The Office of the National Coordinator (ONC) is feeling the heat from Physicians who, in a coalition of 35 organizations, have outlined a seven-point plan to change the EHR certification process to relieve Physician frustrations and to “better align end-to-end testing” by focusing on usability, interoperability and safety. Concern that EHR companies in particular and the health IT industry in general are prioritizing Meaningful Use certification over Physician needs, patient safety and innovation is at the heart of the coalition’s recommendations.
In a letter to Karen DeSalvo and signed by Physician organizations such as the American Medical Association, the American Academy of Family Physicians and the Society for Post-Acute and Long-Term Care Medicine, the coalition highlighted EHR challenges in terms of patient safety, security, long-term success, test methods, exception handling and scenario-based testing, and interoperability and EHR certification. Citing concerns over the lack of adequate security measures to protect patient information, the excessive burden of tying compliance to data collection and exchange methods, inadequacies in testing methods and the absence of clear and consistent implementation guidance, the coalition recommended the following:
1. Decouple EHR certification from the meaningful use program;
2. Reconsider alternative software testing methods;
3. Establish greater transparency and uniformity on user-centered design testing and process results;
4. Incorporate exception handling into EHR certification;
5. Develop CCDA guidance and tests to support exchange;
6. Seek further stakeholder feedback; and
7. Increase education on EHR implementation.
The recommendations come on the heels of the ONC's “Federal Health IT Strategic Plan 2015-2020,” in which the ONC outlined five goals: 1) Expand adoption of health IT; 2) Advance secure and interoperable health information; 3) Strengthen health care delivery; 4) Advance the health and well-being of individuals and communities; and 5) Advance research, scientific knowledge and innovation.
While the strategic plan’s goals are “top of mind” for some Physicians, the goals place significant administrative burdens upon Physicians who are also focused on healthcare’s broader aims of improving the health of entire populations, enhancing and the patient experience and reducing healthcare costs. In addition to the ONCs health IT goals, Physicians like AAFP Board Chair Reid Blackwelder are calling upon the ONC to give immediate attention to population health management, care coordination and patient engagement.