Cost of New CCHIT EHR Certifications

Time to take a look at the costs associated with the 2011 CCHIT Certification programs. If you’re not sure which programs I’m talking about, you need to go read my post about Preliminary ARRA Certified 2011 and CCHIT Certified 2011.

The following are the costs that CCHIT plans to charge for their 2011 EHR certifications:
CCHIT Certified 2011 Ambulatory EHR – $37,000 with a $9,000 annual renewal
CCHIT Certified 2011 Inpatient EHR – $49,000 with a $9,000 annual renewal
CCHIT Certified 2011 Emergency Department – $37,000 with a $9,000 annual renewal
CCHIT Certified 2011 ePrescribing – $18,000 with a $9,000 annual renewal

Preliminary ARRA Certified 2011 1-2 modules – $6,000 with a $1,000 annual renewal
Preliminary ARRA Certified 2011 3-5 modules – $10,000 with a $2,000 annual renewal
Preliminary ARRA Certified 2011 6-10 modules – $15,000 with a $3,000 annual renewal
Preliminary ARRA Certified 2011 11-20 modules – $24,000 with a $4,000 annual renewal
Preliminary ARRA Certified 2011 >20 modules – $33,000 with a $5,000 annual renewal
*These are estimates subject to final approval

Of course, the ones that matter most are the CCHIT Certified 2011 Ambulatory EHR for $37,000 and the Preliminary ARRA Certified 2011 >20 modules for $33,000. Why? These are the two certifications that most people care about. If you’re an EHR vendor, then you’re going to want to do one of these two options (Assuming you’re going to go with CCHIT certification. More on that later.). These are the two options which should eventually be recognized as the certified EHR requirement for the ARRA EHR stimulus money.

Which CCHIT Certification Should I Do?
The question an EHR vendor has to make is which of these two certifications make sense. Will having CCHIT Certified 2011 help you to sell more EHR software than just being Preliminary ARRA Certified? I’m guessing that it probably won’t. Most people I’ve seen really just want to make sure they get the ARRA stimulus money to pay for their EHR. Plus, with either certification you’ll be able to honestly tell a clinic that you have a “certified EHR.” Most doctors won’t know or care about the difference in the certification types.

Many might think that it’s only a $4,000 difference between the Preliminary ARRA 2011 certification and the CCHIT Certified 2011 so why not just get the later. It is interesting that the costs are so close to each other. However, remember that this isn’t the only cost associated with becoming certified. One EMR vendor I talked to put the software development costs to become CCHIT Certified in the six figures. We won’t know for sure until CCHIT publishes the final certification criteria, but I project that the CCHIT Certified requirements will number close to 300 while the Preliminary ARRA requirements will be close to 100. That’s a huge difference in development costs to meet 200 more requirements which your customers may or may not find useful.

Some might use the CCHIT Certified 2011 to try and assure potential buyers that they’ll have a more successful EMR implementation because of this certification. Many might actually believe it, but unfortunately there’s no evidence to prove this is actually the case.

EHR vendors should also be aware that CCHIT is looking at doing a site certification as well. This might be a better option for some EHR vendors who work with people who have few people actually interested in the EHR stimulus money.

Other EHR Certification Options Beyond CCHIT
It’s still too early to know for sure if other EHR certifying bodies are going to be created to handle the HHS certification requirements for EHR. However, I’m willing to bet that at least a couple will be created.

Basically, CCHIT has set the price for EHR ARRA certification at $33,000 with a $5,000 annual renewal. I could be wrong, but that seems like a lot of money to certify a piece of software. I’m guessing that some entrepreneurial folks will find a way to do it for cheaper. Could you certify 100 EMR vendors for less than $3.3 million? We’ll see what ONC/NIST requires from a certification organization, but seems like a pretty nice business model to me.

For EMR vendors, this is important because competition amongst certifying bodies will most certainly drive the cost of EMR certification down. Then, the PR battle between CCHIT and the new certifying bodies will begin. Basically, this could be really interesting to watch if someone else decides to join the EHR certifying fray.

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.

13 Comments

  • John:

    I’d bet the house that providers will only qualify for Medicare bonus payouts if they are certified by an HHS/ONC-approved certification body. So it does matter which agency certifies your EHR.

    So far, HHS/ONC has not empowered any certification agency to carry its mail.

    Though it’s likely that CCHIT will be so empowered, so will other agencies, the days of the monopoly are over.

    When it comes time for vendors to select among HHS/ONC-empowered certification agencies, it would behoove them to remember that CCHIT has no experience promulgating or certifying against outcomes-oriented criteria of the sort ONC has developed for “meaningful use.”

