The Tech Doctor: The Fed’s Seal of Approval

Imagine you are a physician in solo practice and you have made the intellectual and economic decision to proceed with purchasing an EMR. As you begin your shopping process, questions you hadn’t before considered begin to emerge.

How do you start narrowing down your list of potential vendors? At my last count, more than 250 companies were claiming to sell EMRs.

And after you’ve narrowed down that list, how do know your vendor will have the features you need both now and in the future to operate in an increasingly interconnected healthcare system?

Enter CCHIT.

CCHIT stands for the Certification Commission for Healthcare Information Technology. The primary objective of the commission is to certify EMR products. In essence, CCHIT puts a “Good Housekeeping” seal of approval on EMR products that have been tested by the commission and meet a detailed list of feature requirements. CCHIT tests encompass how well the product works, how well it communicates with other computer systems, and even whether the product’s vendors meet certain standard policies and procedures.

The basic idea is to make it easier for practices to buy an EMR with confidence that the vendor they selected has met a series of standards defined and verified by an independent, expert third party with no commercial ties or affiliations.

This all sounds good, but what’s in it for CCHIT, and exactly what is CCHIT?

CCHIT’s mandate

CCHIT is a nonprofit organization that currently has a three-year, $7.5 million contract with the Department of Health & Human Services to “accelerate the adoption of robust, interoperable HIT throughout the U.S. healthcare system, by creating an efficient, credible, sustainable mechanism for the certification of HIT products.” It’s worth a moment to analyze some of these buzzwords to determine what they really mean:

• “Accelerate the adoption” - allowing more practices to purchase EMR products (because CCHIT is making it easier);

• “Robust” - establishing a functionality standard that defines the specific features one should expect in an EMR;

• “Interoperable” - meaning an EMR from Company X can electronically communicate with an EMR from Company Y, since both are using defined standards for communication; and

• “Certification” - giving a third-party seal of approval to the product.

CCHIT believes that practices will look to a nonpartisan organization that follows a predefined testing protocol to help verify that a given product either meets or does not meet acceptable quality control standards regarding EMRs.

So, in summary, CCHIT (and the government, which is footing the bill) want more people to buy EMRs. But not just any EMRs; only those that meet specific levels of capability.

Part of the reason for establishing this minimum standard is to protect consumers by helping ensure they select fully featured and capable systems. However, this standard also helps advance the legitimate public policy goal of an EMR-based, interconnected healthcare system in which all primary players are empowered with the proper tools to make meaningful improvements in both the quality and efficiency of healthcare services. In other words, EMR Utopia.

A hefty task

The scope of CCHIT encompasses a huge chunk of healthcare IT: outpatient and inpatient EMRs and the network components that connect different systems. Hence, CCHIT has obtained a three-year grant with the first year focused on ambulatory EMRs, the second year on inpatient EMRs, and the final year (which ends September 2008) on the interoperability among EMR systems.

Equally ambitious is the scope of effort CCHIT is undertaking to certify all aspects of EMRs. Besides functionality - that is, the features within an EMR system - CCHIT hopes to certify EMR security functions (to ensure they are HIPAA compliant), the reliability of EMR systems, and their ability to easily communicate with one another (which will likely mean that vendors will have to adhere to national standards). CCHIT will create separate certification protocols for this functionality, security, and reliability. Currently, for ambulatory EMRs, the focus is on functionality.

What’s in it for you?

How does this certification process work? In principle it’s quite simple: Vendors voluntarily submit their products (for a fee), they are evaluated against a functionality script, and certification is either received or denied.

What does all this mean for you? Well, if you haven’t purchased an EMR yet, CCHIT can help you narrow your field of potential vendors. Additionally, it should give you greater confidence in the technical prowess of the company you ultimately select (assuming that it has been certified).

If you already have an EMR or are about sign a contract to purchase one, ask your vendor if it is planning to have its product certified by CCHIT. Because this undertaking is very new, only a small number of vendors will have earned certification. (As of press time, CCHIT was scheduled to begin receiving applications from vendors for certification in April 2006 and complete its first round of certifications by June 2006.)

You can also review CCHIT’s functionality standards posted on its Web site (www.cchit.org) with your vendor to see how closely it complies.

Bruce Kleaveland is president of Kleaveland Consulting, a management consulting firm focused on healthcare IT. Prior to forming Kleaveland Consulting, he was chief operating officer at a leading EMR company. He can be reached at 206 527 6633, bkleaveland@msn.com, or via editor@physicianspractice.com.

This article originally appeared in the June 2006 issue of Physicians Practice.