What is CCHIT Certification?EHR/ EMR platform or system with an efficient process for certification. (EMR / EHR / Electronic Medical Records / Electronic Health Records are used synonymously in this article).CCHIT – Expanding Its’ Purpose
- Ensure that EMR products protect the highest level of privacy of personal health information
- Develop bona-fide incentives enhancing the development, availability, and adoption of EHR software and hardware solutions by Physicians
- Facilitate interoperability of EMR products with the emerging national health information network, also referred to as RHIO’s
The EHR CCHIT Certification Criteria
In 2004 the key certification criteria included EHR products that were designed for use in Physician offices and today these are referred to as Ambulatory EHR.
- Increased electronic prescribing features including better access to a patients’ medication history, formulary, and eligibility
- Improved and safer medication dosing adjusted for a patients’ weight, age, gender, and other related physiological factors
- Greater prevention of adverse reactions caused by drug interactions or allergies
- Implementation of standardized formats and platforms for exchanging fundamental patient information including medical history, current diagnosis and treatment, and other patient demographics for continuity of safe and high quality patient care.
- Enhanced ability to send, receive, and review X-rays, Scans, and other diagnostics imaging
- More accurate, protected, and better management of patient consents and authorizations
- Increased use of standardized formats and platforms receiving, storing, and sharing laboratory and diagnostic results
Does CCHIT Certification increase the cost of EMR to Physicians?How many vendors make the CCHIT certification grade?
- Only 92 EHRs have received certification under the 2006 Ambulatory EHR criteria which were not officially certified until April 30, 2007
- Only 55 EHRs have been have been certified under the official 2007 certification criteria of which, many are simply multiple updated versions of the same product by the save vendor
- A mere 15 EMRs have been certified under the official 2008 criteria of which a number of those are previously certified products that added-on certifications for Child Health and Cardiovascular Medicine
Compare these numbers against the 300+ prominent and 100s of other less active EHRs in the market, one could reasonably infer that there are many smaller players that may offer very innovative and cost-effective solutions but may not have the time nor financial resources to expend on certification let alone, the doubling of costs for recertification every time they make significant changes. This then begs the question, could formal certification actually be creating an unfair playing field and even barring smaller or newer competitors whom otherwise, may be pioneering the “next big thing” from entering the marketplace and ultimately lead to limiting the choices and higher prices to Physicians and Hospitals?
If this is the destined result of CCHIT certification for Physicians, there may be some financial relief in sight. The current Administrations’ Economic Stimulus Package recently received legislative endorsement and was signed into law by President Obama on February 17, 2009. Included in this package is a very specific piece that clearly demonstrates the Presidents goal of having a Personal Health Record for every American within the next 5 years. To achieve this end, $19 billion is earmarked for Healthcare Industry Technology advancement. At face value, utilizing the omni giant Medicare system as the vehicle of distribution, a portion of these funds are to be used as bonus payment incentives to encourage Physicians and Hospitals to make the transition to EHR and other technologies, sooner than later. The Office of National Coordinator for Health Information Technology (ONCHIT) is charged with developing and implementing financial incentive programs for qualifying Physicians and Hospitals who can expressly exhibit and document the “meaningful” use of certified EHRs and meet performance-reporting guidelines.What does CCHIT certification really net to Physicians?Sometimes too much of a good thing is just that, too much
The following is a list of critical questions and steps a Physician or Hospital should initially consider in their EHR selection process:
- Is the Electronic Medical Record or Electronic Health Record vendor solution CCHIT certified? If yes, then ask to which years’ standard and then to prove it. If the answer is no, then ask them if their solution meets the latest certification standards or if they going to become CCHIT certified, and to prove it.
- Does their EHR / EMR solution support all of the requirements of the Physicians specialty? This is especially important because CCHIT acknowledges that its’ criteria may not meet the needs of all specialties such as Behavioral Health, Emergency Specialists and Departments, and many other specialty Practices)
- Does it allow the Practice or Hospital to share information electronically with other Physicians, Hospitals, Pharmacies, Laboratories, Radiology Centers, and other related medical service providers? (the basic requirement of any compatible system in these regards, must have an HL7 Interface both inbound and outbound with the ability to interoperate with other systems)
- Does it enable Physicians or Hospitals to measure and report critical Quality Indicators as required to be eligible for the impending Federally supplemented, bonus payment incentives? (based upon the “meaningful use” of Healthcare Information Technology and Levels of Performance that were signed into law by President Obama on February 17, 2009)
- Can the vendor demonstrate a proven track record of providing outstanding customer support before and after the sale?
- Are references from similar type, specialties, and size Practices and Hospitals available, preferably within nearby proximity, who can provide independent opinions about the vendors product and their experiences working with them in terms of need assessment, planning, implementation, function, and on-going support?
- Does the vendors’ solution effectively monitor and Flag potential adverse drug reactions and interactions?
- If you are currently using a Practice Management or Billing software, does the vendors’ EMR have its’ own stand-alone interface that seamlessly integrates with your PM or Billing software or, will you be required to purchase an additional third party software to interface with your system as well as, be able to share a common database through their EHR product? (either way, ask them to prove it)
- If you are updating, replacing, or a first time user of a PM or Billing software and introducing EMR to your Practice, Group Clinic, or Hospital, does the vendor have its’ own single-source and fully integrated PM and EHR which does not require purchasing any third party interfacing software? If yes and as needed can their solution be phased-in over a period of time, to better fit within any budgetary concerns and for cases where key Staff and Provider adoption and learning curve experience may be an issue in order increase utilization efficiency and contribute to a quicker ROI?
- Over the course of the next 3 to 5 to 7 years as Practices and Hospitals needs change with growth, advancements in technology, or as Federal Regulations, Mandates, or political or economic climates may change, can the vendor or their existing solution meet or adapt to these new challenges and provide on-going support, upgrades, or new solutions, and Medical Business Insight
The majority of these questions are primarily foundational and functional in nature while there is another pressing list of non-functional requirements that require equally important attention in the Electronic Medical Records selection process. An essential non-functional aspect of every Medical Practice and Hospital they share in common are their Human Resources (key staff and provider opinion leaders, their commitment, adoption attitude, and ability to deal with change). The other areas of non-functional value needing consideration include Capital Investment (start-up cost, hardware, annual maintenance, and IT costs, ROI) and, the Organization Structure (owners, stakeholders, decision makers, and key management leaders)
While all this can be an overwhelming task that few have the time to do, there is light at the end of this Healthcare Information Technology tunnel in that Physicians and Hospitals do have an option for help that can also ensure eligibility for the various bonus payment incentives designed to encourage a speedy transition to EHR. There is an emerging selection of qualified Independent EMR / EHR and PM consulting firms who will do all the cumbersome and costly up-front legwork for you while navigating you through the stormy ocean of choices. In fact, there are well established companies that will perform these initial services and at no cost to Physicians or Hospitals. It follows then, that it would be wise before you buy, to do some homework and seek-out a reputable Independent EHR Consulting company that can save you thousands of dollars right up-front, thus steering clear from companies charging hefty up-front fees and then followed by expensive per hour consulting billing hours, which may range from $125 to $200 per hour, plus expenses.
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