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.
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.
"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?