The American Medical Association (AMA) has sent a letter to the National Coordinator for Health Information Technology, Karen B. DeSalvo, M.D., urging that the certification of electronic health records (EHR) be decoupled from meaningful use certification requirements. “Unfortunately, we believe the meaningful use certification requirements are contributing to EHR system problems, and we are worried about the downstream effects on patient safety,” the letter said.

“Many physicians find these systems cumbersome, do not meet their workflow needs, decrease efficiency, and have a limited, if any, interoperability,” the letter said. “”Most importantly, certified EHR technology can present safety concerns for patients.”

AMA believes there is an urgent need to change the current certification program to better align end-to-end testing to focus on EHR usability, interoperability, and safety..

AMA suggested seven changes to the EHR certification. In addition to decoupling EHR certification from the meaningful use program, AMA is also urging the U.S. Department of Health and Human Services to reconsider alternative software testing methods; establish greater transparency and uniformity on user centered design testing and process results; incorporate exception handling into EHR certification; develop consolidated clinical document architecture guidance and tests to support exchange; seek further stakeholder feedback; and increase education on EHR implementation.

“Ensuring patient safety is a joint responsibility between the physician and technology vendor and requires appropriate safety measures at each stage of development and implementation,” the letter stated. Physicians, software developers and vendors have reported to the AMA that meaningful use certification has become the priority in health information technology design at the expense of meeting physicians’ needs, patient safety and product innovation.

“While training is a key factor, the safe use of any tool originates from its inherent design and the iterative testing processes used to identify issues and safety concerns. Ultimately, physicians must have confidence in the devices used in their practices to manage patient care,” the letter said.

The letter was also signed by 35 medical societies and specialty societies.