The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administration's health IT efforts

How to choose a (more) usable Electronic Health Record (EHR) system

The usability of the system is probably the most important factor in making an informed choice of which EHR to use for your practice. Most every bit of software says that it is easy to use, but how can you choose an EHR that is actually usable?

ONC Releases First Draft Test Scenario To Gauge EHR Systems' Usability

The Office of the National Coordinator for Health IT has released the first draft test scenario for assessing the real-world usability of electronic health record systems under Stage 2 of the meaningful use program, Modern Healthcare reports.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.

About the Test Scenarios

The use of test scenarios is optional. EHR vendors are not required to pass the test scenarios for their systems to receive certification under the meaningful use program.

The first draft test scenario evaluates the ability of EHR systems to receive information -- such as a medication and allergy lists -- from an outside source.

According to an ONC release, the first draft test scenario aims to ensure that EHR systems can achieve "a clinically plausible test flow" of data (Conn, Modern Healthcare, 2/6).

Comment Period, Future Releases

The agency is accepting public comments on the first draft test scenario. Comments can be submitted to certification@hhs.gov (Durben Hirsch, FierceEMR, 2/6).

ONC plans to develop additional test scenarios in the future (Modern Healthcare, 2/6).

Source: iHealthBeat, Thursday, February 7, 2013

OMB Reviewing Proposed Rule for Stage 3 of Meaningful Use

Last week, the Office of Management and Budget received the proposed rule for Stage 3 of the meaningful use program, Politico's "Morning eHealth" reports.

In addition, OMB received a proposed rule from the Office of the National Coordinator for Health IT that would adjust the EHR certification program to "make it more broadly applicable to other types of health IT health care settings" (Gold, "Morning eHealth," Politico, 1/5).

OMB review is one of the last steps before rules are published in the Federal Register (iHealthBeat, 9/16/13).


Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.

In March 2014, the Health IT Policy Committee voted to approve recommendations from its meaningful use workgroup for new objectives for Stage 3 of the meaningful use program (iHealthBeat, 3/11/14). The Policy Committee in its recommendations aimed to tighten the focus of Stage 3, which begins in 2017, and relieve some of the burden on stakeholders (Slabodkin, Health Data Management, 1/6).

The approved recommendations were sent to CMS to develop a proposed rule (iHealthBeat, 3/11/14).

Stage 3 Proposed Rule Details

In the submission to OMB, HHS states that the proposed rule for Stage 3 focuses on improving health outcomes and furthering interoperability. The proposed rule also explains the criteria eligible professionals and eligible hospitals must meet to demonstrate meaningful use under the program.

In addition, HHS said that Stage 3 proposed rule includes changes to the meaningful use program's:

  • Reporting period;
  • Structure; and
  • Timelines.

For example, it would provide a single definition of meaningful use.

HHS said it will work with CMS and the Office of the National Coordinator for Health IT to "ensure that the Stage 3 meaningful use definition coordinates with the standards and certification requirements being proposed and that there is sufficient time to upgrade and implement these changes."

Next Steps

Both proposed rules will be posted in the Federal Register upon completion of OMB's review (Health Data Management, 1/6). ONC expects the proposals to be approved by OMB sometime this winter ("Morning eHealth," Politico, 1/5).

Source: iHealthBeat, Tuesday, January 6, 2015

Interoperability takes Center Stage at Health IT Committee Meeting

Connected computers to represent interoperability in healthIT

The Office of the National Coordinator for Health IT shared "early strategic elements" of a draft 10-year roadmap for achieving an interoperable health IT infrastructure, Health Data Management reports (Slabodkin, Health Data Management, 10/16).

In June, ONC released a paper outlining health IT interoperability goals the agency hopes to achieve over a three-, six- and 10-year time period (iHealthBeat, 6/5).

The agency plans to release a final version of its 10-year national interoperability plan by the spring (Conn, Modern Healthcare, 10/15).

The updated draft roadmap was presented at a joint meeting of the Health IT Policy and Standards committees by ONC's Interoperability and Exchange Portfolio Manager Erica Galvez.

During the meeting, Galvez said ONC has adopted the Institute for Electrical and Electronic Engineers definition of interoperability, which calls for a system or product to work with other systems or products without special effort on the consumer's end.

She said that the draft report, which will be available for public comment in January 2015, takes an incremental approach to achieving interoperability (Health Data Management, 10/16). The draft report states:

  • By 2017, providers and patients should be able to send, receive, find and use basic electronic health information;
  • By 2020, providers and patients should be able to contribute to and access their health information at a granular level and seamlessly use remote monitoring devices;
  • By 2024, patients should be able to regularly track and share data from mobile and medical devices electronically, and providers should have increased longitudinal information to contribute to a learning health system (ONC draft report, 10/15).

According to the draft report, ONC will create and launch a program that monitors who complies with the voluntary national framework (Bowman, FierceHealthIT, 10/14).

During her presentation, Galvez also touted the nation's existing interoperable system, noting, "There is a base from which we can build. We're not starting from zero."

For example, she noted that health care organizations have increased the number of directed exchange transactions through health information exchanges by 225% to more than 226.6 million transactions between the second quarter of 2012 and the fourth quarter of 2014 (Modern Healthcare, 10/16).

Overall, committee members generally agreed with the draft roadmap (Gold, PoliticoPro, 10/15).

In addition, the Health IT Now Coalition in a statement applauded ONC for a plan that "immediately challenges the status quo to think beyond pecuniary interests to transforming health care."  Health IT Now Coalition Executive Director Joel White said the Policy and Standards committees must "step up," take charge and demand better outcomes for consumers (Health Data Management, 10/16).

Committees Approve Several JASON Task Force Recommendations

Also on Wednesday, the Policy and Standards committees formally approved a set of six recommendations from the JASON task force that calls on CMS to focus efforts on public application programming interfaces, Clinical Innovation & Technology reports (Pedulli, Clinical Innovation & Technology, 10/16).

The JASON task force was created as a short-term joint workgroup under the Policy and Standards committees to analyze and synthesize feedback on a previously released JASON report, which was prepared by an independent group of scientists that advises the federal government on issues pertaining to science and technology (iHealthBeat, 9/4).

In a final report, the JASON task force recommended using Stage 3 of the meaningful use program as a "pivot point" to begin the transition to public APIs (Durben Hirsch, FierceEMR, 10/14).

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of EHR systems can qualify for Medicaid and Medicare incentive payments.

Specifically, the committees approved recommendations to:

  1. Focus on interoperability by realigning the meaningful use program and initiate adoption of public APIs;
  2. Create a coordinated industry-based exchange architecture to support API-based interoperability;
  3. Create nationwide data sharing networks;
  4. Enable the public API to allow data- and document-level access to clinical and financial systems;
  5. Develop priority API Services; and
  6. Have ONC monitor the progress of adopting APIs and implement non-regulatory steps to assist with the adoption (Sullivan, Government Health IT, 10/15).

According to Healthcare Informatics, the committee members did not approve language that would encourage CMS and ONC to delay or stagger Stage 3 of the meaningful use program (Raths, Healthcare Informatics, 10/15).

The Policy and Standards committees will draft a letter to ONC and CMS formally endorsing the task force's recommendations (Clinical Innovation & Technology, 10/16).

Source: iHealthBeat, Thursday, October 16, 2014