Halamka: Rethinking Certification

Dr. Halamka of BIDMC has been a supporter of the ONC and their quest for meaningful use. He has been a “no whining, just solutions” voice in the industry, helping the ONC gain at least a little bit of traction to test their Meaningful Use wings.  I applaud him for his patience and stoicism,   but also now welcome his constructive criticisms of the meaningful use guidelines.   He calls for the ONC to make up it’s mind on which standards to use. Hear! hear!


We have recently re-visited our schedule for meeting meaningful use and put in a list of high/medium/low priorities for what tasks we have left. The tasks that are uniformly low on our priority list are functions such as “reporting to immunization health agencies”.  We run a cancer clinic. We MIGHT give out a flu shot or two, but we are not giving assays of immunizations to two year-olds.

Another feature is the displaying of growth charts. Why do we need to clutter our interface so that you can display a pediatric growth chart when our patients are reliably all over 20? The are just two examples of the ‘plumpness’ that still exists in the meaningful use guidelines that is nearly irrelevant to the success of medical specialty software.


And it is clear why such requirements are there. Our politicians want to show us how to make software by pointing to the horizon and shooting some money out of a cannon.  All of the software vendors start running in the same direction without asking “why?”, or saying “can you check the map again’?”  Instead, they fall in and throw enough money at a problem until all the tests pass. Success.


I can’t put it better than Dr. Halamka about how to foster a better healthcare software ecosystem:

Certifying organizations would not be prescriptive about user interfaces, workflow, or exhaustively test every variation of every option.   Instead, they would certify that an EHR can securely send a precisely formatted clinical summary and securely receive a compliant but less than perfect clinical summary.


How simple, succinct, successful.

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