Physicians can’t meet meaningful use requirements without certified electronic health records (EHR), but the current EHR certification program ties EHR design and testing too closely to the meaningful use program. Medical associations recommended three broad changes to improve the EHR certification process and make it easier for physicians to use EHRs and care for patients.
In a letter (log in) to the Office of the National Coordinator for Health IT, 36 physician groups said there are many issues with EHRs, but addressing EHR certification is an improvement that can be made in the short-term to guide further efforts in the long-term.
“Ensuring patient safety is a joint responsibility between the physician and technology vendor and requires appropriate safety measures at each stage of development and implementation,” the letter said. “Ultimately, physicians must have confidence in the devices used in their practices to manage patient care.”
In 2014, regulators made some improvements to the meaningful use program, including allowing physicians to use new, old or a combination of both versions of certified software to meet meaningful use. But the changes didn’t go far enough, and only about 3 percent of physicians and other eligible providers had attested to Stage 2 of meaningful use in 2014, highlighting the difficulty of the program.
To make improvements to the EHR certification process, physician groups told ONC it should focus on three areas:
- Usability. The method used to test EHR usability is underdeveloped, and testing doesn’t often mimic real-world medical practice. More rigorous testing to include a variety of different scenarios, including test cases that represent the needs of medical specialists, would help to improve how the technology is used in real-life workflows. EHRs should also demonstrate their ability to handle input errors, bad data or system malfunctions. For optimal performance, an EHR should be able to flag and manage erroneous data entered by mistake to protect patients from unsafe events.
- Interoperability. “The act of two computers sending and receiving data does not constitute functional interoperability—the ability for information to be exchanged, incorporated, and presented to a physician in a contextual and meaningful manner.” the letter said. Rather, efforts should be placed on ensuring the necessary health information follows patients during transitions of care. For example, currently EHRs exchange lengthy documents that provide little value if they’re simply imported in to a patient’s record. ONC must clarify and standardize how these documents should be exchanged and create tests to verify their conformance to those standards.
- Security. Protecting the privacy and security of patient information is crucial, yet current methods for accessing data, like passwords and tokens, are cumbersome and can still be compromised. Health IT regulators and EHR vendors should look toward advancements in consumer electronics and developing identification solutions to reduce many of the authentication difficulties medical professionals face.
Last year, the AMA released a blueprint outlining ways to improve the meaningful use program and a framework that details eight priorities for moving toward more usable EHR systems.
Read more about EHR improvement at AMA Wire®.
Tell us: What would make the EHR certification process easier for physicians? Tell us in a comment below or at the AMA Facebook page.
