Provider uncertainty is hindering the implementation of the Designated Test EHR Program, a data exchange initiative launched earlier this year by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT.

[See also: McKesson, Meditech to test data exchange]

More than 500 healthcare providers have signed up for the testing program, which aims to determine whether they can successfully share electronic health records with providers using different technology, as required under Stage 2 meaningful use.

But a representative from one of the two EHR vendors tapped to take part in the program's tests says the early going has been challenging.

"We've been surprised by the lack of understanding on the part of eligible providers in terms of what they have to do to complete the testing process," says John Valutkevich, manager of interoperability initiatives for Meditech. "It's slowing us down."

The transition of care objectives mandated in Stage 2 require that eligible professionals, eligible hospitals and critical access hospitals either 1) conduct one or more electronic exchanges of a summary of care document with a recipient that uses a different vendor's EHR technology, or 2) conduct one or more successful tests with a CMS-designated test EHR during the reporting period.

CMS and ONC announced in January that Meditech and McKesson would be the first vendors to implement the Designated Test EHR Program. A third healthcare systems provider, iPatientCare, was added as a program vendor this month.

The three vendors are registered on a software system, EHR Randomizer, an online tool hosted by the National Institute of Standards and Technology. The software randomly matches an EP, eligible hospital or CAH with a test EHR designed by a different vendor than their own. Only test data, not live data, is used in the program.

Avinash Shanbhag, director of the ONC's implementation and testing division, says that while ONC and NIST are fielding a number of queries from users, the test program is going well overall.

"We get a decent amount of questions on this program," he says. "For example, some of the providers find the user requirements too technical, so we come up with documentation to help guide them."

A Google group established for EHR Randomizer users offers a glimpse of their typical concerns. One practice is unsure whether to register as a single entity or register each practitioner individually. Another is having problems filling in fields on the registration form.

As the testing program continues, Shanbhag says, "We will continue to get more information to the providers so they can understand it."

But Valutkevich notes that ONC already offers guidance.

"I don't think people are checking it," he says. "I'm surprised by the amount of office assistants and even physicians calling and saying they don't even know where to start."

The EHR test program will go on until health agency officials are satisfied that the EHR mandates of meaningful use are being met. Shanbhag says ONC is looking for more test EHRs, but doesn't have a specific number in mind.

For his part, Valutkevich hopes other vendors are soon added to the testing program, which he says "could go on past this year."

"Unless more (EHR) vendors jump on board, it will be difficult for the three of us," he says.

To be considered, an EHR vendor's technology must have and maintain certification under the ONC's HIT Certification Program.