CCHIT going on almost as if nothing happened

CCHIT going on almost as if nothing happened

Summary: Will hospital administrators and practice managers insist on the comprehensive CCHIT-approved label, or will they accept any solution that brings them that sweet, sweet stimulus cash?


One of the big controversies early this year was over the role CCHIT was playing, certifying vendors to sell Electronic Health Record (EHR) software.

CCHIT (Certification Commission for Health Information Technology) was formed in 2004 out of HIMSS (Healthcare Information and Management Systems Society), an industry group, and began certifying EHR systems in 2006. Until this year you entered the EHR market by first undergoing CCHIT certification.

Was their approach right, or was it too rigid? Was it really helping buyers, or just pointing them toward expensive solutions from members of the HIMSS industry group?

When we last left the story the good guys seemed to have won. The standards under which software will be approved for stimulus cash are functional, requiring meaningful use. They're not programmatic. It's not what the software does, but whether it's used, and for what, that counts.

So what happened to CCHIT? They're going along pretty much as before.

In an extended interview with Healthcare Informatics, CCHIT head Mark Leavitt (above) said the group has added a new Preliminary ARRA 2011 Certification to its suite of products.

"It doesn't really matter" what the National Coordinator of Health IT, David Blumenthal, or his policy committee come up with, Leavitt told Anthony Guerra.  CCHIT's "Get Certified" seminar in October drew an overflow crowd.

Blumenthal's policy committee called its government standard "HHS certification." Leavitt called the same set of criteria "Preliminary ARRA Certification" because the Department of Health and Human Services (HHS) may give it yet-another name, and because the rules on all this don't go out until next month in any case.

Even after that there will be time for CCHIT and others to comment, and for those comments to be digested, before they are final. Then certifying authorities must be appointed, and CCHIT has applied to be one. Meanwhile hospitals and doctors are having to make decisions that may haunt them through their professional lifetimes.

In his interview, Leavitt called the ARRA rules "basic" and his own rules "comprehensive," but in fact one is the government standard and the other CCHIT's private one.

What has happened is that CCHIT has been forced to take a step back, from being the gatekeeper of market entry to being one of perhaps several groups looking to be certification authorities under the new rules.

This is not Leavitt's spin on the matter:

We’ve heard from provider groups, we’ve heard from the specialties that the marketplace was not making adequate progress in making the products they needed with all the features they needed.

There’s more than just federal standards, there are other requirements they have as providers, such as supporting workflows and maintaining a legally adequate record. They really thought CCHIT was a way to have a community conversation and move the entire marketplace forward.

We're not a gatekeeper. We're a community conversation. The CCHIT "comprehensive" standards aren't for the  "sophisticated CIO," in Leavitt's words, but for small hospitals, for small practices, the people who need help in making an informed choice.

Maybe, but these same customers also have the most constrained budgets, and fairly basic needs. Do they need something a private industry group has deemed meets "comprehensive" standards or not?

That is a question the market will have to decide. Will hospital administrators and practice managers insist on the comprehensive CCHIT-approved label, or will they accept any solution that brings them that sweet, sweet stimulus cash?

Topics: Government US, CXO, Enterprise Software, Government, Health, IT Employment

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  • CCHIT Happens

    Thats it.
  • Republicans up to no good again.

    Another buck for doing nothing.
    • This story contained no politics

      You can attack the industry group HIMSS, which helped create CCHIT, or CCHIT, or big buyers who expect some high-level certification before pulling the trigger on a big purchase.

      But I put no politics here.
  • We bought a package that was CCHIT certified, one of our requirements.

    We had plenty of other requirements for an EHR, but they wanted to make sure it was certified by someone else just incase the goverment came up with a standards requirement.

    We figured, if they were certified(as most EHR's were doing), we wouldnt have an issue when the feds came out with their requirements, mainly because they tend to follow industry standards for the most part.

    Obviously we made part of our contract require that they remain CCHIT certified. We also forced them to adhere to any new federal requirements that came down the pipe. Again, no one saw this as an issue because they would most likely use the industry standard for their base requirements.

    I hope this helps clear things up. We firmly believe the feds will follow CCHIT for atleast the base requirements. It seems many others believe the same.

    As for their membership, sometimes you just have to have industry people on the panel. I dont think its an exclusive group though. Healthcare folks like to make money, but they also like making things easier for themselves. CCHITs ensures compatibility with most other systems if an interface is required.
    • Thanks for the note

      My problem with CCHIT is at the bottom of your finely-written note "CCHITs ensures compatibility."

      That's the problem. It doesn't. It only shows that they have the capability of doing whatever, not that they have compatibility with any other vendor. Including equipment vendors.

      As you know, equipment often drives the decision on an EHR. It's the peripherals tail wagging the EHR dog.
    • base requirements

      "We firmly believe the feds will follow CCHIT for at least the base requirements."

      No problems with that. It's just that far more is needed to ensure HIT efficacy, safety, reasonable user centered design, etc.

      And perhaps a terminology change from "certified" to "features qualified" unless rigorous in-field testing has been done.

      -- SS
  • Competition Is Good, Might Not Help in Short Term

    The decision by HHS to open up the EHR certification business to competition is in principle a good one. Despite still being the only game in town, CCHIT has been adjusting to the prospect of competition, of which it now has its first example in the Drummond Group.

    New CCHIT moves to certify systems that have been cobbled together from in-house efforts and/or multiple vendors and to permit smaller HIT companies to certify individual modules rather than full-scale EHRs are welcome and only reflect the reality of what's being used in the marketplace. CCHIT's latter move is particularly welcome to small makers of web-based services, which are currently accounting for much of the promising innovation in HIT and of which my company, Lime Medical, is one.

    On the downside, the decision to create certification competition is in the short term simply adding to the uncertainty (and anxiety) surrounding meaningful use, the mechanics of ARRA reimbursement and healthcare reform generally that is keeping many physicians and healthcare organizations on the HIT sidelines. This is aside from the general air of skepticism with which many physicians greet the topic of EHRs, an attitude typically formed from first-hand experience.

    This uncertainty will no doubt subside over the longer term, and if the various HHS committees charged with defining standards and meaningful use do their jobs well enough, the abysmal EHR adoption rates we've got now should begin to improve. The rest of it will be up to us, the technologists developing products and services for physicians.

    John Bader
    Lime Medical
    John Bader
  • RE: CCHIT going on almost as if nothing happened

    Dana, if you haven't seen it yet, check the <a href="">stunned analysis</a> by the uber-knowledgeable Vince Kuraitis about the big shift this week.

    (Hey, am I missing something, or is there no checkbox here to be notified of further comments?? Why not?)
    e-Patient Dave