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ADVANCE Perspective: HIM

CCHIT Opens Up

Published June 17, 2009 10:47 AM by Cheryl McEvoy

During an online "Town Call" yesterday, the Certification Commission for Healthcare Information Technology (CCHIT) revealed its new strategy for certifying EHRs that meet "meaningful use" requirements under the stimulus act. Speaking to open source developers and vendors (though about half the audience admitted to being outside the open source community), Mark Leavitt, MD, PhD, chairman of CCHIT, outlined changes that will make it easier for open source vendors to earn certification--and for providers to cash in on incentives.

The Webcast couldn't have come at a better time for me. I just wrapped my print and Web articles on open source software, and I was curious to see what would come of certification issues. While researching open source technology, I repeatedly came across blogs and forums lamenting CCHIT's narrow focus on big name vendors. The certification process, they said, stifles innovation.

But lo and behold, just a few days before my article went to press, a press release announcing the Town Call snaked its way through spam filters and plopped into my inbox. Would these new "certification paths" be any better?

Here's the gist: instead of one path to certification, CCHIT plans to offer three forms of approval. EHR-C (for comprehensive) will be like the current certification process, a comprehensive review of features and functions that gives providers "maximal assurance" a vendor's EHR will work, according to Dr. Leavitt. EHR-M (for module) will certify vendor products using "meaningful use" definitions as a checklist. An e-prescribing module, for example, meets this, this and this, but doesn't meet that or that. EHR-S (for site) lets individual providers get certified for homegrown EHR systems. Basically, CCHIT is checking the system - which is already in use by the provider - actually does what it should.

Each path has its perks and setbacks. EHR-C pretty much guarantees (in theory) the EHR system will go above and beyond federal standards, but it also carries the whopping $30,000-$50,000 price tag vendors are used to seeing. EHR-M lets products that don't necessarily meet all requirements get approved for the ones they do. It can mean smaller dent in the wallet, too, ranging from $5,000-$35,000. EHR-S is site-specific, so the product can't claim certification if another provider wants to deploy it, but certification can be had for the bargain price of $150-$300.

The real boon for open sourcers (or should it be "sorcerers"?), though, is the end to "version lockdown." In other words, once a product gets certified, it doesn't have to get recertified with each new development. The theory, Dr. Leavitt said, is that any elements needed to earn certification won't be removed in upgraded versions.

I haven't heard an official response from the open source community, but if anything, I'd say the new paths are an improvement. Open source developers may still struggle to pay for EHR-C certification, but at least they can certify a few modules at a cheaper price. Worst comes to worst, individual open source users can get EHR-S certified. Then again, saying "Hey, all these hospitals that got EHR-S certified? They're using our product!" isn't quite the same as boasting an EHR-C seal of approval.

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