Committee Suggests 'Preliminary Certification' for EHRs

WASHINGTON — Electronic health records systems should be precertified to comply with Recovery Act requirements even before the government issues its final certification rules, a federal advisory panel recommends.

Since the final rules may not go into effect until next year, “the suggestion is to establish something called preliminary certification based on the assumption that vendors would be willing to take a reasonable risk that what has been proposed in the regulatory process is probably pretty close to what is going to come out the other side,” Paul Egerman, cochair of the certification/adoption workgroup of the Health and Human Services Department's Health Information Technology (HIT) Policy Committee, said at a meeting of the committee.

That way, vendors could start certifying based on the proposed criteria, “and when the regulatory process is completed, hopefully there's only a very small adjustment that we can tack on” before the software becomes HHS-certified, he added.

Whether and when HHS will adopt its committee's recommendation is uncertain at this point, according to Dr. David Blumenthal, the committee's chair and national HIT coordinator at HHS.

“We'll have to do this in a deliberate way that includes public comment and takes the necessary steps within the department and in the federal government generally,” he said during a conference call. “I think the rule-making process we have to go through will make it very difficult to react in that time frame.”

Under the Recovery Act, formally known as the American Recovery and Reinvestment Act, $19 billion has been set aside to encourage HIT adoption, including electronic health records. The money includes $44,000 in financial incentives for each physician who purchases a certified EHR system and makes “meaningful use” of it by 2011; physicians who adopt EHRs later will also get an incentive, but the amount will diminish gradually over several years and disappear completely after 2014. Providers who have not adopted EHRs by 2015 will see reductions in their Medicare reimbursement.

Currently, only the Certification Commission for Health Information Technology can certify EHRs; however, certification/adoption workgroup members emphasized the need for more than one certifying organization and recommended that any certifying groups be distinct from those that set the certification criteria.

To help physicians and hospitals get ready to implement EHRs, the Obama administration is making $598 million in Recovery Act funds available now to establish 70 HIT “extension centers” that will provide hospitals and clinicians with hands-on technical assistance in the selection, acquisition, implementation, and meaningful use of certified EHRs. The extension center grants will be awarded on a rolling basis, with the first being issued in fiscal year 2010, which begins on Oct. 1. Another $564 million is also being made available in fiscal 2010 to states and state-designated groups to implement health information exchange.

HHS also will provide assistance to health care providers through the HIT Research Center, which will disseminate relevant information on effective practices and help the extension centers collaborate with one another and share best practices on EHR use.

Committee member Dr. Neil Calman, a family physician and president of the Institute for Family Health in Bronx, N.Y., said the committee needed to do a better job of convincing health care consumers that exchanging health information is a good idea.

“People are worried about privacy and security because we haven't really sold them on what the benefits are of this [information] exchange to them,” he said. “Is [the information] relevant to this individual provider who I'm seeing right now? Do they need to see everything or do I only want to share a part of it? I think that's a big part of what we need to be pushing in order to move this forward.”

WASHINGTON — Electronic health records systems should be precertified to comply with Recovery Act requirements even before the government issues its final certification rules, a federal advisory panel recommends.

Since the final rules may not go into effect until next year, “the suggestion is to establish something called preliminary certification based on the assumption that vendors would be willing to take a reasonable risk that what has been proposed in the regulatory process is probably pretty close to what is going to come out the other side,” Paul Egerman, cochair of the certification/adoption workgroup of the Health and Human Services Department's Health Information Technology (HIT) Policy Committee, said at a meeting of the committee.

That way, vendors could start certifying based on the proposed criteria, “and when the regulatory process is completed, hopefully there's only a very small adjustment that we can tack on” before the software becomes HHS-certified, he added.

Whether and when HHS will adopt its committee's recommendation is uncertain at this point, according to Dr. David Blumenthal, the committee's chair and national HIT coordinator at HHS.

“We'll have to do this in a deliberate way that includes public comment and takes the necessary steps within the department and in the federal government generally,” he said during a conference call. “I think the rule-making process we have to go through will make it very difficult to react in that time frame.”

Under the Recovery Act, formally known as the American Recovery and Reinvestment Act, $19 billion has been set aside to encourage HIT adoption, including electronic health records. The money includes $44,000 in financial incentives for each physician who purchases a certified EHR system and makes “meaningful use” of it by 2011; physicians who adopt EHRs later will also get an incentive, but the amount will diminish gradually over several years and disappear completely after 2014. Providers who have not adopted EHRs by 2015 will see reductions in their Medicare reimbursement.

