The Office of the National Coordinator for Health IT has eliminated two technical guides for standards for public health surveillance and reporting because they did not include the technical descriptions to enable electronic health records to exchange symptom surveillance data.
They were "adopted in error" in the final rule for the initial standards, specifications and certification criteria for electronic health records, ONC said.
Specifications in the rule, which are designed to guide vendors on how to add functions to an electronic health record (EHR), did not "appropriately" describe two corresponding standards versions for public health surveillance and reporting by electronic health records, ONC said.
An interim final rule that described the changes was published in the Oct. 13 Federal Register, and the fixes will take effect Nov. 12. The standards and certification measures are required for EHRs to meet meaningful use.
In its final rule published in July, ONC adopted two exchange standards for electronically submitting public health surveillance and reporting. The rule required the use of two Health Level 7 (HL7) standard versions, and adopted two technical descriptions for how public agencies can deploy the standard message structure to report diseases to the Centers for Disease Control and Prevention (CDC) over the public health information network.
The rule did not provide guidance to enable users of electronic health records to "electronically record, modify, retrieve and submit syndrome-based public health surveillance information," ONC said in the interim final rule.
"The ultimate purpose is to facilitate the electronic exchange of de-identified nationally notifiable conditions," it said.
After consulting with the CDC, ONC decided that the specifications were adopted in error. The specifications provide public health agencies with the methods to report conditions, but not for how electronic health records should be designed to be capable of the standard.
Since July, ONC had received comments from state public health agencies and other organizations about whether the specifications were correct. Authorized certifiers and testers of EHRs also had voice concern to ONC.
"They correctly point out that because these implementation specifications are inappropriate for the adopted standard and would likely frustrate achieving the capability specified in the adopted certification criterion, testing and certifying with them would be wasteful and unproductive," ONC said.
The interim final rule is online.
