EHR certifications revoked
Not all electronic health records are created equal. At least that's the message ONC officials communicated April 25 when they announced that two EHRs, previously certified under the EHR Incentive Programs, failed to meet industry requirements and have since had their certifications revoked.
As a result, National Coordinator for Health IT Farzad Mostashari, MD, said providers can no longer meet meaningful use requirements using these products.
EHRMagic-Ambulatory and EHRMagic-Inpatient, both developed by Santa Fe Springs, Calif.-based EHRMagic, are the first-ever EHRs to have their certifications revoked, ONC officials told Healthcare IT News. An ONC-authorized certification body must re-test the EHRs before they regain official certification.
"No providers have attested using these products," wrote ONC's Peter Ashkenaz, in an emailed statement.
Both ONC and InfoGard Laboratories, an ONC-authorized certification body, received complaints that the EHRMagic products failed to meet meaningful use certification requirements, and the products should not have been certified, officials say. InfoGard looked into the complaint and subsequently contacted EHRMagic, launching the ONC-ACB required surveillance activities. InfoGard concluded that it was necessary for the EHR products to be retested for select requirements. EHRMagic participated in retesting and subsequently failed.
"We and our certification bodies take complaints and our follow-up seriously," said Mostashari, in a press statement. "By revoking the certification of these EHR products, we are making sure that certified electronic health record products meet the requirements to protect patients and providers. Because EHRMagic was unable to show that their EHR products met ONC's certification requirements, their EHRs will no longer be certified under the ONC HIT Certification Program."
However, one of many questions still persists: Why were the products given the green light in the first place?
Mark Shin, chief operating officer at InfoGard, said the products were initially certified October 2012. "We follow the test procedures, and based on the results of the test procedures, the products did pass these requirements," he said. After receiving a complaint, however, the company re-examined the products and found otherwise.
Due to confidentiality agreements with the vendor, Shin said he is unable to discuss where specifically the products fell short. ONC officials also said they don't have specific details around why the products failed to achieve certification.
Since 2010, InfoGard has certified 242 EHR products from 146 different vendors, representing 4 percent of all EHR products certified. Under the 2011 criteria, ONC-authorized certification bodies have certified more than 6,000 EHR products.
In terms of improving the EHR certification process, Alisa Ray, chief executive officer of the Certification Commission for Health Information Technology, says there's still a long way to go. However, the process that's in place now is gradually raising the bar, adds Ray. "A side effect of this increase in (EHR) adoption is that it can expose some of the imperfections in the system, but that's OK because more people are using them and they're ready to have that dialogue."
However, others say progress isn't moving fast enough, and detail surrounding the certification process itself is markedly vague. "Pea soup would be clearer," says Frank Poggio, president of the Kelzon Group consulting firm. "(ONC) came up with some fifty quick measures to test a system that has millions of lines of program code and takes years to build," he adds.
Poggio points out that to get certified for demographics in Stage 1 or Stage 2, you need to capture and track: age, sex, race, ethnicity, date of birth, date of death and preliminary cause of death.
"Where's patient name, address, insurance, next of kin?" he asks. "So to pass the demographic test, all I need to show is the six 'required' data elements. The tester cannot request to see anything else. If you do not have an input field for the other info and the tester were to ask, you could say, 'next release.' You pass!"