CCHIT proposes three certification paths June 18, 2009

* By John Moore
* Jun 17, 2009

The Certification Commission for Healthcare Information Technology has floated a proposal that would create more certification options for health IT firms and healthcare providers, including open-source developers.

The group’s proposal would create three certification paths: EHR Comprehensive (EHR-C), EHR Module (EHR-M) and EHR Site (EHR-S). EHR-C, which most closely resembles CCHIT’s current EHR certification effort, would provide what the organization termed a “rigorous certification of comprehensive EHR systems that significantly exceed minimum federal standards.”

EHR-M, meanwhile, would offer a more flexible certification option for vendors whose products might be more specialized than a comprehensive system. And EHR-S is geared toward providers who take a do-it-yourself approach to EHR and assemble systems from noncertified components.

“We obviously need to change,” said CCHIT chairman Dr. Mark Leavitt during a conference call June 16. “When you look at our work before [the American Recovery and Reinvestment Act] and after, it’s just dramatically different.”

Leavitt noted that ARRA casts EHR adoption into law, with incentives for deployment and penalties for waiting. The law provides those incentives to providers who demonstrate meaningful use of certified EHR systems. Currently, CCHIT is the only federally recognized certification entity, but ARRA states that the national coordinator may recognize more than one program.

Against the backdrop of ARRA, CCHIT needs a solution that satisfies “broader swaths” of the marketplace, Leavitt said.

Some of the impetus for change stems from the open-source community. Leavitt said feedback from a CCHIT-hosted forum in April showed open-source developers are concerned with the cost of certification. As for meeting all of CCHIT’s criteria, open-source developers run into licensing issues when they attempt to include certain code sets, Leavitt added.

Another issue is that although CCHIT certifies a specific version of a given software product, open-source software, by its nature, is frequently modified.

Leavitt said he anticipates that EHR-M might attract open-source developers. The certification track offers lower pricing compared with EHR-C, which the CCHIT proposal indicates will cost as much as $50,000. The proposal places EHR-M in the $5,000 to $35,000 range, depending on the scope of the module. CCHIT said scholarships might be available for nonprofit suppliers, if grants can be obtained.

In addition, open-source vendors would not be compelled to address the full spectrum of criteria required for EHR-C.

“EHR-M…is meant to be much more flexible,” Leavitt said.

In another shift, Leavitt said project forks splitting from certified open-source software will inherit certified status without the need for CCHIT approval. The same principal will apply to software certified under the EHR-S effort, he noted.

“We will make this change,” he said.

However, broader changes that would map CCHIT’s certification criteria to ARRA’s meaningful use language could take longer than anticipated.

Leavitt said it was “a bit of a surprise” when the Health IT Policy Committee tabled its meaningful use definitions in a meeting June 16.

He said he assumed the policy committee would accept the definitions at the June 16 meeting, at which the committee heard a presentation by its Meaningful Use Workgroup. The timetable for resolving the definition of meaningful use could affect the timing of CCHIT’s certification programs for the ARRA 2011-2012 incentive window, he suggested.

About the Author

John Moore is a freelance writer based in Syracuse, N.Y.