ONC publishes final EHR certification criteria

Under a new final rule released on Thursday, the U.S. government has chosen not to proceed with its proposed voluntary 2015 Edition Electronic Health Record (EHR) certification criteria for the meaningful use program.

Instead, the Office of the National Coordinator for Health Information Technology (ONC) said it has elected to adopt a small subset of the original proposals for the 2015 Edition as optional 2014 Edition EHR certification criteria. It has also revised the 2014 Edition EHR certification criteria to provide "flexibility, clarity, and enhance health information exchange," as well as removing regulatory text from the Code of Federal Regulations) and adding improvements for the ONC HIT Certification Program.

The revised 2014 Edition EHR Certification will now be known as 2014 Edition Release 2.

"We note that EHR technology developers do not have to update and recertify their products to the 2014 Edition Release 2 nor do eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) have to upgrade to EHR technology certified to the 2014 Edition Release 2," ONC wrote in the final rule. "However, we encourage EHR technology developers and the EPs, EHs, and CAHs that they support to consider whether the 2014 Edition Release 2 offers any opportunities that they might want to pursue."

Release 2 adds 10 optional and two revised certification criteria. Of note to radiology: the optional criteria include the splitting of the computerized physician order entry (CPOE) criteria into three certification criteria based on capabilities (medications, laboratory, and diagnostic imaging).

ONC also changed the name from the proposed criterion that supports CPOE from "radiology/imaging" to "diagnostic imaging."

"We have made these revisions to eliminate any potential confusion as to the type of orders we are referencing," ONC wrote. "We note, however, that these revisions in no way alter the required capability."

Other optional certification criteria cover transitions of care; clinical information reconciliation and incorporation; automated numerator recording; an applicability statement for secure health transport; an applicability statement for secure health transport and IHE Cross-Enterprise Document Reliable Interchange/Cross-Enterprise Document Media Interchange (XDR/XDM) for direct messaging; and Simple Object Access protocol (SOAP) transport and security specification and XDR/XDM for direct messaging.

The revised certification criteria include a revised "view, download, and transmit to third party" (VDT) certification criterion and a revised "safety-enhanced design" certification criterion that includes the optional CPOE certification criterion and the optional clinical information reconciliation and incorporation (CIRI) certification criterion.

In other changes, ONC indicated it's also discontinuing the "Complete EHR" certification concept starting with the next certification criteria edition that will be adopted in a subsequent final rule. That decision will not impact certification to the 2014 Edition, however.

The final rule can be found here.

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