I’ve written previously about the cost of EHR certification with Drummond Group and CCHIT. However, this just addresses the hard cost of certification that’s paid to the certifying bodies. This cost doesn’t take into account a lot of other costs associated with becoming a certified EHR like the cost to develop and test the features that certification requires.
Keith Boone on his blog Healthcare Standards has done a great blog post that evaluates the other costs associated with certifying an EHR software beyond the fee you pay to the certifying body. If you’re an EMR vendor, this is an article that you definitely want to look at and consider. Plus, I’d love your feedback on things he missed or where he might have missed costs or estimated to high on costs.
Here’s Keith’s projections for EHR certification costs based on his estimates:
Average yearly developer salary: $80,000
Fully Burdened yearly cost: 200,000 – 240,000
Times the length of the project (~5.5 years)
Total certification labor cost: $1.1M – $1.32M
Of course, this number matches the estimates that came out with the HITECH act as well. ONC estimated between $500k-$1.5 million. So, this is pretty close.
I’ll leave the impact (good or bad) of this expense open for discussion. I think most people know where I stand on it.
Having been a CEO for several software companies and having managed probably close 100 s/w projects over my 20+ years, I appreciate Keith’s estimates. I think I view the certification differently. It is a cost of doing business for EHR vendors. If any EHR vendor wants to compete going forward, they need to spend the money and efforts to be ONC certified. As one of my close friend always says, “it is what it is”. As for the impact of this in improving healthcare, I believe it will make a huge difference. First of all, I believe in EHR systems being a key ingredient in improving healthcare (cost reduction, less errors, better care coordination, etc.). With that belief, EHR systems being a commoditized solution that is used by most (if not all) providers/hospitals at some point, will be a good thing for the industry and patients. And although I don’t believe HITECH Act is perfect, it has the ingredients to really accelerate EHR adoptioin. Given that hospitals are at around 9% and non-hospital settings are at little over 20% adoption rate today, we need help.
I agree that EHR certification costs are a necessary evil for EMR vendors now. The only exception might be really niche EMR vendors that focus exclusively on a specialty that isn’t really affected by the stimulus money.
I hope that HITECH does improve EHR adoption. Considering the numbers it will hard for it to make it worse. It has definitely increased awareness of EHR and that’s a good thing in and of itself (with little money spent so far).
My fear though is that HITECH incentivizes the wrong EHR software which will lead to more failed EHR implementations and an uproar from those who adopt that they “hate their EHR.” This would really damage the long term adoption rates of EHR.
All good points John. I do hope that “survival of the fittest” prevails in the EHR vendor market 🙂
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