CHIME, an organization that represents 1,400 healthcare CIOs, is calling for a rapid analysis of existing electronic health record certification programs, asserting that "above all else providers need a stable marketplace."

In a letter filed April 7 with the Office of the National Coordinator, CHIME (The College of Healthcare Information Executives) said it supported the general concept of moving to a two-stage approach for creating a certification process for EHRs, but added "significant questions still surround the creation of the approach."

"We are very concerned that the introduction of a two-stage approach for certification will prolong the current instability in the health IT marketplace, which exists because of the un-finalized status of meaningful use and certification regulations," CHIME wrote. "The introduction of two separate certification schemes – one temporary and one permanent – carries a risk of continuing the uncertainty and promoting needless product replacement in the marketplace."

To mitigate uncertainty, CHIME called for the temporary process to be a provisional or interim one that builds on current certification strategies and is "harmonized" with the eventual permanent certification process.

In its comments, CHIME asserts that the certification process should be the responsibility of the vendor, and that the purpose of certification should be to provide healthcare providers and professionals with assurance that the product they are purchasing can help them achieve meaningful use.

CHIME also called for more specificity in language to define what constitutes a self-developed EHR. Current wording in the regulation suggests that any complete EHR or EHR module that's modified by a healthcare provider or a contractor could require certification.

CHIME also recommended that:

• Changes in certification requirements be made only when they are necessary to meet meaningful use evolution or advance interoperability, not just because a certain amount of time has passed.
• If CMS maintains the "adoption year" approach originally advanced in proposed regulations, providers should not be required to have products certified for capabilities not required in their current adoption year.
• Individual EHR modules be certified to ensure that they can communicate according to adopted standards, and that the interoperability of those modules as used by providers be deemed as certified.
• HIT vendors fully disclose functions for which their products are certified and fully disclose known compatibility issues.
• In the event of a certification body losing its authority to certify products, vendors should have six months to recertify products, and providers should not be penalized for a change in a product's certified status if they are still able to demonstrate the meaningful use of the technology.