We have our Final Rule on the Temporary Certification Program for HIT.  It came out on Friday afternoon. It is not yet officially on the Federal Registry, but you can find the rule here on the ONC site: http://www.federalregister.gov/OFRUpload/OFRData/2010-14999_PI.pdf

The bulk of the document is related to comments made on the NPRM as well as the responses from ONC. While not truly part of the temporary program final rule itself, it is quite valuable in understanding the thinking behind their decisions. In reviewing this, it was apparent how closely ONC read and considered each comment. Some comments were not accepted, but valid reasons were always provided as to why they were not. Other comments did impact changes to the final rule reflecting ONC’s willingness to listen and adjust their direction. They are to be commended for that.

The official Final Rule itself starts on page 183. The Final Rule is largely unchanged from what was published in the NPRM. If you want to see only the changes from the NPRM, go to page 143 and look under the section called Provisions of the Final Regulation.  Below are a few of the more important changes made.

* Waiving of the 30-day delay in the effective rule. This is by far the most significant “change” in terms of how it impacts vendors, providers and hospitals. Typical procedure for Final Rules is to have 30-day delay after it is on the Federal Register before it becomes “effective”, but this can be waived in certain situations. What this means practically is that once the Final Rule goes into the Federal Register, say around July 1, the Temporary Certification Program will be active and ONC can begin processing applications from organizations like ourselves intending to be ATCBs. ONC does give themselves 30 days to process and approve the application so you still may not see an ATCB officially testing until possibly August.

* Temporary Certification Sunsets No Earlier than 12/31/11. The NPRM had stated that the Temporary Program ends (and the Permanent Program begins) when there is an accredited ONC-ACB. Now, the Temporary Program is given a clear window of operation through the end of 2011, and it may be extended if an ONC-ACB is not found by then. This gives more stability to the Temporary Program.

* All ATCBs Must Support Remote Testing. The NPRM had previously only required support of testing at the local ATCB facility. Now, remote testing is required for all ATCBs. Remote testing can be done either at the development site (vendor) or deployment site (provider or hospital implementation). Based on our DGI surveys, remote testing was by far the preferred method, and ONC also received the same feedback.