving an application we will render a decision and those organizations will be open for business," he added. “I don't think we have a complete application yet. By the end of the summer, I expect we'll have more than one.”
Scott suggested that providers talk to their vendors to ensure that they will receive latest-edition software needed to meet the new meaningful-use criteria. "If they can't meet all of the meaningful-use requirements, get them to suggest how you can," he said.
With modular certification of EHR components, it might be possible for providers to back-fill functions needed for meaningful use missing from their systems with software from other vendors.
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