HHS Relaxes Electronic Health Record Certification Criteria

Rosemary Frei, MSc

October 2014, Vol 5 , No 8 - Health Policy

The US Department of Health and Human Services (HHS) has responded to the chorus of voices calling for less complex rules governing electronic health records (EHRs) by not adopting the Voluntary 2015 Edition Electronic Health Record Certification Criteria. In its final rule, released in September 2014, the Office of the National Coordinator for Health Information Technology has instead included 10 optional and 2 revised certification criteria.

“The 2014 Edition Release 2 incorporates stakeholder feedback on particular 2014 Edition issues identified as impacting innovation and causing undue burden,” according to the HHS. “The 2014 Edition Release 2 also seeks to continue to improve EHR technol­ogy’s interoperability and electronic health information exchange.”

Value-Based Cancer Care asked Anna E. Schorer, MD, a Minnesota-based oncologist and a member of the American Society of Clinical Oncology’s Health Information Technology Work Group, to comment on these new regulations. She noted that the key certification criteria:

  • Focus on the encryption of health information if it is stored on end-user devices; that is, increase protection of patient data that are stored on devices, such as laptops, that can be lost or stolen
  • Require EHR technology to be able to support corrections and amendments to a patient record—this should help reduce errors from incomplete or misentered clinical notes
  • Improve the exchange of laboratory test results between hospitals and ambulatory providers
  • Focus on the receipt of laboratory test results, which references a common interface that is standard for ambulatory EHR technology
  • Enable secure messaging between providers and patients
  • Permit a patient to securely view and download, as well as electronically transmit his or her health information, including the ability to track the use of these patient capabilities.
The last 2 items are key to patient–clinician communications being asynchronous rather than relying on a telephone conversation or an office visit, said Dr Schorer.

“Note that physicians cannot bill for e-mail, but they also cannot bill for phone calls, filling out forms, etc, no matter how many hours a week they chew up,” she said. Therefore, increasing the feasibility of secure e-mail/Internet-based communications will make this end of the practice more efficient, Dr Schorer noted.

The HHS is also hoping that the revisions will allow providers to choose and customize the EHR technology according to their individual practices’ needs.

In addition, the criteria focus on increased interoperability, which means smoother EHR data exchange. For example, the HHS is attempting to have all EHR systems use the same format for dates to standardize the configuration of data for computers.

“Information exchange will be a great help to clinical personnel; pretty much everyone would agree on that,” Dr Schorer said. “The trick is,…in a world in which the vendors will prioritize resources to meeting the standard for information exchange, the other pieces are likely to be put in the waiting queue.”