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ONC Offers Guidance on EHR Safety

Posted on January 17, 2014 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

ONCHIT has released a new set of guidelines and tools designed to help providers make safer use of EMRs and related technology. ONCHIT calls the set of nine toolkits SAFER, or Safety Assurance Factors for EHR Resilience. (Access the toolkit here.)

According to Healthcare IT News, the SAFER tools include checklists and recommended practices designed to optimize EHR safety.  ONC officials say that this suite follows up on, and forms an important part of, the Health IT Patient Safety Action and Surveillance Plan released by HHS this past July.

The toolkits, which include self-assessment checklists, practice worksheets and recommended practices, include the following topics:

  • High-priority practices
  • Organizational responsibilities
  • Patient identification
  • CPOE and decision support
  • Test results review and follow-up
  • Clinician communication
  • Contingency planning
  • System interfaces
  • System configuration

According to officials, the SAFER guides complement existing health IT safety tools already developed by ONC and the Agency for Healthcare Research and Quality.

The idea behind these guides, it seems, is to bring evidence-based practices to an area which is still evolving rapidly. As things stand, EHR use and workflow development is subject to a lot of guessing, especially as to what pathways work best in getting providers to use EHRs most effectively and safely.

All that being said, hospital executives are eyebrow deep in operational and IT issues related to their EHR, and may be simply too overwhelmed to shift their work processes to adopt these evidence-based tools.  It will be interesting to see, in other words, whether the industry considers these guidelines to be “nice to have” or necessary.

EHR Certification Value (or lack therof)

Posted on September 21, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It seems like this question comes up every couple months about the value of EHR certification. A reader of EMR and HIPAA, QA, recently offered the following comment about EHR certification.

The issue is less that the certification bodies are unscrupulous and more that the certification criteria themselves are a joke.

If one thinks that certification denotes that a system is safe, usable, reliable and will support the care delivery needs of any particular healthcare organization, then one will be quite disappointed.

If one thinks that certification denotes that a company offering a system has certain financial stability, legal liability coverage or quality management systems in place, one will be similarly disappointed.

ONC has no interest in rigorous certification. Only higher attestation numbers.

I think this comment hits the nail on the head. I won’t say that EHR certification provides no value, but let’s not do what far too many people are doing and misconstrue the value EHR certification offers. I echo QA’s comments that EHR certification does not certify:

  • EHR Safety
  • EHR Usability
  • EHR Reliability
  • EHR Financial Stability
  • EHR Liability Coverage
  • EHR Quality Management

Let’s not make EHR certification into more than what it delivers. I think most people have gotten this message, but a few are still lingering in the shadows.

EHR Certification Fraud

Posted on August 17, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently got this disturbing email in my inbox:

I recently came across a healthcare IT firm that used backdoor tactics with the 170.304b test case of Meaningful use certification. The message format has been tampered with making it compliant with NIST v8.1 XML while the actual transmitted message is not. Whom do I report this to? This can be proved if the company is again put through the same test case.

Will this be considered as fraud? if yes, whom should I notify. I wonder what other test cases have been tampered too.

This email comes as Anne recently reported that the EHR Safety Watchdog EHR Event was shutting down. I can’t say I’m really that surprised that some percentage of the 600+ certified EHR vendors are gaming the EHR certification process. The challenge is where do you turn when this is happening?

Obviously, the above comment was somewhat short on details, but I suggested that they take the information to ONC/CMS to report it. I guess they got a response that basically the people at HHS would look into it, but that they didn’t report findings. I also suggested that they might want to talk to the EHR certifying body for that EHR software. I’m not sure exactly what the EHR certifying can or would do, but it would be interesting to find out.

I know an EHR consultant that’s done a few hundred EHR certifications and he told me that not all EHR certifications are equal. However, when the EHR certification is issued, it gives the appearance of equal. It’s a fallacy that everyone should know and understand.

What I think also could get interesting is those doctors who use an EHR that’s using tactics like the ones mentioned above. Could this come back to damage those doctors who use an EHR that’s using less than honorable methods to get by? I still believe that it’s not in HHS’ best interest to drag a practice that’s implemented an EHR through the mud, but time will tell.