Monday, June 22, 2009

CCHIT To Provide 3 Certification Options

On June 18, the Certification Commission for Health Information Technology (CCHIT) announced that it is extending its certification options in response to concerns from open source developers and in an effort to better position itself to vie for appointment as the certification agency required under the HITECH provisions of the American Recovery and Reinvestment Act (ARRA).

The three options include:

  • "A rigorous certification for comprehensive EHR systems that significantly exceed minimum Federal standards requirements. This certification (EHR-C) would be targeted to the needs of providers who want maximal assurance of EHR capabilities and compliance
  • A new, modular certification program for electronic prescribing, personal health records, registries, and other technologies. Focusing on basic compliance with Federal standards and security, the EHR-M program would be offered at lower cost, and could accommodate a wide variety of specialties, settings, and technologies. It would appeal to providers who prefer to combine technologies from multiple certified sources.
  • A simplified, low cost site-level certification. This program would enable providers who self-develop or assemble EHRs from noncertified sources to also qualify for the ARRA incentives."

These certification options are targeted to be available for 2011-2012 certifications which kick off in January 2010.

CCHIT has been criticized for too close a relationship to Health IT vendors, led most visibly by David Kibbe and Brian Klepper, who have asked "If the HITECH monies are spent on CCHIT certified EHRs that can't do any of these patient-centered tasks, or EHRs that don't come equipped with the features and functions to extend health IT capability to the patients and consumers, do we really think that the money will have been spent wisely? But that's the pathway we seem headed down, led by the vendors." Mark Leavitt, Chair of CCHIT, has responded forcefully to this criticism.

CCHIT's announcement addresses the concern that certification was previously only available to vendors able to deliver monolithic solutions covering all EHR requirements.


David Kibbe MD MBA and Brian Klepper PhD said...

Thanks for the mention. While CCHIT's new certification options do broaden their umbrella - e.g., offering a modular EHR option shows that CCHIT is at least listening to the market - those actions have almost certainly been taken to mollify the increasingly agitated Health IT community that continues to see CCHIT as a governmental agency shaped by legacy vendors for their own interests. After all, tens of billions of dollars in federal subsidies are at stake. Until now, CCHIT has narrowly defined the eligibility criteria for those dollars, in ways that presumably have favored HIMSS members and have eliminated from contention newer players.

You provide little background on why Dr. Kibbe and I have been critical of CCHIT. The record shows that CCHIT was established by HIMSS. It's Executive Director, Mark Leavitt, was a HIMSS executive and, as Robert O'Harrow reported in the Washington Post recently, was paid directly by HIMSS until late 2008. HIMSS President and CEO, Stephen Lieber, is Chair of CCHIT's Board of Trustees. Can any reasonable person argue that these linkages do not constitute an overwhelming conflict of interest? As it is currently constituted, CCHIT should be disqualified from serving in its certification capacity. There is little question that the interests of health IT vendors and those of the nation are different.

Finally, while Dr. Leavitt may have "snapped back" on The Health Care Blog - the most widely read health care expert forum - the comments in response to his post took uniform umbrage to his comments. His column - described as a "drive-by post" by one health IT blogger - was criticized for its unsubstantiated allegations. Nor did he return to the Health Care Blog to answer any of the responses his post elicited.

Brian Klepper, PhD
904.425.1698o, 904.343.2921c

CCHIT Certification said...

Well that's good. But IMO, it would be more productive if there was only one universal EHR. Why can't the CCHIT oversee that?