Meaningful Use and HIT certification program require reforms, says Halamka

The program of Meaningful Use and HIT certification program is stifling technical innovation and lacks a concentration on outcomes-based care, while the certification program is “filled with outdated requirements” and is an important drain on health information technology developer resources.

That is the contention of John Halamka, MD, outspoken chief information officer at Boston’s Beth Israel Deaconess Medical Center.

“The program of Meaningful Use and HIT Certification program served a very beneficial purpose when (National Coordinator for Health IT) Dave Blumenthal did Stage 1—which is, it constructed a floor, and it ensured that doctors and hospitals had the basics of functionality that would be foundational for anything we’d do in the future,” claims Halamka, who is also been active on federal HIT committees.

Although, he asserts that Meaningful Use “went on with far too much prescriptive detail, and we are now to the point where we just require to morph the program into something else,” like outcomes- and quality-based payment models for providers, “offering vendors and clinicians more latitude in how they acquire them.

“It is time to reconsider what it is we are going to inquire clinicians to do and how we are going to measure it, rather to just issuing prescriptive regulations,” adds Halamka. “In short, the Meaningful Use Stage 3 concept and HIT certification program should be morphed into a different program.”

Under the new Quality Payment Program (QPP) from the Centers for Medicare and Medicaid Services (CMS), Meaningful Use is importantly restructured into a new Advancing Care Information (ACI) performance category as part of MIPS for purposes of calculating payment. At the similar time, the measures discovered within the ACI category are deployed on the measures adopted by the Electronic Health Records Incentive Programs for Stage 3.

The aims in the ACI performance category of MIPS emphasize measures that support clinical effectiveness, information security and patient safety, patient engagement, as well as health information exchange (HIE). The new ACI performance category score under MIPS explains a meaningful EHR user as a MIPS-eligible clinician who possesses certified EHR technology, utilizes the functionality of CEHRT, and reports on applicable objectives and measures.

But, in accordance to Halamka, while CMS has made development toward simplifying Meaningful Use and the ACI category of MIPS, ONC hasn’t followed suit with its certification program. Subsequently, he claims the certification program is “filled with outdated requirements and is a primary drain on health IT developer resources, with no incremental gain to patient care.”

Halamka charges that, in few cases, the certification program of ONC has “gone way beyond the Meaningful Use program and the intended scope of HITECH by being highly prescriptive in places unrelated to Meaningful Use, as opposed to being functional.”

Nevertheless, he claims that he is “not opposed to certification in principle” but “it is just that the certification rule as currently written is too broad.”