The hits keep on coming as two industry groups spoke out against voluntary 2015 EHR certification under meaningful use.

On Monday it was the EHR Association claiming the criteria are neither necessary nor workable. And on Tuesday the American Medical Association and Telecommunications Industry Association joined the cause.

[See also: EHRA has complaints about 2015 criteria]

In a letter to National Coordinator Karen DeSalvo, MD, the AMA said its constituents are concerned that the meaningful use program requirements are "overly rigid," and that the certification process "is not focused on ensuring interoperable and usable systems."

According to AMA's analysis of the most recent CMS data on meaningful use, approximately 20 percent of eligible professionals have dropped out of the program, "a figure we expect to rise once all the data for 2013 are tabulated."

In addition, AMA officials say that poor EHR usability is partially due to a disconnect between development of the EHR and its use in the real world. More testing could remedy this, AMA said, including requiring vendors to perform scenario-based testing prior to certification.

"The AMA firmly believes that the MU program and certification process must be substantially overhauled so physicians can leverage technology to help ensure improvements in healthcare delivery," AMA officials wrote in the letter. "We specifically encourage ONC to focus on more comprehensive testing along with greater transparency of these results."

TIA officials, meanwhile, explained in public comments that they are concerned the proposed regulatory pathway for more frequent certification cycles "could be the cause of confusion and create unintended consequences."

The TIA also urged CMS to use more flexibility in their evaluations and administration of eligible participant hardship exceptions, and added that the group supports the proposal to create a new definition and category for non-meaningful use CEHRT, but noted that parts of that proposal lack clarity.

While the proposed 2015 criteria is distinct from Stage 2 meaningful use, as early as October of last year EHR vendors were surprised by the complexity of Stage 2, citing clinical quality measures, interoperability and automated measure calculation for reporting metrics among the most challenging issues.