One of my regular readers, Jack, sent me the following email:
“One (actually I had many….) of the real question marks I had since 2005 about CCHIT and certification of EMR was that, “Should every vendor that applies be able to pass certification?”, or put another way, “What kind of certification is it that allows everyone who applies to pass and be certified?” My notion of certification was that not everyone who applies can make it. Why have certification if everyone passes it?”
Then, he followed up with these comments:
“In prior years, I think every vendor that paid their money passed certification. I can’t ever remember an instance of a vendor failing. If its that easy to get certified…what good is it? What benefit is there? Are we really weeding out products that just don’t cut it? If so, where are they? The ones that don’t apply?”
Of course, the sad answer to Jack’s questions are that EHR certification isn’t a benefit. At least not a benefit to the doctors. The only exception now is that it is a necessary requirement to get EMR stimulus money, so having an EMR vendor that is certified will make it possible to try and get the EMR stimulus money if you so desire. Outside of that, the certification doesn’t really provide a benefit to the doctor.
EMR vendors get some benefit as far as marketing and giving them a tool to provide a false assurance to the providers who don’t understand what EHR certification is really all about.
Back to the point of every EHR vendor that pays becoming certified, yes that does diminish the value of the certification. When CCHIT first came out, we talked about this in amazing detail on EMRUpdate.com. We discussed all sorts of options and methods for certification. One such thread discussed the idea of providing grades instead of just a straight up pass/fail certification. In fact, the grades should likely be given on a feature by feature basis.
The challenge with giving grades for EHR is that it’s quite subjective. Plus, which subjective viewpoint do you use. Do you give it an F for specialists and an A for general medicine? At that point, you’re becoming so granular that it’s just not able to scale in any reasonable manner.
What’s the solution? If I knew, I’d probably be doing it. What is clear is that EHR certification wasn’t meant to help doctors.