EHR Certification Reference Sites – CCHIT

Every couple posts I have to write about CCHIT or EHR certification. It’s one of my favorite topics to write about, and I believe it’s one of my readers favorite topics as well (at least that’s what traffic tells me).

Today I want to take a look at what I believe is a new addition to the CCHIT 2011 EHR Certification. At least I hadn’t heard of it before. This is what CCHIT is calling Reference Site Verfications. From what I can gather they’re basically planning to verify that there are 2 live sites that have been using the certified EHR for at least 45 calendar days. For those new EMR, they can be certified with what CCHIT is calling “Pre-Market” status, but the EMR vendor must have 2 approved sites within 1 year of when they were initially certified. I also like that CCHIT is requiring that the 2 approved sites have no financial relationships with the EMR vendor. However, I’m not sure how they’re going to know if this is the case or not.

The questions I have is how they’re going to know and test that the 2 reference sites are using the EMR. According to CCHIT guidelines these EMR sites must be actively using key Meaningful Use components:
Ambulatory: ePrescribing, Drug decision support, Electronic receipt of labs, Problem list, Quality reporting
Inpatient: CPOE for medications, Drug decision support, Electronic receipt of labs, Problem list, Quality reporting

I admit that I love the concept of verifying that the software’s actually being used as it should be being used. My challenge is I haven’t figured out how CCHIT can do this effectively across so many different systems and locations. I know Sue from CCHIT has read some of my previous posts, so hopefully she can respond in the comments and give us more details.

CCHIT has also planned an annual monitoring of the certified EHR systems. Basically a look at one of the previous reference sites and a new site.

I find this reference site plan by CCHIT to be very interesting. I like that they’re trying to find places that actually use the EMR and they use the full set of features of the EMR as well. However, I’m not sure how well they’ll be able to measure this effectively and even if they could I wonder if 2 locations is enough to provide a valuable measure.

Of course, I should also clarify that this is just for the CCHIT 2011 certification and not the certification that CCHIT will be doing for those interested in the ARRA EMR stimulus money. At least that’s my understanding.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, 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,
    Sounds good, until the site happens to be your office and the CCHIT people want to come in and verify your site (office). If anyone has had to deal with audits, you know it is time consuming and disruptive for a medical practice. But that is just part of my objection to this idea.
    I believe it is yet another way CCHIT is protecting the large EMR companies and trying to do away with small EMR companies that tend to have a faster response time and are more receptive to client (Physician) suggestions for innovation.
    If a practice is looking at two solutions and one is “Pre-Market” and one is fully CCHIT certified which do you think carries a greater weight? If a Physician doesn’t know the potential downfalls of a CCHIT certified EMR, and are looking to CCHIT to help them decide what EMR they should have in their practice they will considered the fully market ready CCHIT certification as having more weight.
    But that is just my opinion. =)
    I really enjoy your stuff, and read it almost daily!

  • Bea,
    It’s an interesting point why a doctor’s office with no financial ties to the EMR vendor would allow auditors to come in and do the appropriate audit. However, maybe it’s not really an audit which presents its own problems no?

    I will say that someone who is selecting an EMR vendor who doesn’t have 2 reference sites probably doesn’t care much about CCHIT in the first place. So, I’m not sure that will be much of an issue. Big or small EMR vendor should be able to meet the 2 reference site program.

    Thanks for the kind words of the site and glad you read it so often. I gave you the Halloween weekend off;-)

  • Jim,
    Just because an EMR company has a client list doen’t mean that any of those clients want to have people in their office examining the way that they are using the EMR. It is possible that they (the client) may think that the reporting that will most likely be part of the Meaningful Use should be enough of an “audit”, without the addition of CCHIT people coming into their offices to verify that they are using a product according to the MU regulations.
    Large EMR companies are more likely to have a large install base and have the ability to have clients that are willing tohave “auditors” in to look at their system.
    I work with a small EMR company that is far different from most other systems. We have a nice install base, but several of our clients (especially in southern california, where they have famous patients (we work in dermatology)) do not want to be “reference” sites.
    (everyday = workdays…It’s good but not good enough to do on my days off!)

  • It’s certainly a challenge as I said in my comment. What motivation does an office have to be a reference site for an EMR vendor? Plus, we’re talking about CCHIT certification and not the EHR certification that will help people get the EMR stimulus money. If it were the EHR certification for stimulus money, then doctors offices might have more motivation to help get the stimulus money. Even then it would be a stretch for most doctors offices to care enough to do it.

    I still think most EMR companies can find 2 if they beg enough;-) It’s an interesting point and could inadvertently “discriminate” against small EMR vendors. I don’t think CCHIT’s intent with these reference sites was to discriminate against the small EMR vendors. It just might be a result of the policy.

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