    Thanks,
    Glenn Laffel MD, PhD
    Sr VP Clinical Affairs
    Practice Fusion
    http://www.practicefusion.com
    Free, Web-based EHR

  • Glenn,
    I’m not a betting man, but I’m sure that the Medicare bonus will depend on the HHS/ONC approved certification bodies (I think we can safely say more than one as well).

    Only thing I disagree with you is that CCHIT won’t be one of those that ONC recognizes as an EHR certification agency. I think CCHIT has a few million dollars that they’ll spend if needed to do whatever it takes to get there.

    Of course, that doesn’t mean that the difference between what CCHIT is working on now and what ONC/HHS Approves won’t be a wide gap that CCHIT will have to scramble to figure out. Not sure about this part of the equation.

  • It occurs to me that since it’s inception CCHIT has been more concerned with defining what certification is than with the act of certfying. I think that others will definitely join the fray. A lean organization that spends no resources trying to define what an EMR should be could definitely beat the price.

  • Perhaps we should each offer our own certifications. I am curious to hear if any provider feels they receive any benefit from either certification or meaningful use.

    I am betting they don’t. In that case, at the prices John pulled together for us, isn’t certification nothing more than a tax? What the ROI?

  • Russ Reese,
    Great observation. There is a huge cost to creating a criteria and another cost to certify against the criteria. I like that description a lot.

    More to Paul’s point, I haven’t seen any benefits of certification for providers or patients. If we could create a certification that would do such, I’d be all about joining in with that movement.

    Certification is bought so EMR vendors can sell more product. There’s no doubt certification gives providers a sense of hope that it’s a better system. Too bad it’s a false hope that hasn’t been proven. If it had been proven, it would have been shouted from the hilltops.

    What will be interesting is if they go ahead with site certifications. Then, it really is a lot about paying money to get your site certified so you can get the EHR stimulus money.

  • This attempt to extort money for no apparent benefit looks similar to the Cap-n-Trade legislation. In that instance, there’s no need for the bill because (1) there has been no global warming since 1998, and (2) neither man nor CO2 cause global warming. But even though the science is against Al Gore, the political issue exists to scare people into succoming to an additional tax. Like with red-light cameras: “its the revenue, stupid”.

    This expensive certification requirement is yet another shakedown attempt.

  • David Swink,
    I don’t know enough about Cap-n-Trade to really comment on the parallel. However, I actually don’t see certification as a shakedown attempt. Possibly for a couple people. However, I think that most people are just not understanding how EHR certification works. They misunderstand the benefits (or lack thereof) of EHR certification. They make a bunch of assumptions which are wrong.

    I guess I’m saying that I think there’s a gross misunderstanding by the people who added EHR certification. Hmmm…maybe that does sound like what you’re talking about a little.

    The question is how many doctors will fall for the same misunderstanding. Short answer: far too many.

  • John,
    You are right, in saying “certification” is misunderstood. I firmly believe that less than 5% of all doctors who do buy a “certified” EMR are going to collect. I can tell you who will collect. I would be very surprised if anyone who reads this blog will collect. For example, how many here, or even heard of someone, have actually collected the e-prescribing incentive?

    My job as CEO of an EMR vendor is to set direction for the company and determine budgetary priorities. To do this I read about and am involved with government and market priorities about half of my day, everyday, now for years and since the Stimulus healthcare spending was announced. Again, NO doctor here is likely to get Stimulus funds.

    A doctor here that gives anything more than very minor consideration to certification in their purchase decision is at risk of at best “junking” the purchase at worst destroying their practice. Statistics are everywhere now to prove this.

    Historically, in 2005 everyone was saying they must be CCHIT certified. almost 100 vendors did so – cost is a lot more than the fee. To-day only about a dozen CCHIT certified for 2008 – only large hospital systems or poor “boobs” who are new vendors.

    CCHIT “certification” was originally to help doctors determine if an EMR vendor was legitimate and the EMR would work. It turned into a control mechanism for large vendors. This is the same thing in “meaningful use. It is a wolf in sheep clothing, CCHIT is trying to set the price for others, what if another certifier charges $750 dollars now, what it should actually cost in my opinion, they will be tainted as somehow less. Make no mistake the people at CCHIT are fighting for their jobs, and the vendors behind CCHIT are fighting to keep control.

    Medscribbler is likely to weather this out as we did with CCHIT, HIPAA hesteria, HL7 “must have,” e-prescribing, etc. We met all of the above and more we just didn’t waste our time and money on the “flash in the pan” fad of the day.

  • @ Michael. Well said. I have never before seen such a rush of people to buy applications without understanding what business problems they are trying to solve.

    The number of people not drinking the Kool Aid is growing. We may need two Kias to drive us all to the lick-off meeting.

  • Michael Milne,
    Thanks for the comments. Always on point and provide a great additional perspective. I will disagree with you 5% number as far as collection. Probably will be more like 10 or 15%.

    I’m going to create a new post and see what other people think.

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