EHR Certification is a Black Box

The EHR vendors have not been sharing HOW their products are being certified. Currently, it is a black box. This is VERY frustrating. Especially since hospitals and doctors are supposed to be using the EHRs as cerified. Often there are many ways for an EHR to accomplish a testing objective. The current certification just produces a check box and a pretty certificate.  How do we deploy and use the product in a certified way is a mystery. My EHR vendors have not been forthcoming with this informtation (slippery is a term that comes to mind).

During a HIMSS meeting with an ONC official, it became apparent to me that ONC now realizes this is a problem. There was a discussion that the vendors should provide screen shots for each step to share this with their customers. ONC can compel them to do this, but I would like to see the vendors do this on their own.

For me, this is one more reason to take the self certification route.

6 thoughts on “EHR Certification is a Black Box

  1. I couldn’t agree more. The only justification for certification is to separate the “have” vendors from the “have nots”. A provider’s productivity can drop by 30% and yet they still qualify as a meaningful user. Being narcissistic regarding EHR is one way for providers to do what is best for them

    • The brave new world of health care reform is all about the “have” and “have nots” and this has been well published by health IT experts and the ONC in terms of vendors and health care delivery systems. Its a zero sum game; get on board with it.

  2. It would depend on each vendor as to how they are approaching their certification. In general, many are focusing on Meaningful use stage 1. The ONC and other entities will have suggestions as the certification process moves forward to MU 2. These suggestions will most likely become requirements.
    Our company is focused on Interoperability. For MU 1 hospitals, they are only required to attest to the fact they have a Continuity of Care Document (CCD). For MU 2 which starts in October, the CCD will have to work. Our company developed a CCD which meets the more stringent requirements. In addition, we have passed the ONC onboarding process for our gateway onto the Nation Wide Health Information Network.

  3. I guess you will have to take this up with NIST who wrote and administers the rules for certification. Maybe your CFO can convince your bondholders and banks that “self-certification” of your financial statements is more appropriate than having independent external auditors perform that. Has your EHR vendor passed certification yet under the new rules of NIST? EPIC, Cerner, AllScripts, Centricity and others have already done so.

    • Our hospital EHRs both have certified versions (Meditech and GE). I don’t understand your analogy of self-certifying financial statements. When our auditors perform our financial audits there is complete transparency into the process including the documents and controls they reviewed. What I get back from EHR certification is a meaningless certificate without any understanding of how that process was accomplished.

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