|
September 17, 2009
Filed Under (CCHIT, EHR, EMR, Electronic Health Records, Electronic Medical Records, Health) by admin
By Joseph Conn / HITS staff writer
The Certification Commission for Health Information Technology is adopting a two-tier system of testing and certifying IT systems.
In a conference call with vendors and developers of health IT systems Thursday, CCHIT Chairman Mark Leavitt announced the not-for-profit organization’s new testing program, as the group readies itself for the new realities of the healthcare IT market since passage of the American Recovery and Reinvestment Act of 2009.
One testing and certification program, dubbed Preliminary ARRA 2011 Certification, will specifically test for compliance with what is expected to be—at least initially—a fairly limited set of criteria that HHS and the CMS will use to determine eligibility by hospitals and office-based physicians for an estimated $34 billion in federal subsidy payments for the purchase of EHRs under the stimulus law.
The other, the so-called CCHIT Certified 2011 testing program, will use an elaborate set of about 300 criteria, primarily developed by the organization since its founding, that will closely resemble previous CCHIT testing and certification programs. The core CCHIT criteria will be tweaked to ensure systems that pass muster for its more advanced testing program also will meet ARRA requirements.
When it began testing IT systems in 2006, and on through 2008, CCHIT had offered just one, gold-standard set of criteria for each type of EHR system it tested—ambulatory EHRs or inpatient EHRs, for example.
But by April, CCHIT announced it would halt further testing to adapt its systems to accommodate the stimulus law criteria, development of which remains a work in progress. At the time of the announcement, Leavitt said the organization would keep its full-featured certification program, but would add two new testing and certification regimes scaled down to meet the minimum requirements of the stimulus law.
One new program would have tested IT systems by “module” against the new criteria under the recovery act, which requires providers to put “certified” EHR systems to “meaningful use” in order to qualify for federal subsidy payments. The proposed new modular approach was expected to appeal to some physician office practices and, more commonly, to hospitals, that want to piece together a comprehensive IT system from component parts produced by multiple IT vendors.
The other new CCHIT regime would have offered “on-site” testing and certification of EHR systems—again, against the less stringent stimulus law criteria with an eye toward qualifying for federal subsidies. This form of testing would have been conducted on systems installed at physician offices or hospitals. It was an approach targeted to appeal to providers who have developed their own EHRs or planned to assemble an EHR from noncertified sources, and to the open source development community, according to CCHIT.
According to Leavitt Thursday, CCHIT’s testing scheme will be modified again, but only somewhat. While site certification has been dropped as a certification scheme in and of itself, “site certification is still there,” Leavitt said. “In Preliminary ARRA Certification 2011, you can get a product or a site certified.”
Leavitt said it’s unclear whether providers adopting EHRs that have passed the test under the more rigorous CCHIT Certified 2011 program would want on-site certification, but if there is demand for the service, CCHIT will provide it.
Starting in June and running through its latest report in August, the HIT Policy Committee, which was created under the recovery act, has issued three sets of recommended definitions of meaningful use. Some of those recommendations have been controversial. To have market relevance, however, any program of certification of EHR systems that CCHIT develops must take those meaningful use standards into consideration to ensure that certified systems will enable providers to meet meaningful use standards and qualify for federal subsidies. The meaningful use standards, ultimately, will be developed by the CMS, which is tasked with running the bulk of the EHR subsidy program through Medicare and Medicaid.
In addition, CCHIT has to keep an eye on the Office of the National Coordinator for Health Information Technology at HHS, which, on behalf of the HHS secretary, will issue its own certification criteria for EHR systems, since, to qualify for subsidies under the stimulus law, providers also have to use “certified” EHR systems. Leavitt said CCHIT is forecasting ONC will issue its final rule on certification standards by Dec. 31 this year and that they probably will be the same or perhaps even less stringent than the recommendations the HIT Standards Committee made to ONC in August.
“We believe the final requirements will be the same as or less stringent that the current recommendations,” Leavitt said.
Both CCHIT testing and certification programs will open for vendor applications Oct. 7. Duration of certification is expected to run though Dec. 31, 2012, when certification criteria under the ARRA are expected to be ratcheted up, becoming both more numerous and more stringent.
Fees for certifying systems will vary with the certification scheme and the product, according to CCHIT Executive Director Alisa Ray. Under the CCHIT Certified 2011 program, the fee to a vendor to certify an EHR is $37,000 for either an ambulatory-care or an emergency department system, $49,000 for an inpatient system and $18,000 for an electronic prescribing system. Annual renewal costs are $9,000 for each, except e-prescribing, which is $7,000.
