More Practical CCHIT Information

After my original posting about CCHIT and pediatricians, I heard from a number of folks off-line. I had the beginning of an excellent conversation of someone associated with the AAP’s effort to promote pediatric-specific features within the CCHIT process, but vacations, snow days, and fire alarms intervened. I hope to get back to that conversation so we can hear the AAP’s side of the story.
One interesting piece I received is from softwareadvice.com. I will copy their message to me with my comments in red. Even though they are a service that directs you to a number of our competitors, I think their brief summary of the CCHIT certification pros and cons is good. Read this and the accompanying article. Please note: my comments are not aimed at the messenger, as their review of the facts is quite correct. It just gives me a good chance to get out the soapbox.

As you may already know, the debate on CCHIT certification is intense and physicians are trying to determine what role the certification should play in their EHR selection. We recently wrote a fair and balanced article on
the topic that we wanted to present to you: http://www.softwareadvice.com/articles/medical/should-cchit-influence-your-ehr-selection/

Here are five of the key takeaways from our analysis:
* CCHIT has developed an important set of criteria for functionality, interoperability and security that can help physicians better understand what an EMR can deliver. These criteria could help consolidate the EHR market, which some argue is over-populated with software products.
Unfortunately, even if this were true (they really don’t have the interoperability piece down yet, do they?), it still leaves many, many important issues open unresolved and the vendors, in particular, are deliberately clouding the issue. You’ll see my comments below.
* CCHIT is binary in nature. While it specifies 250+ qualification criteria, not every physician will need all of those capabilities. So, physicians seeking a low-cost or “lightweight” EHR should understand why the products they like may not be CCHIT certified (i.e. the product did not have every one of the 250+ criteria, even if it had
most of them).
I agree, but I’d like to expand this definition: it’s not just the low-cost and “lightweight” EHRs that lack CCHIT certification. Look at Office Practicum in the pediatric market (from a pediatric perspective, perhaps the most heavy-weight of them). Further, the term “lightweight” implies that there are features or services missing from the product that might be important – not so. In particular – and this is where the confusion reigns – many of the “lightweight” vendors have support that runs circles around certified vendors. Still, they make an important point.
* CCHIT may have an impact on the reimbursements physicians receive. Being the only federally recognized certification body for EHRs, CCHIT can improve a physician’s ability to participate in payment incentive programs from the Centers for Medicare & Medicaid Services (CMS) and other payers.
May?! PCC clients in any number of locales already face constant pressure to use an EHR – never suited to pediatrics, of course – or face financial consequences. Their list of choices would almost always force them to stop using PCC, which they don’t want to do, so they are stuck. Ultimately, the federal push to ram CCHIT down the throats of the physicians acts specifically as a barrier to businesses such as ours.

The irony of this is that PCC has yet to see a P4P program that Partner (our billing system) can’t provide the data to in a fashion often better than most EHRs. I specifically did work for an unnamed HMO in an unnamed-New England state, for example, where I went through their P4P measurements (all of which are modeled after the CMS measurements). I pointed out that we could provide the measurements, tomorrow, for any PCC customer in the state without having to change our billing software. Free. No cost. Don’t have to change a thing.
“But you’re not a CCHIT certified EHR.” So even though we have the data, even though it would be free, the HMO isn’t interested. Instead, the HMO will force all the providers in the state onto one from a short list of CCHIT certified EHRs…none of which is even remotely suspected to be appropriate for pediatrics. [BTW, I’m not talking about Partners in MA, as their article references – we have plenty of clients dealing with that challenge.]
* An important element of EHR selection is the product’s ability to support specialties with unique EHR requirements. CCHIT does not analyze specialty-specific EHR requirements at this time, but intends to start this year, beginning with a focus on cardiology and pediatrics.
I agree, but I can’t wait to see what the pediatric criteria are. I know some of the folks who are part of that process (fortunately, they are practicing physicians).
* CCHIT doesn’t evaluate all criteria a physician should consider when selecting an EHR. For example, it doesn’t evaluate ease-of-use, customer support or the financial viability of the company offering the EHR software. CCHIT makes this clear in their 2007 Physician’s Guide.
CCHIT can make this clear all day long, but it doesn’t matter. The vendors, in particular, are glossing over this INCREDIBLY IMPORTANT PIECE OF INFORMATION. And, with the MCOs and states making CCHIT the single barrier-of-entry for their approved vendor list, this lack of understanding doesn’t even matter. They’ve hit the nail on the head, here, but not enough people are getting this message.

Thanks to the folks from Software Advice, I appreciate their effort to get this word out. I hope they don’t mind my markup too much…

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