Real Purpose of EHR Certification

I figured I’d round out my recent posts about the new CCHIT EHR certifications before moving on to meaningful use. There’s just so much to say about both issues.

Taking a step back for a moment, I tried to remember why it was that we wanted to have an EHR certification in the first place. Certainly the reason we’re having this discussion today is because “certified EHR” is an important aspect of the ARRA EHR stimulus money. That’s taken what was previously kind of a side conversation in regards to EHR and launched it into the spotlight (only overshadowed by meaningful EHR use).

So, let’s try and get into the heads of our politicians (scary thought I know) and think about why we might want an EHR certification and how the various proposed EHR certification paths can help solve these issues.

Certifying EHR Compliance with ARRA Ideals
One certain motivation for having an EHR certification is certifying compliance with the ideals espoused in ARRA. If this is the case, then the new EHR-S certification proposed by CCHIT should be sufficient to achieve this goal. It could possibly be used in combination with EHR-M, but EHR-C would not be needed to accomplish this goal.

EHR Certification’s Impact on Successful EHR Adoption
Let’s say that the goal of EHR certification is about increasing the successful adoption of EHR systems. Sadly, none of these certifications has been shown to decrease EHR implementation failures. In fact, some people (like myself) have argued that it may in fact increase the number of EHR implementation failures. The facts are that none of the EHR certifications ensure the usability of the EHR.

It is true that CCHIT does seem to instill some confidence (false as it may be) in doctors selecting an EHR. The question is whether this will backfire if a bunch of doctors implement unusable EHR software that ends up getting scraped or will enough of them choose the good EHR-C software that the other failures won’t matter. This one we’ll have to wait and see.

Final Thoughts
Wow, I’m a little surprised I could only think up two reasons why they might want to have an EHR certification. Are there others that I’m missing? I just think it’s healthy to try and look at the goals and purpose of EHR certification. Let’s not try and make it more than it needs to be or was intended to accomplish. Hopefully the people at ONC and HHS are keeping these perspectives in mind.

Now time to turn my posts attention to the draft meaningful use document. I’m sure later next week I’ll come back and discuss more about CCHIT’s attempt to add usability measures to their EHR certification along with EHR user ratings to the EHR certification process as well. Until then, time to enjoy a weekend of meaningful use.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, 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, EXPO.health, 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.

7 Comments

  • Certification implies meeting certain minimal standards which I think is important. From a user standpoint it is similar to having our in-office labs certified. It is somewhat of a headache and lots of paperwork and additional cost but in the end I think we offer a more consistent reliable product to the patient. Same goes for Board Certification – certainly does not insure a good doctor but does state that the doctor is willing to meet standard scrutiny and criteria. Also, the user can use this as a tool to encourage the vendor to keep up with certain needs. Downside – it may tie up developer time with what ends up to be unimportant details just to remain in compliance, thus robbing the end user of time that could have been spent improving the product.

  • Unfortunately, in its current form the plan has much more downside than upside. Best of breed components not accounted for (so we end up with lesser products.) Some of the smaller, more innovative vendors will stop serving the industry (so we end up with less competition.) Other (more important) innovation will be stalled and a stifled (so we have even lesser products.) All of these will add to have the opposite effect of what was intended. We absolutely do not need vendor certification here. We already have a process in place to manage Medicare compliance. EHR standards could be managed the same way….eg, “The system you use must do x, y, and z.” If you can’t demonstrate that, then you cannot bill at the “enhanced” level. And, you should be able to demonstrate that with your own home grown software, multiple software packages, or even open source solutions…not just a single solution sold from a vendor who wrote the certification requirements. The vendors will build what makes you compliant and what you want to buy. CCHIT/ARRA simply adds a layer that adds no value. We also have another model to follow in HIPAA compliance. Practices are the ones to comply. If software vendors don’t provide solutions that help them comply, they won’t be purchased. I’m really surprised that there hasn’t been a bigger uproar over this. But with $5 trillion deficits and collapsing banking and auto industries, this may be small potatoes. Either way, let’s hope this debacle isn’t as bad as it could be.

  • Tim,
    The difference between certifying an EHR and a lab is that labs are much more standardized than clinical practices. Once we get the same standardization in the way a doctor practices and treats patients, then maybe it’s worthwhile.

    Also, what do you think about the major issue with CCHIT certifying EHR systems which can do all the feature/functions that are required by the certification standards, but are completely unusable? Now you just gave the false impression to a doctor that it’s a certified product and then they later find out that the system can do it, but in a practical setting will never happen.

  • Business Is Art,
    As I wrote this post and the more I look at certification the more I realize that the EHR stimulus money should have never said certified EHR. The new EHR-S certification almost seems to be going to what you describing. Basically it just wants to know that you can do the requirements of ARRA. Only question is why would CCHIT do it?

  • I really understand your thought process and in certain ways agree. In my opinion, most practices are going to look at the certifi8ed list and then go from there. While this is not the only criteria it is certainly a starting point and many or maybe most medical practices are going to be reluctant to drop $100’s of thousands without some baseline to evaluate from. It has taken us two years to really get completely knowledgable of everything that our EHR can do and the fact that our company keeps up wtih current criteria is comforting to us and the enhancements have been postive. We spent a lot of time looking at 3 systems intensely. Perhaps we could have spent more time looking at other systems but this business has so many players that it is likely that the ones that don’t spend to keep up may be gobbled up.

  • Tim,
    Sadly I think you’re right about a lot of practices just picking up the list of certified EHR and choosing from that list. However, what if ARRA recognizes the broader certification or site certifications? Then, it changes the game a little bit I think.

    Also, while you are probably right that many will work off the list of certified EHR, that just gives me more reason to try and inform people why that’s not a good idea. At the end of the day, I don’t personally have any real skin in the game. However, one of the major goals of this website is to inform and educate. Certainly I can’t reach everyone, but hopefully educating people on the realities of EHR certification will be beneficial to those who read about it.

    You actually also gave me an idea for doing an analysis of the various certified EHR companies and compare some numbers. We’ll see how time permits.

    One thing is certain. The EHR industry has too many players. There are far too many EHR software for people to evaluate them all. Some merging, failing and gobbling up will have to occur.

  • Hi
    I’m newbie and looking forward to make career in Healthcare sector. I’d like to know few things regarding the same. Whats the difference in EMR, EHR and HIPAA Certification? I came across HIPAA certification details on Edifecs. Can you tell me what are the requirements for EMR EHR and HIPAA?
    Thanks & Regards

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