A 5-year Goal to Transition the ONC Health IT Certification Program’s Testing Portfolio

Steven Posnack | August 3, 2017

Throughout its seven-year history, the Office of the National Coordinator for Health Information Technology’s (ONC) Health IT Certification Program (Program) has evolved in many ways, including improvements that enhanced the Program’s integrity, transparency, and efficiency. Central to the Program’s administration is the use of electronic, automated testing tools for health information technology (health IT). These tools enable health IT to be repeatedly and rigorously tested relative to its ability to accurately create standardized data files and perform interoperability oriented transactions. Over time, and in partnership with other federal agencies such as CDC, CMS, and NIST, ONC has expanded the Program’s electronic test tool portfolio, including how comprehensively these tools test standards’ conformance consistent with the additional interoperability requirements we included in adopted certification criteria.

Since 2010 and across three editions of health IT certification criteria, ONC and its partner agencies have made substantial investments with tax-payer dollars to develop and maintain the Program’s testing tools free of charge to the health IT community. At the same time, ONC’s regulations permit the private sector (including health IT developers, standards development organizations and other consortia) to provide testing tools that could replace and even exceed the testing infrastructure that the Program currently supports. A diverse mix of testing tools, including those developed in partnership with or solely administered by industry, can help optimize the certification experience.

In that regard, and as we look toward the implementation of Title IV of the 21st Century Cures Act (Cures Act), we have set a goal to transition the Program’s existing testing portfolio over the next five years to include as many industry-developed and maintained testing tools as possible in lieu of tax-payer financed testing tools. Achieving this goal will enable the Program to more efficiently focus its testing resources and better align with industry-developed testing tools, which could help support the “real world testing” envisioned by the Cures Act.

In June, ONC approved the NCQA’s testing method for eCQMs as an alternative to the existing test method used in the ONC Health IT Certification Program. This approval was a first step toward our five-year goal and is a clear signal that the Program can and will approve industry-developed testing methods. Similarly, we are actively coordinating with standards development organizations (such as the National Council for Prescription Drug Programs (NCPDP) for e-prescribing testing) and others that administer health IT interoperability testing tools. These tools could ultimately serve as the sole testing method approved by ONC for use in the Program. Additionally, we envision a future where Program participants, including the ONC-Authorized Testing Labs and Certification Bodies individually, collectively, or through partnerships with the private sector develop testing tools, similarly to what stakeholders do in other industry programs.

These changes will take time and in some instances could result in new business arrangements and fee structures based on who has invested in the testing tool(s), the costs to administer them, and the scope and scale at which they could be used (e.g., for 2015 Edition certification as well as a consortium’s “on boarding” process). We look forward to continued collaboration with health IT stakeholders in pursuit of our goal.