Should CCHIT Influence Your EHR Selection?
The CCHIT is becoming increasingly relevant as the Department of Health and Human Services develops guidelines for what constitutes a “qualified EMR.” To be eligible for EMR subsidies outlined in the Stimulus Bill, healthcare providers must demonstrate use of a “qualified EMR” in a “meaningful manner” (for more information, read The Stimulus Bill and Meaningful Use of Qualified EHRs / EMRs).
The Certification Commission for Healthcare Information Technology (CCHIT®) has gained substantial momentum since the organization’s founding in 2004. As a result, buyers of electronic health records (EHRs) – or electronic medical records (EMRs), as they are also known – often ask me what role CCHIT certification should play in their purchase decision. The answer is not always simple, so I decided to explain what CCHIT is, what it is not, and why some participants have passionate views for or against it.
What is CCHIT?
CCHIT is a private, non-profit organization formed to certify EHRs against a minimum set of requirements for functionality, interoperability and security. It was founded in 2004 by three industry associations( HIMSS, AHIMA and the Alliance). It was subsequently funded further by the California Healthcare Foundation and a group of payers (e.g. United HealthGroup), providers (e.g. HCA) and software vendors (e.g. McKesson). In 2005, CCHIT was granted a $2.7 million contract by the Department of Health and Human Services (HHS) to support its mission. A number of other medical associations have since supported CCHIT. Despite the HHS contract, CCHIT is not an extension of the federal government.
As of March 2009, Eighty-some ambulatory EHRs received certification against the 2006 CCHIT criteria, sixteen EHRs received certification against the more rigorous 2007 criteria and twenty have achieved CCHIT certification for the 2008 Ambulatory EHR criteria. We estimate this equates to roughly 30% of all ambulatory EHRs being certified, while additional EHR vendors are currently pursuing certification for their systems.
Visit this page for a list of CCHIT certified EMRs / EHRs.
What are the benefits of CCHIT?
CCHIT is performing an important role in defining EHR functionality and promoting standards for EHR interoperability and security. While most healthcare participants agree that moving medical records to an electronic format is important, there is little consensus on what should constitute an EHR and how those systems should securely share data. The problem is complicated by the large number of EHR products (~300), an unending barrage of marketing claims and the unfortunate reality that many EHR implementations fail.
CCHIT has taken on the task of defining the key functional components of an EHR, how it should communicate with other systems and how it should protect patient information. The CCHIT criteria consist of a list of detailed product capabilities against which EHRs are evaluated. At the very least, CCHIT has created a functional requirements checklist for EHR buyers. Adopted in full, CCHIT has provided buyers with a list of EHRs that meet every one of these requirements.
Why does CCHIT generate some controversy?
As CCHIT gains momentum, many EHR buyers are using its certification as a filtering mechanism for which EHR products to include in their selection process. Moreover, many payers, associations and healthcare information exchanges (HIEs) are also mandating CCHIT certification in various ways. This, of course, is CCHIT’s intended role. Software vendors that are CCHIT Certified® like this trend because it is more likely their products will be included in those purchase decisions. Non-certified vendors hate it because it eliminates them from those opportunities, even if their product could have been a good fit for the provider. The most intense detractors have labeled the organization an anti-competitive “cartel” that forces small vendors out of the market. We don’t support the cartel allegation, but we also don’t downplay the impact that CCHIT is having on the EHR competitive environment. Both supporters and detractors of CCHIT make logical arguments as to what role CCHIT certification should play in EHR selection processes.