ONC Task Force Weighs In on EHR Ratings

Ken Terry

February 02, 2016

A new task force of the Office of National Coordinator for Health Information Technology (ONC) recently made recommendations on how to give providers more comparative information on health information technology (IT), including electronic health records (EHRs). Its findings emerged at about the same time the US Senate Committee on Health Education, Labor and Pensions (HELP) unveiled draft legislation on health IT that includes a formal EHR rating system.

ONC created its Certified Technology Comparison (CTC) Task Force to comply with Congress' request for a feasibility study regarding the need for a certified health IT comparison tool. That request was part of the Medicare Access and CHIP Reauthorization Act of 2015.

Specifically, the CTC Task Force was charged with advising the Health IT Policy Advisory Committee and the Health IT Standards Advisory Committee on the benefits of and the resources needed to develop and maintain a certified health IT comparison tool.

Robust Tools Available

The task force told the advisory committees that comparative ratings of health IT are needed to help providers make their first purchases of these products, consider modular component purchases to meet new health IT needs, consider replacing existing health IT products, and develop an ongoing health IT strategy.

According to the task force, some robust comparison tools are available. However, they may not meet the needs of all providers, especially small and/or rural practices, specialty practices, and groups that lack technical support.

Also, most of the existing tools lack empirical sources of comparison for quality report, objective usability information, comparative product costs, and information about the products' ability to integrate with other kinds of health IT. The task force suggested that comparative, objective data may encourage competition and may simplify the process of purchasing health IT products.

The task force recommended that ONC give priority to beefing up its certified health IT product list to supply more comparative information to providers. Another recommendation was that the office contract with one or more comparison tool vendors to ensure such tools are accessible to and meet the needs of small-practice and specialty providers. In addition, the task force said, ONC might recommend existing comparison tools for "private sector consideration," but should not endorse any specific products or develop its own tool.

The committee also explored what an ideal comparison tool ought to include. High-priority topics for such a tool should include usability, total cost of ownership, regulatory requirements, and privacy and security, the task force noted.

How HELP Bill Differs

Unlike the HELP bill, the ONC task force did not consider any kind of enforcement regime that would penalize vendors for poor performance in the ratings. The legislation proposed by the HELP committee — which will not be introduced until after the committee receives public comments — would set up an EHR rating program. It would require EHR vendors to provide information on their products' performance every 2 years and would solicit feedback from providers and other stakeholders. If an EHR received a poor rating, its vendor would have to take correction action; if the product didn't improve, the company could be penalized or lose its certification.

The EHR Association (EHRA) of the Healthcare Information Management and Systems Society, the leading vendor group, initially praised the HELP committee for opening the process up to stakeholder input before settling on a final bill. It also lauded several provisions in the measure, although not the EHR ratings portion.

In a recent interview with Politico, Leigh Burchell, EHRA chair and vice president of government affairs for Allscripts, said that EHR vendors oppose the HELP committee plan to create a government-run ratings system. Existing private ratings firms offer services that can give providers the information they need, she said, adding that she prefers the recommendations of the ONC task force.

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