Physician Practice

ONC’s health IT oversight plan draws criticism

Physician Practice Insider, May 17, 2016

The Office of the National Coordinator for Health IT’s (ONC) proposal to take direct oversight of health IT certification has come under fire from commenters. Some industry stakeholders say the agency may be overstepping its bounds and lacks the resources to support the plan.

The ONC raised the possibility of increasing its role in the certification, review, and testing of health IT products in a proposed rule released March 1. The proposed rule would also give the ONC greater oversight of health IT testing bodies, as well as the ability to decertify health IT products and prevent information blocking in health IT—deliberately preventing information being sent between health systems or products developed by different vendors.

The proposed rule received a mix of criticism and support from several high-profile stakeholders such as the College of Health Information Management Executives (CHIME), the American Medical Informatics Association (AMIA), the Healthcare Information and Management Systems Society (HIMSS), and the American Medical Association (AMA). The decertification process in particular raised questions; the proposed rule would give the ONC the ability to suspend a health IT product’s certification at any time. Transitioning from a decertified health IT product to a certified product would cost providers an average of $792,000.

CHIME acknowledges that the proposed rule represents an attempt to address clinician concerns about the usability of EHRs, as well as concerns from other users, including CHIME members, who have voiced concerns that some health IT products don’t function as intended. However, the list of health IT non-conformities listed in the proposed rule could jeopardize nearly every vendor’s certification, CHIME says in its statement.

Providers who use products that lose their certification would then be required to replace systems in part or whole; CHIME recommends that the ONC allow providers a safe harbor if a health IT product they use is decertified. CHIME also says the agency should be wary of using patient safety as a catchall phrase to encompass a wide variety of errors blamed on EHRs.

AMIA expresses general support for the proposed rule, but recommends the ONC scale back its definition of actionable nonconformities to only those involving medical errors or that jeopardize patient safety. The current list of nonconformities is so broad that AMIA believes it would detract from the ONC’s stated goal of patient safety and diffuse review efforts beyond a practical scope. AMIA advises the ONC to continue to refine its current certification program.

Although the AMA approves of a number of measures in the proposed rule it believes will help physicians and patients, it also raised concerns about the effects of decertification on physicians and patients.

The proposed rule’s approach to health IT oversight may lead to duplication of effort, according to HIMSS. Additionally, the ONC should revise its plans for the certification and decertification process to emphasize policies that encourage improvement rather than punitive actions, HIMSS says.

This article originally appeared the in Revenue Cycle Daily Advisor.

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