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Timing for EHR certification, adoption remains a sticky issue

The time crunch on developing and adopting certified electronic health record systems concerns health IT professionals, who have tight meaningful use deadlines to meet.

As the deadline for commenting on the EHR certification proposed rule approaches, the time crunch on developing and adopting certified electronic health record systems continues to concern health IT professionals.

Stakeholders have until May 10 to submit their comments on the proposal -- the last of three federal rules that will guide vendors and providers adopting and rolling out health IT and implementing meaningful use criteria -- but already some are saying that the two-pronged EHR testing and certification process needs some tweaking.

Until all the standards, criteria and certification requirements are known, "it's still wait and see," said Ken Perez, senior vice president of marketing at MedeAnalytics Inc. in Emeryville, Calif., a vendor that develops clinical and business performance management applications and has put together a meaningful use resource center for providers.

One reason for the time crunch, which affects providers, developers and vendors alike, is that the three federal rules are all connected.

• Providers need to purchase certified EHR systems that will allow them to meet meaningful use criteria, but those criteria are not yet finalized.

• EHR developers must use the technical standards outlined by the federal government to achieve those meaningful use requirements, but that final rule also is still awaiting some refinement.

• Vendors must ensure their products are tested and certified to federal requirements; however, that process is still in the beginning stages of development.

Under the HITECH Act, compliance with Stage 1 of meaningful use kicks in when the calendar turns to 2011.

The EHR testing and certification process does not concern several larger hospitals and health systems that have been using EHRs already, according to Perez. For the vast majority of providers that are just starting implementation, on the other hand, there might be frustrations in trying to find a vendor and product to buy. "They'll have to deal with some of the growing pains," he said.

The EHR certification proposed rule, released by the Office of the National Coordinator (ONC) for Health Information Technology in March, establishes a temporary and a permanent process for testing and certifying EHR systems to meet meaningful use criteria. Organizations can apply to test and certify vendor products under the temporary process once the rule is made final, which is expected to happen sometime in late spring.

ONC hopes the temporary EHR process can be used to help vendors and provider comply more quickly with federal regulations while it develops the permanent process, something it believes will take as long as nine months.

The Certification Commission for Health Information Technology (CCHIT) has been certifying technology for the last six years, and has said it will apply for the temporary EHR process as soon as ONC starts accepting submissions.

I believe ONC is underestimating the complexity of [EHR] certification and the infrastructure required for a successful program, even a temporary one.

Margalit Gur-Arie, partner, Gross Technologies Inc.

IT professionals commenting on the proposed rule are applauding the two-pronged EHR testing and certification process, but they also are saying that the temporary process should begin as soon as possible. In its comments letter to ONC, GE Healthcare suggested that the office expedite applications by organizations looking to become certifying bodies under the temporary process.

"Time is very short for vendors to make any adjustments to EHR technology to meet certification criteria and processes, and then to have certified EHR technology available timely for providers to demonstrate meaningful use during 2011," the health care unit of General Electric Co. wrote in its comments.

Others suggest that ONC award CCHIT temporary certification status so that the EHR testing and certification process is accomplished efficiently during Stage 1 of the meaningful use rollout. CCHIT has the institutional experience to help vendors and providers, said Margalit Gur-Arie, a partner at St. Louis-based EHR consulting firm Gross Technologies Inc., in a comment to ONC.

"I believe ONC is underestimating the complexity of certification and the infrastructure required for a successful program, even a temporary one," Gur-Arie wrote. "Please remember that if all goes well, there will be a tremendous wave of adoption in the coming year, and it will all be done under temporary certification bodies. In order to sustain future expansion of [health IT], it is imperative that physicians have a good experience in 2010-2011."

Let us know what you think about the story; email Jean DerGurahian, News Writer.

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