Final rule scraps optional 2015 CEHRT Edition; revises 2014 Edition

Rather than finalize a rule that would adopt criteria for an optional 2015 Edition of Meaningful Use EHR certification, the Office of the National Coordinator for Health IT (ONC) has issued a new final rule that makes the 2014 Edition of certification criteria more flexible and adds clarity and improvements to the current 2014 Edition of certification criteria through a new release of optional and revised criteria. (2014 Edition Release 2).

ONC has abandoned its 2015 voluntary edition of EHR certification criteria which was announced in a Feb. 21 proposed rule. More than 200 public comments came in with very little support for the option.

The new final rule, published in the Sept. 11 Federal Register, notes that ONC still believes that many of the reasons for creating the voluntary certification edition were valid, but "upon consideration of public comment, further reflection of ONC goals and timelines, and a desire to adhere to the administration's principles ... we have not adopted the Proposed Voluntary Edition."

The rule adopts a smaller subset of criteria from the original proposal, now called @014 Edition Release 2. The agency also made revisions to 2014 Edition EHR certification criteria "that provide flexibility, clarity and enhance health information exchange."

The new rule includes 10 optional and two revised criteria, such as separating the computerized physician order entry criterion into three certification criteria covering medications, laboratory and radiology/imaging order, and revising the view/download/transmit criterion to provide more options in transport methods. 

"This final rule reflects ONC's commitment to continually improve the certification program and respond to stakeholder feedback," National Coordinator for Health IT Karen DeSalvo, MD, MS, MSc, said in a statement. "It provides more choices for health IT developers and their customers, including new interoperable ways to securely exchange health information. It also serves as a model for ONC to update its rules as technology and standards evolve to support innovation."

For now, the 2015 Edition is scaled down and renamed but ONC intends in 2015 to publish a new edition of certification criteria that will be called the 2015 Edition under the new naming procedure. If the government subsequently issues a final rule in 2016 with certification criteria to support another HHS program or make changes to the 2015 Edition, the new rule in 2016 will be known as 2015 Edition Release 2.

“Importantly, this provides stakeholders with a consistent and predictable naming approach for future editions and also supports ONC’s broader interests to have the ONC HIT Certification Program be generally accessible to other programs either within or outside government,” according to the rule. “Stakeholders that seek to leverage the ONC HIT Certification Program would then be able to choose which edition of certification criteria (or subset of criteria within an edition) is most relevant and appropriate for their program needs.”

The final rule also discontinues use of the certification term “Complete EHR” following the current 2014 Edition of certification to reflect expanded flexibility in becoming certified and to respond to a situation where some EHR vendors only plan to offer a certified Complete EHR to customers.

“While we recognize EHR technology developers may choose to pursue various approaches for designing and marketing their products, we are in a position to modify our policy so that it does not encourage EHR developers to offer only a single certified solution,” according to the rule. “In general, we believe the decision to seek certification only for a Complete EHR serves to defeat the flexibility provided by the 2014 Edition CEHRT definition. Consequently, by discontinuing the availability of the Complete EHR certification, the EHR technology market could be driven by EHR technology developers competing on the capabilities included in their EHR technology rather than on the type of certification issued (Complete EHR or EHR Module).”

ONC clarified that EHR developers do not have to update and recertify their products for this 2014 Edition Release 2, and providers do not need to upgrade their EHRs. However, ONC encourages eligible providers, eligible hospitals and critical access hospitals to consider whether the rule now offers "opportunities that they might want to pursue."

Access the complete final rule.