Journal of AHIMA - May 2012

nology would be required to support a patient’s ability to view, download, and transmit his or her information to a third party. Transport standards include two specifications that were developed under ONC’s Direct Project, which enables direct, provid-er-to-provider exchange of information.

Systems must be capable of generating patient summaries, and in ambulatory settings, systems must enable secure messaging with providers.

A Shift to “Base EHRs” in 2014

ONC also proposes changes to its definition of a “qualified” EHR, intended to give providers more flexibility.

In response to feedback, ONC would allow professionals and hospitals the ability to implement only the EHR technology that they need to demonstrate meaningful use.

Under the current definition, program participants must have EHR technology that has been tested and certified to all applicable certification criteria adopted for the setting for which it was designed. Thus, for example, an eligible professional who quali-fies for an exclusion of an objective and associated measure still must have EHR technology that supports the capability.

Effective 2014, ONC’s rule would require professionals and hospitals to possess a “base EHR” to support universal fundamental capabilities. They would then require any additional technology necessary to meet the program objectives and measures for the applicable stage of meaningful use, and the technology needed to capture and report clinical quality measures.

The revised definition reads: “All EPs, EHs, and CAHs must have EHR technology (including a Base EHR) that has been certified to the 2014 Edition EHR certification criteria that would support the objectives and measures, and their ability to successfully report the CQMs, for the MU stage that they seek to achieve.”

Infobutton, Please

Underpinning the objectives related to clinical decision support
and patient-specific education resources, ONC proposes the
use of the HL7 Context-Aware Knowledge Retrieval Standard,
International Normative Edition 2010—or “Infobutton.”
The Infobutton standard has been in active use for several
years, ONC notes, and many reference content vendors provide
their products using the standard. Providers are increasingly
using Infobutton to identify and provide patient-specific educa-
tion resources.

Accounting of Disclosures

Among a set of “additional” comments that ONC requests are questions related to an EHR’s ability to support accounting of disclosures.

ONC’s 2011 certification criteria include an optional account-
ing of disclosure certification criteria, requiring EHR technol-
ogy be capable of electronically recording disclosures made for
treatment, payment, and healthcare operations. Systems must
record date, time, patient identification, user identification, and
a description of the disclosure.

Reference

Office of the National Coordinator for Health Information Technology, Department of Health and Human Services. “Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology.” March 7, 2012. www.gpo. gov/fdsys/pkg/FR-2012-03-07/pdf/2012-4430.pdf.