CCHIT and Open Source HIMSS Meeting – Audio and Powerpoint Slides

I’ve been meaning to post about the CCHIT and open source meeting at HIMSS for a while now and just haven’t ever gotten around to it. I did post my twitter thoughts on the CCHIT/Foss meeting, but I think there’s plenty more that could be said about that meeting.

For those of you that missed it, you can find the audio of the meeting on the CCHIT website and I’ll embed the powerpoint presentation from the meeting below:

My biggest complaint from the meeting was a slide that Mark Leavitt used to describe why he feels that CCHIT isn’t excluding the little guy. Basically it talks about the size and market share of the EHR vendors that have applied for CCHIT certification (you can see it as slide 12 above).

I can’t quite place why this measure feels wrong, but it does. Maybe it goes back to something one of my professors taught me when doing research analysis. He basically said, that when first looking at the numbers does it feel right. Considering what I know about the EHR and EMR market and CCHIT certification in particular, I know that something doesn’t feel right. Let me explain a few reasons and hopefully someone else smarter than me can comment on what else is wrong with this measurement.

First, the graph showing practice sizes served is misleading. I don’t know specifically how they found out which size practices a certified EHR vendor served, but I’m guessing it was self reported by the EHR vendor itself. If this is the case, most EHR vendors will say they can work in any practice size. So, that basically makes the data pretty useless. Possibly you could look at the size of the practices using the EHR system, but even then you get into trouble because how do you define “using” the system. A few EHR vendors can claim tons of purchases of their EHR software, but then you find out that very few if any of those purchases are actually implemented.

The second part of the slide shows a nice pie chart of the size of EHR vendors that are certified. The challenge I have with this chart is that it may just illustrate how small the EHR industry really is right now. The revenues of EHR companies are spread out over 300-400 EHR companies. Considering 5-15% (depending on where you look) adoption, that means that the majority of EHR companies are all small businesses with very low revenue.

I bet if we did a percentage of EHR vendors that did CCHIT certification for each of their annual revenue classifications you’d see something like this:
> $100 million – 100% CCHIT certified
$21 – 100 million – 90% CCHIT certified
$11 – 20 million – 50% CCHIT certified
$1 – 10 million – 15% CCHIT certified
< $1 million - 3% CCHIT certified I'm just pulling these numbers out of the air, but I think you can see the principle of how CCHIT certification is being adopted by large EHR vendors and not as many small EHR vendors. CCHIT's measure is just wrong. It should be percent in that EHR size category that are getting certified. It's not the percentage of all CCHIT vendors that are doing it. Reminds me of the common phrase that statistics can tell you anything you want to know. Something for all you EMR and EHR fans to chew on over the weekend.

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John Lynn

John Lynn

John Lynn is the Founder of, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • John,

    I think you put your finger on the problem with your estimates of EHR vendors CCHIT certified broken down by revenue. I think your estimates are very reasonable.

    …so the problem with the CCHIT pie chart on slide 12 is that it only includes the universe of CCHIT certified vendors, not the universe of EHR vendors.

    The inference CCHIT is trying to get you to draw is that certification is being sought and achieved by a mix of large and small companies.

    …but that’s a false inference. What we don’t know is how many companies HAVE NOT SOUGHT or HAVE FAILED certification. This pie chart would almost certainly look very different and unbalanced…

  • I agree, practice size data on slide 12 is kind of meaningless.

    Interesting to see if they talked about levels of certification for open source

    Can you please post the link to audio recording? The link on this page goes to another blog post. Links from their go to more blog posts.

    There are about 36 CCHIT 08 certified EMR products (fewer vendors), see Slide 12 has a sample size of 77. Not sure how the numbers line up.


  • Abhi,
    My fault on the link to the audio. The link is updated now and should link to the audio you’re looking for. Let me know if you still can’t find it.

    As I recall, I don’t remember them talking about levels of certification. Honestly, it was a bit of a scattered meeting to me, but I don’t remember them ever addressing the idea of levels of certification. They did talk about the issue of version certification for open source.

    There were only 36 that have the CCHIT 08 certification, but many more in 07 and 06. Since it goes for 3 years (wherever they came up with that arbitrary number), many didn’t renew each year. That’s why the number of their sample size is larger than 36.

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