Thoughts on the new certification regime

There’s a lot of detail and a few unruly new acronyms (ONC-ATCB for ONC-Authorized Testing and Certification Body) to sort through in the 184-page Certification Notice of Proposed Rulemaking released March 2 by the Office of the National Coordinator.

As the ONC admits, it is forced by the Medicare incentive timetable into a slightly awkward two-step process in which it would establish a temporary certification program so that testing can begin this year. That program will be followed by a permanent program that would separate the responsibilities for performing testing and certification, introduce accreditation requirements, and would include the potential for certifying other types of health information technology besides EHRs.

On the one hand, the proposal seems to be pretty much what people expected based on recommendations of the Health IT Policy Committee, and many industry observers have applauded the shift in focus from certifying software feature lists to how the technology is actually deployed.

Edmund Billings, MD, chief medical officer and executive vice president of product at open source EHR vendor Medsphere Systems Corp., wrote about this change in emphasis last November in a piece in For the Record magazine. “In a shift away from the CCHIT’s previous focus on comprehensive feature function criteria, the revamped EHR certification standards will be relatively simple,” he wrote. “This time, there will be no focus on vendor-locking features. Instead, the committee will place an emphasis on desired uses and results—more practical for clinical purposes—and work on security, privacy, and interoperability issues.”

CCHIT will continue as a certifying body, but it is expected to be only one of several such entities, with NIST overseeing standards development. One question is how many organizations will apply to be certification bodies. How many are needed?  ONC states that it anticipates only three applicants under the temporary certification program.” As far as I know, only one organization other than CCHIT has announced it would apply to be a certifying body: the Texas-based Drummond Group Inc., an interoperability testing lab. ONC estimates it will have six applicants under the permanent program.

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