Tag: Stephanie Jamison

EHR Association Turns 20: Celebrating Two Decades of Groundbreaking Collaborations and Milestones

By Stephanie Jamison (Greenway Health), Chair, EHR Association Executive Committee

It’s been 20 years since 21 of the industry’s leading EHR vendors came together to create the HIMSS EHR Vendor Association in 2004 to accelerate the widespread adoption of EHRs. The new association was also tasked with helping HIMSS establish its strategic direction and official positions on issues related to the EHR and providing input and feedback on the certification process established by CCHIT.

Now called the EHR Association, what started as a bold concept is still going strong in 2024 with a current membership base of 29 companies: competitors working collaboratively to advance health data interoperability, safely embrace new technologies, and improve the quality and efficiency of care. Our initial focus on furthering the initiatives laid out in the Health IT Strategic Framework, released in July 2004 by the Office of the National Coordinator for Health Information Technology (now known as the Assistant Secretary for Technology Policy, or ASTP), has expanded and evolved along with the state and federal regulatory environment.

At the time, founding Chair Charlene Underwood described the establishment of the EHR Association as a historic opportunity to directly impact healthcare delivery in the US, noting in the press release announcing the new association that “EHR technology has proven its ability to make healthcare safer, more efficient, and more convenient for patients as well as providers.

“As EHR vendors,” she continued, “we have a responsibility to our customers to shape the future of interoperability for effective and secure sharing of patient data, and to the nation to promote the widespread adoption of this life-saving technology.”

Today’s health IT market is vastly different from those early years when hospital EHR adoption was 9% and office-based physician practice adoption was 17%. Now, well over 96% of hospitals and 78% of physicians use an EHR, most of which are certified through the ASTP-driven process. In the years since its establishment, many of the EHR Association’s founding member companies have gone through acquisitions or mergers, and new entrants have stepped up.

The Developer’s Voice

The Association’s record of accomplishments since 2004 reflects the health IT market’s evolution. Over the years, we’ve worked to ensure our members’ voices were heard on regulatory and policy issues of critical importance to both EHR developers and the providers using our technologies. We’ve met with policymakers and submitted comments on everything from meaningful use and standards development to the Nationwide Health Information Exchange and TEFCA to the 21st Century Cures Act and, most recently, HTI-1 and HTI-2.

Our efforts weren’t limited to offering recommendations and feedback, however. We’ve held numerous Congressional Briefings over the years, focusing on issues such as the role of EHRs in value-based care and the 21st Century Cures Act, as well as COVID-19 and health IT, information blocking, and social determinants of health and health equity.

We’ve also leveraged our collective expertise to provide member companies with tools to navigate a tumultuous regulatory landscape. This includes publishing the industry’s first EHR Developer Code of Conduct reflecting our members’ commitment to supporting safe healthcare delivery, fostering continued innovation, and operating with high integrity in the market—a commitment we maintain to this day.

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Concerns and Uncertainty In the Wake of Sweeping HTI-1 Rule

Stephanie Jamison

By Stephanie Jamison, Executive Committee Chair and Public Policy Leadership Workgroup Vice Chair, EHR Association.

In the months that have passed since the Office of the National Coordinator for Health Information Technology (ONC) issued the final Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) rule, the health IT sector has been working diligently to meet the earliest compliance timelines even as it continues an in-depth analysis of the regulatory impact on both developers and the providers who use certified technology.

For the EHR Association, that analysis has given rise to several concerns and ambiguities that need to be addressed to ensure HTI-1, which was published in the Federal Register on Jan. 9, 2024, achieves ONC’s stated goal of advancing patient access, interoperability, and standards.

The new regulations are an important step toward implementing key provisions of the Cures Act and enhancing ONC’s Certification Program. However, there are several aspects of HTI-1 that we believe may have unintended consequences for certified EHR technology (CEHRT) developers and users.

Decision Support Interventions (DSI)

One significant area of concern is with regulations around DSI, which carry the earliest compliance deadlines. While the scope of DSI requirements was narrowed in the final rule, many of the compliance timelines are still insufficient for developing, testing, and implementing the necessary upgrades.

The first deadline is Dec. 31, 2024. That is when CEHRT developers must deliver DSI capabilities to maintain certification. Achieving compliance will necessitate substantial development efforts, including in novel areas for the program like AI/ML for predictive DSIs. Other areas of concern include requirements for:

Meeting these requirements within the 12-month timeframe presents a formidable challenge for CEHRT developers – a challenge amplified by the lack of a certified companion or other resource guide to support developers with compliant updates. Also coming into play are current CMS requirements governing providers’ use of CEHRT that would force developers to deliver updated technology to their customers well in advance of the ONC deadline.

To alleviate these challenges, we are urging ONC to consider implementing an enforcement discretion period of six to 12 months. This would provide much-needed relief for CEHRT developers and healthcare providers alike, while still ensuring that meaningful progress is made toward real-world implementation of DSI provisions by the 2024 deadline.

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