There was a recent Town Hall meeting with Mark Leavitt from Certification Commission for Healthcare Information Technology – CCHIT. CCHIT is currently taking a lot of heat for a new certification they are implementing to try and certify an EMR system. While I think the idea of helping doctors have an idea of the quality of an EMR system and which EMR providers have met a certain standard, CCHIT certification doesn’t seem to be the right way. I like the idea that they are looking at costs and making sure that they charge enough to keep the certification lasting. However, the costs are not reasonable for many of the mid range EMR providers to handle. Since CCHIT is heavily backed by the government I don’t think that it’s going to go anywhere for a while, but I’m not sure there are any easy solutions to this problem. Here’s some really interesting comments about the pricing structure discussed at the town hall meeting and were posted to EMRUpdate:
To put it bluntly, we are looking at a MINIMUM fee of $28,000 a year. We currently have a new release every 3 months, so technically, our fee could be MUCH higher. We could, of course, cut our own throats by restricting new releases to once a year and lose our pricing and customer service advantages.
The argument is that this certification is Optional and we dont have to do it. And then the rep from the MGMA gets up and says that they are recommending that their members only buy CCHIT certified EMRs and so does the AAFP, AMA etc. So how optional is it going to be? I dont buy that argument at all.
One of our fellow EMRUpdate members at the meeting did mention the discussions here and essentially the response was blogs never hurt me, so blog away!
I am seriously convinced that the alternative certification option is looking more and more attractive. How many of the small vendors on this board want to pay a minimum of $28000 a year? The MGMA rep was essentially quoting a per doctor EMR cost of $33,000 and so this is less than one sale. How many of us charge less than a fraction of that per doctor? This certification pricing model is seriously flawed. If we used a model like this, our customers would leave a vapor trail out of our offices.
So bottom line? We could toe the CCHIT line and raise prices, cut innovation and eventually go out of business as all our competitive advantages will have evaporated. Or vigorously back an alternative standard. I think I know where I would like to be. All you thoughts and comments are welcome.
That doesn’t sound too good. They described the reason for the charges in this manner:
$28,000 up front to start the review process. 3 reviewers (1 doc and 1 security tech will be on each team) shall conduct the review for 8 hours. If the review takes longer than 8 hours, then the vendor will be charged for the extra. For the 8 hours, the Doc will be paid $1200 – $1600 and about $1200 each for the other 2 reviewers out of the $28,000 collected.
The real question I have is how do I get on that review board. That’s a lot of money to be reviewing an EMR system. Maybe I should created the EMR and HIPAA review board and charge them half the price. I’d be more than happy to review an EMR provider for $14,000 using the same criteria that CCHIT has already published. I wouldn’t even need $14,000 each year to renew it. After having seen it the year before it shouldn’t cost nearly as much to certify it again. I think it should also contain some component of actual user base information. You could spot check to make sure that the user base isn’t being tainted by the EMR provider, but if the user base says certain components haven’t changed over time then why should you check it again?
It looks like some of the Health IT media has picked up on the CCHIT meeting also. Neil Versel – the Healthcare IT Blogger wrote an article on this CCHIT meeting in Health IT World. Since I think the cost of the certification is one of its main problems, here’s an excerpt from the article:
Certification testing for 2006 costs $28,000, regardless of the size of the vendor seeking approval. Of that, $23,200 goes to the actual testing process and $4,800 is the annual fee to maintain certification. Vendors may use a certification for up to three years as long as they pay the annual maintenance fee, though they may choose to re-test annually to get a current-year certification stamp.
The cost and the renewal process were key targets of vendor ire. Several vendors promised that they will raise their prices if they have to pay the $28,000 testing fee. They also worried about spending money for a full re-testing next year so as not to appear that their products were out of date with a 2006 sticker in 2007.
Leavitt tried to assuage concerns by saying that certification will help business. If you dont see an acceleration in the [EHR] market, then weve failed, he said.
I agree wholeheartedly that the $28,000 plus annual fees plus recertifications will raise prices for EMR providers which will get passed on to the doctors. More importantly, I believe that this large of a fee and the requirement for recertification with every major release will stifle innovation which sounds just like where many clinics are today. Lack of innovation would be the worst thing that could happen to EMR.