Kyle Meadors, director of EHR testing with the Drummond Group, an authorized testing and certification body of the ONC said, information-sharing among the certification bodies would maybe force some clarity.

 

"Some of the issues we've raised have not been pushed out to other certifiers," Meadors said. "We aren't privy to each other's interpretations. ONC needs to start engaging the certification bodies on a regular basis, to see what challenges they’ve faced, what they have allowed — that's where it really gets tricky. You start seeing different interpretations from other vendors."

 

And Mark Shin, chief operating officer of certifying body InfoGard said the confusion extends to auditing as well where, so far, "there's been a troubling lack of guidance from ONC."

 

Never soon enough

 

Banas said the effect of all this has been an erosion of the exuberance he and his team once felt over the meaningful use program.

 

"VCU has numerous examples of instances where our health system already meets the intent of the measure, but our CEHRT was certified for said function in a different manner," Banas testified. "Not knowing any differently, our EHR vendor tells us that we will need to do it the way in which they certified in order to reliably meet MU requirements."

 

At least for the time being. ONC has a recent history of being pragmatic enough to listen to feedback, digest what stakeholders have told them, and when appropriate change rules accordingly.

 

"I don't think it was ever our intent to put you in the position you are in. How can we 'certify' the intent of what we're trying to accomplish?" asked certification workgroup member Charlene Underwood, senior director of government and industry affairs at Siemens Medical. "It gets lost in the standards. How do we enable you to meet the intent of meaningful use through a certified body?"

 

Jacob Reider, MD, deputy national coordinator — who has been put in charge of "fixing certification" by the current national coordinator, Karen DeSalvo, MD — said ONC is gearing up a new initiative that will soon address the inconsistencies and gray areas in certification and auditing.

 

That cannot come soon enough for the likes of Banas and Lorenzi.

 

"The world I live in is the world of fear," NewYork-Presbyterian’s Lorenzi said. "Gray is really hard, if someone's going to audit you. It's a big deal."