Panel Supports 'Preliminary Certification' for EHRs

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

The final rules may not go into effect until next year, so “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.

Vendors then 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” for HHS certification, he added.

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

Despite Dr. Blumenthal's cautious response, the Certification Commission for Health Information Technology (CCHIT)—currently the only federally approved certification body for EHR systems—is moving ahead. During a Sept. 3 conference call, CCHIT officials announced plans to publish precertification criteria in late September. The organization plans to begin accepting precertification applications on Oct. 7. CCHIT will revise its criteria after certification requirements are final—slated for next spring—and perform any additional testing needed to ensure that precertified systems conform to the final regulations.

The Recovery Act provides $19 billion to encourage HIT adoption, including electronic health records. The money includes up to $44,000 in 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 over several years and disappear after 2014. Providers who have not adopted EHRs by 2015 will see reductions in Medicare reimbursement.

The Obama administration is making $598 million in Recovery Act funds available to establish 70 HIT “extension centers” that will assist hospitals and clinicians in acquiring and implementing certified EHRs. The first grants will be issued in fiscal year 2010, which begins on Oct. 1.

In other business, the committee refined its proposed definition of certification: “HHS certification means that a system is able to support the achievement of privacy and interoperability, and that the system is able to support the achievement of the meaningful use results that the government expects.”

The workgroup on the definition of meaningful use outlined its plans, including a meeting in October to hear from specialist physicians about how to make criteria for meaningful use relevant to them. The workgroup also wants to address the needs of smaller practices and hospitals, and of safety net providers.

The committee also discussed barriers to widespread EHR adoption. Committee member Judith Faulkner of Epic Systems Corp., Verona, Wis., said cost was not the biggest issue for many providers she had spoken with.

“It doesn't matter what the incentive money is,” she said. “The real barrier is legal concerns. Our customers are not jumping on [EHRs] because lawyers and their other advisers are much more [concerned] about legal issues, and I don't think the money matters as much.”

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

The final rules may not go into effect until next year, so “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.

Vendors then 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” for HHS certification, he added.

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

Despite Dr. Blumenthal's cautious response, the Certification Commission for Health Information Technology (CCHIT)—currently the only federally approved certification body for EHR systems—is moving ahead. During a Sept. 3 conference call, CCHIT officials announced plans to publish precertification criteria in late September. The organization plans to begin accepting precertification applications on Oct. 7. CCHIT will revise its criteria after certification requirements are final—slated for next spring—and perform any additional testing needed to ensure that precertified systems conform to the final regulations.

The Recovery Act provides $19 billion to encourage HIT adoption, including electronic health records. The money includes up to $44,000 in 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 over several years and disappear after 2014. Providers who have not adopted EHRs by 2015 will see reductions in Medicare reimbursement.

The Obama administration is making $598 million in Recovery Act funds available to establish 70 HIT “extension centers” that will assist hospitals and clinicians in acquiring and implementing certified EHRs. The first grants will be issued in fiscal year 2010, which begins on Oct. 1.

In other business, the committee refined its proposed definition of certification: “HHS certification means that a system is able to support the achievement of privacy and interoperability, and that the system is able to support the achievement of the meaningful use results that the government expects.”

The workgroup on the definition of meaningful use outlined its plans, including a meeting in October to hear from specialist physicians about how to make criteria for meaningful use relevant to them. The workgroup also wants to address the needs of smaller practices and hospitals, and of safety net providers.

The committee also discussed barriers to widespread EHR adoption. Committee member Judith Faulkner of Epic Systems Corp., Verona, Wis., said cost was not the biggest issue for many providers she had spoken with.

“It doesn't matter what the incentive money is,” she said. “The real barrier is legal concerns. Our customers are not jumping on [EHRs] because lawyers and their other advisers are much more [concerned] about legal issues, and I don't think the money matters as much.”

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

The final rules may not go into effect until next year, so “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.

Vendors then 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” for HHS certification, he added.

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

Despite Dr. Blumenthal's cautious response, the Certification Commission for Health Information Technology (CCHIT)—currently the only federally approved certification body for EHR systems—is moving ahead. During a Sept. 3 conference call, CCHIT officials announced plans to publish precertification criteria in late September. The organization plans to begin accepting precertification applications on Oct. 7. CCHIT will revise its criteria after certification requirements are final—slated for next spring—and perform any additional testing needed to ensure that precertified systems conform to the final regulations.

The Recovery Act provides $19 billion to encourage HIT adoption, including electronic health records. The money includes up to $44,000 in 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 over several years and disappear after 2014. Providers who have not adopted EHRs by 2015 will see reductions in Medicare reimbursement.

The Obama administration is making $598 million in Recovery Act funds available to establish 70 HIT “extension centers” that will assist hospitals and clinicians in acquiring and implementing certified EHRs. The first grants will be issued in fiscal year 2010, which begins on Oct. 1.

In other business, the committee refined its proposed definition of certification: “HHS certification means that a system is able to support the achievement of privacy and interoperability, and that the system is able to support the achievement of the meaningful use results that the government expects.”

The workgroup on the definition of meaningful use outlined its plans, including a meeting in October to hear from specialist physicians about how to make criteria for meaningful use relevant to them. The workgroup also wants to address the needs of smaller practices and hospitals, and of safety net providers.

The committee also discussed barriers to widespread EHR adoption. Committee member Judith Faulkner of Epic Systems Corp., Verona, Wis., said cost was not the biggest issue for many providers she had spoken with.

“It doesn't matter what the incentive money is,” she said. “The real barrier is legal concerns. Our customers are not jumping on [EHRs] because lawyers and their other advisers are much more [concerned] about legal issues, and I don't think the money matters as much.”