In a really thoughtful post on HISTalk, Dewey Howell MD, PhD, Founder, CEO Design Clinicals, Inc. wrote a n article called “The Real Problem with CCHIT Certification.” In it, Dr. Howell basically makes the case against CCHIT, because it doesn’t take into account all of the various specialized EHR which only need to do a few things really well. His example was an EMR for “ambulatory, inpatient, and emergency settings.”
These arguments remind me when near the beginning of the CCHIT certification process it included such things as growth charts. Sure, growth charts are essential to a pediatric EMR, but not so much so for other EMR companies. Luckily, the vetting process did remove this criteria and what CCHIT ended up with was much better than what they started to create. Unfortunately, it’s still an onerous process for a specialized EHR to be CCHIT certified.
Dr. Howell also provides this really interesting insight:
Another deficiency of the current certification process is the lack of requirement for certification of results or outcomes. How do we certify and validate that the system actually delivers the outcomes that we are trying to achieve? The current process encourages vendors to throw a button or screen into their application that produces a specific action or display. But, there is no accountability to the patient and quality of care delivered with the tool. It encourages technology for technology’s sake, presuming that outcomes will be “better” just because a product is certified, instead of really validating results. Maybe this is a much tougher nut to crack, but it is considerably more important than things like, “The system shall provide the ability to allow users to search for order sets by name.”
I like how he described the need to measure results or outcomes. We’ve often mentioned on this blog CCHIT’s biggest problem is actually measuring usability, but results and outcomes are another way to look at the challenge of certification.