For Preliminary ARRA 2011 Certification, costs are pegged to the number of modules being tested, with fees set at $6,000 for one or two modules, $10,000 for three to five, $15,000 for six to 10, $24,000 for 11 to 20 and $33,000 for more than 20. Annual updates range from $1,000 to $5,000.
According to EHR vendor representative Justin Barnes, who listened in on Thursday’s CCHIT call, CCHIT probably has hit on the right strategy by launching its new testing and certification program this fall, based on an educated guess at what the government’s criteria might be, but before the final rules are published. Barnes is the chairman of the Electronic Health Record Association, and a vice president overseeing corporate development, marketing and government affairs for Greenway Medical Technologies, a Carrolton, Ga.-based EHR system developer.
“The detail that we have right now around meaningful use, you really can’t write a product to it,” Barnes said. “The interim final rule will come down at the end of this year. I think that will be a fairly close definition that we could follow. I think it will be plenty to work off of. The certification process, I believe, will be tweaked a little bit as well.”
Barnes said he hopes Leavitt is right when he predicts the ONC and the CMS will not vary too far from the current recommendations in writing the preliminary rules. He also said he hopes they don’t dally in unveiling their preliminary rules so everyone involved, both EHR vendors and users, have time enough to act.
“If there are any discrepancies, that could pose an interest to some people if you have to do heavy product development,” Barnes said. “It takes 12-plus months for the product cycle to add functionality on the ambulatory side and 18-plus months on the inpatient side. There is a word of caution here. That’s why we’ve urged ONC to move on this as fast as they can.”
Above article published on http://www.modernhealthcare.com/article/20090904/REG/309049989/0
September 01, 2009
By Ken Terry While the debate over “meaningful use” of electronic health records rages on, it has been easy to forget the other half of the requirement for getting government health IT subsidies: Physicians and hospitals must use “qualified” EHRs.
Since the passage of the HITECH Act, part of last spring’s stimulus package, there has been speculation that a qualified EHR would have to be certified by the Certification Commission for Health Information Technology (CCHIT), which so far has been the only game in town. But the Health IT Advisory Committee, which advises the Department of Health and Human Services on information technology matters, has decided that there should be multiple certification bodies. All of them would have to certify EHRs under criteria developed by HHS.
According to the work group that made the recommendations approved by the whole committee, CCHIT’s criteria for certification are too detailed and the organization is too close to the industry to be the only certifying entity. Other observers have pointed out that CCHIT is very close to the Healthcare Information and Management Systems Society (HIMSS), a trade association for health IT professionals that include many software vendors among its members. In addition, Mark Leavitt, MD, chair of CCHIT, used to be a HIMSS executive and, before that, led an EHR company. However, there is no evidence that CCHIT’s ties with HIMSS have influenced its approach to certification, which has been implemented by workgroups that include a wide range of industry professionals.
In any case, CCHIT plans to certify EHRs under the criteria that will be established by HHS. Meanwhile, the advisory committee has asked CCHIT to submit a proposal for developing a “Preliminary HHS Certification” process that would allow it to provide preliminary certification to EHR vendors so that providers can begin purchasing qualified products, perhaps as early as October. In addition, the committee approved a plan to grandfather in vendors that have 2008 CCHIT certification, with the proviso that they upgrade their products later.
In a signifier of what this debate is really about, the committee has approved the certification of “open-source” EHRs, which contain non-proprietary code that is available to anyone who wants to use it. The best-known example in the healthcare arena is the VA system’s Vista EHR, which has been available to software developers for a number of years. In addition, the comment about CCHIT’s criteria being too detailed suggests that the committee wants to use looser criteria under which less advanced (and less expensive) EHRs could qualify for government aid.
I applaud this decision on a couple of grounds: First, continuing to tighten criteria for “qualified” EHRs would help a dozen or so vendors consolidate their hold on the market as providers sought EHRs that could garner government aid. Second, physicians don’t need all of the bells and whistles in current EHRs to improve health care. Relaxing the criteria in certain respects would help the development of nontraditional community EHRs, including those linked to disease registries, that might serve the purpose better. But as HHS develops its criteria, it should bear in mind that the EHRs that are qualified for government subsidies must also help doctors demonstrate meaningful use.
Above article published on http://industry.bnet.com/healthcare/10001008/hhs-will-choose-criteria-for-ehr-certification/
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 |
|
