Archive for the ‘CCHIT’ Category
September 01, 2009
The Certification Commission for Health IT is moving forward on plans to launch a less comprehensive certification program that will focus solely on compliance with the “meaningful use” requirements of the federal economic stimulus package, Health Data Management reports.
Under the stimulus package, hospitals and physicians who demonstrate meaningful use of electronic health records will qualify for Medicare and Medicaid incentive payments.
Although the federal government is not expected to issue a final definition for meaningful use until next spring, CCHIT aims to launch its new certification program in October.
CCHIT Chair Mark Leavitt said the commission will base its new program on preliminary recommendations from federal health IT advisory committees. He said this will allow health care organizations to purchase and implement EHR systems in time to receive the maximum incentive payments.
Leavitt added that CCHIT also plans to update and expand its current comprehensive EHR certification system for ambulatory, emergency department and inpatient settings (Anderson, Health Data Management, 8/25).
Recent Certification Changes
Earlier this month, the Health IT Policy Committee adopted recommendations that called for multiple entities to certify EHR systems. The certification and adoption work group said it envisions the establishment of 10 to 12 different EHR certification groups, in addition to CCHIT.
The Policy Committee also proposed a transition plan to help health IT vendors develop products that meet the 2011 meaningful use requirements.
Under the “Preliminary HHS Certification” process, CCHIT likely would provide interim certification for EHR vendors. The plan would invite CCHIT to submit a proposal for developing the preliminary certification process (iHealthBeat, 8/17).
Above article published on
August 26, 2009
The Certification Commission for Health Information Technology is moving forward with plans to launch a new, less comprehensive electronic health records software certification program in light of the federal economic stimulus package.
In October, the commission plans to launch a more limited, modular inspection program for EHR software, focusing only on compliance with standards required for “meaningful use” of EHRs under the American Recovery and Reinvestment Act.
Rather than wait for the federal government’s final rule defining “meaningful use” of EHRs next spring, CCHIT is moving forward with its new certification efforts based on preliminary definition recommendations from federal HIT advisory committees, says Mark Leavitt, M.D., the commission’s chair. That’s because providers will have limited time to select and implement EHRs by 2011 to qualify for maximum Medicare and Medicaid incentive payments under ARRA.
CCHIT also will continue to update and enhance its existing, more comprehensive, EHR certification system for ambulatory, inpatient and emergency department settings, Leavitt said.
The Chicago-based commission will hold an online “town hall” meeting at noon September 3, when electronic health records vendors can learn about and discuss the two CCHIT certification efforts.
The commission’s action comes after the federal HIT Policy Committee’s certification/adoption workgroup recently recommended that multiple organizations offer “HHS Certification” testing of EHRs for the incentive program. The workgroup, in making its recommendation, said that CCHIT’s existing, comprehensive certification of EHRs should not be a requirement for incentive payments. Instead, software should be certified solely for achieving the minimum set of criteria to meet ARRA’s “meaningful use” standard, according to the workgroup.
But federal regulators have yet to make a final decision on a certification approach, much less designate whether CCHIT, or other organizations, will be the government’s recognized certification bodies.
Above article published on http://www.healthdatamanagement.com/news/CCHIT-38877-1.html
July 20, 2009
Gordon Gillerman — chief of the standards division of the National Institute of Standards and Technology — said officials might push for an accreditation organization to oversee the Certification Commission for Healthcare IT, Modern Healthcare reports.
Gillerman delivered a presentation for the Health IT Policy Committee’s certification and adoption work group.
He said an organization such as the American National Standards Institute could serve as a watchdog for CCHIT.
Gillerman added that he does not foresee NIST becoming involved in accrediting certification groups. Rather, he said, NIST could help the Office of the National Coordinator for Health IT develop an appropriate accreditation process (Conn, Modern Healthcare, 7/14).
CCHIT as Sole Certifier
In related news, the Electronic Health Record Association on Monday sent a comment letter to the Health IT Policy Committee’s certification and adoption work group urging officials to designate CCHIT as the single certifying body for electronic health records.
The EHR association is part of the Healthcare Information and Management Systems Society, which co-founded CCHIT.
The EHR group said it “supports CCHIT as the single certifying entity to avoid duplication of effort, unnecessary expense and confusion in the market.”
The association added that CCHIT certification should ensure that a health IT system “is a qualified, comprehensive EHR and is capable of enabling providers to achieve ‘meaningful use’ requirements” (Goedert, Health Data Management, 7/14).
Other Recommendations
The EHR Association’s comment letter also offered recommendations for developing criteria on the meaningful use of EHRs.