Currently, only the Certification Commission for Health Information Technology can certify EHRs; however, certification/adoption workgroup members emphasized the need for more than one certifying organization and recommended that any certifying groups be distinct from those that set the certification criteria.

To help physicians and hospitals get ready to implement EHRs, the Obama administration is making $598 million in Recovery Act funds available now to establish 70 HIT “extension centers” that will provide hospitals and clinicians with hands-on technical assistance in the selection, acquisition, implementation, and meaningful use of certified EHRs. The extension center grants will be awarded on a rolling basis, with the first being issued in fiscal year 2010, which begins on Oct. 1. Another $564 million is also being made available in fiscal 2010 to states and state-designated groups to implement health information exchange.

HHS also will provide assistance to health care providers through the HIT Research Center, which will disseminate relevant information on effective practices and help the extension centers collaborate with one another and share best practices on EHR use.

Committee member Dr. Neil Calman, a family physician and president of the Institute for Family Health in Bronx, N.Y., said the committee needed to do a better job of convincing health care consumers that exchanging health information is a good idea.

“People are worried about privacy and security because we haven't really sold them on what the benefits are of this [information] exchange to them,” he said. “Is [the information] relevant to this individual provider who I'm seeing right now? Do they need to see everything or do I only want to share a part of it? I think that's a big part of what we need to be pushing in order to move this forward.”

WASHINGTON — Electronic health records systems should be precertified to comply with Recovery Act requirements even before the government issues its final certification rules, a federal advisory panel recommends.

Since the final rules may not go into effect until next year, “the suggestion is to establish something called preliminary certification based on the assumption that vendors would be willing to take a reasonable risk that what has been proposed in the regulatory process is probably pretty close to what is going to come out the other side,” Paul Egerman, cochair of the certification/adoption workgroup of the Health and Human Services Department's Health Information Technology (HIT) Policy Committee, said at a meeting of the committee.

That way, vendors could start certifying based on the proposed criteria, “and when the regulatory process is completed, hopefully there's only a very small adjustment that we can tack on” before the software becomes HHS-certified, he added.

Whether and when HHS will adopt its committee's recommendation is uncertain at this point, according to Dr. David Blumenthal, the committee's chair and national HIT coordinator at HHS.

“We'll have to do this in a deliberate way that includes public comment and takes the necessary steps within the department and in the federal government generally,” he said during a conference call. “I think the rule-making process we have to go through will make it very difficult to react in that time frame.”

Under the Recovery Act, formally known as the American Recovery and Reinvestment Act, $19 billion has been set aside to encourage HIT adoption, including electronic health records. The money includes $44,000 in financial incentives for each physician who purchases a certified EHR system and makes “meaningful use” of it by 2011; physicians who adopt EHRs later will also get an incentive, but the amount will diminish gradually over several years and disappear completely after 2014. Providers who have not adopted EHRs by 2015 will see reductions in their Medicare reimbursement.

Currently, only the Certification Commission for Health Information Technology can certify EHRs; however, certification/adoption workgroup members emphasized the need for more than one certifying organization and recommended that any certifying groups be distinct from those that set the certification criteria.

To help physicians and hospitals get ready to implement EHRs, the Obama administration is making $598 million in Recovery Act funds available now to establish 70 HIT “extension centers” that will provide hospitals and clinicians with hands-on technical assistance in the selection, acquisition, implementation, and meaningful use of certified EHRs. The extension center grants will be awarded on a rolling basis, with the first being issued in fiscal year 2010, which begins on Oct. 1. Another $564 million is also being made available in fiscal 2010 to states and state-designated groups to implement health information exchange.

HHS also will provide assistance to health care providers through the HIT Research Center, which will disseminate relevant information on effective practices and help the extension centers collaborate with one another and share best practices on EHR use.

Committee member Dr. Neil Calman, a family physician and president of the Institute for Family Health in Bronx, N.Y., said the committee needed to do a better job of convincing health care consumers that exchanging health information is a good idea.

“People are worried about privacy and security because we haven't really sold them on what the benefits are of this [information] exchange to them,” he said. “Is [the information] relevant to this individual provider who I'm seeing right now? Do they need to see everything or do I only want to share a part of it? I think that's a big part of what we need to be pushing in order to move this forward.”