A new federal rule, HTI-5, removes 14 items from the government's checklist for electronic health record (EHR) software and changes seven more. Your software's features don't disappear. But the government no longer checks that some of them work. So when your EHR contract comes up for renewal, make sure the features your teams depend on are protected in writing, and push for new terms only where they aren't.
What changed
The federal government runs a program that tests EHR software against a checklist. Software that passes is called "certified." Each item on the checklist is called a criterion, and it describes something the software must be able to do, like showing clinicians alerts or sending a patient's summary to another provider.
The Office of the National Coordinator for Health Information Technology (ONC), the federal office that runs this program, published an official summary of the HTI-5 changes on 26 October 2026. It lists 14 criteria removed and seven revised. Thirteen of the changes start when the rule takes effect. Seven removals start on 1 January 2027. One change, to the "transitions of care" criterion, starts on 1 January 2030. STAT reported the same numbers and noted that the program had 60 criteria in total.
A removed requirement is not a removed feature
When a criterion is removed, the government stops checking that certified software can do that thing. The feature itself stays unless your vendor decides to change it. What you lose is the guarantee.
The removed items include clinical decision support (the alerts and suggestions clinicians see while they work), care plans, the Direct Project (a secure way for providers to send each other health information), and two items about how outside apps request patient data, which end on 1 January 2027. ONC's table lists every change and when it starts.