The association called for 2011 EHR objectives to:
Differentiate between inpatient and ambulatory care criteria; Emphasize existing software and standards; and Focus on adoption and use of comprehensive systems. The group also recommended linking computerized physician order entry systems to electronic medication administration records and data on chronic diseases.
The Health IT Policy Committee is scheduled to release its second draft definition of meaningful use during a meeting on Thursday (Merrill, Healthcare IT News, 7/14). Above article published on
July 14, 2009
Rick Weinhaus Dr. David Blumenthal, the new National Coordinator for Health Information Technology, has stressed that the goal of the ARRA/HITECH initiative is to improve patient care, not to mindlessly adopt health information technology. In this regard, he wrote that many CCHIT-certified EHRs “are neither user-friendly no designed to meet HITECH’s ambitious goal of improving quality and efficiency in the health care system.”
It is therefore disconcerting that the Association of Medical Directors of Information Technology (AMDIS) just weighed in on the issue of meaningful use with their letter to Dr. Blumenthal, recommending that the new national HIT Policy Committee use the 2008 CCHIT certification criteria to determine which hospitals and physicians get HITECH incentive dollars.
Even more disturbing is the AMDIS recommendation that meaningful adoption (their newly coined term) substitute for meaningful use until at least 2013.
We see placing the reporting of quality measures in advance of reporting measures of meaningful EHR adoption as akin to putting “the cart before the horse” — the fields that form the basis for automated quality reporting must first be populated on a regular basis . . .
What’s going on here? As I read it, AMDIS is acknowledging that CCHIT-certified EHR technology is so difficult for hospitals and physicians to use that it will take years of training before meaningful use can even be addressed. AMDIS states that process of EHR adoption and use must follow a ‘crawl-walk-jog-run’ progression requiring continuous cycles of training and practice that ‘cannot be skipped or shortened’ [italics mine] without risking failure, introducing errors, and causing the frustrated physicians to give up.
Most disquieting of all is the AMDIS recommendation to exempt hospitals (but note, not office-based physicians) from HITECH’s computerized physician order entry (CPOE) requirement until 2013 or beyond. AMDIS states that even in the hands of its most experienced members, working with EHRs that are already up and running (most inpatient EHRs are CCHIT-certified according to HIMSS) successful implementation of CPOE is a challenging, multi-year undertaking.
AMDIS therefore recommends that inpatient CPOE be deferred for an indefinite time period because “it requires more advanced planning, building, testing, training, experience, data capture, data sharing, and decision support than many practices and hospitals can successfully achieve in the next 2-3 years.” Ironically, CCHIT makes CPOE a cornerstone of its inpatient certification.
AMDIS is warning us about the risk of EHR and CPOE system failures on a national scale. These software system failures have real life consequences. To list just one example, physicians from the Children’s Hospital of Pittsburgh reported a highly statistically significant increase in mortality after implementation of a CCHIT-certified CPOE system.
The first step in fixing a system failure is to acknowledge that there is a problem. Although AMDIS clearly is aware that a problem exists, they continue to promote the flawed CCHIT model. I doubt, however, that their solution (try harder, you can do it!) is what most physicians and patients would choose.
What happens after 2 or more years? Where is the evidence that most physicians will ever be able to ‘jog’ or ‘run’ with EHRs built on the CCHIT model? Where is the evidence that these CCHIT-certified EHRs will be any more usable after causing 2 or more years of inefficiency, error, and potential harm to patients?
As I have written in a previous post, the CCHIT certification model is fatally flawed because it mandates hundreds of required features and functions, which take precedence over good software design.
Fortunately, the situation is not nearly as bleak as it seems. EHR technology can begin to improve patient care right away if we adopt the right model. There is no reason that it should take 2 or more years for physicians to train to use EHR technology. With well-designed, user-friendly EHR software, physicians can be up and running with core functions in 2-3 weeks, not 2-3 years.
We need to remember that Congress and the Obama administration have entrusted the national HIT Policy Committee, not CCHIT, with the mandate to shape our new HITECH policies. The national HIT Policy Committee needs to keep EHR certification rules simple and focused on standards for data, interoperability, and privacy. Keeping certification rules simple will allow physicians and hospitals to select well-designed, user-friendly EHR software that can be used meaningfully from the start.
Rick Weinhaus practices clinical ophthalmology outside Boston. He trained at Harvard Medical School, the Massachusetts Eye and Ear Infirmary, and the Neuroscience Unit of the Schepens Eye Research Institute. Above article published on |
|
