CCHIT Has Become Irrelevant

For those of you that are relatively new to EMR and HIPAA, you might not appreciate this post as much as long time readers of EMR and HIPAA. A few years back, I admit that I was pretty harsh on CCHIT and their EHR certification. I remember one guy stopping me at a conference and after realizing who I was asked, “so what’s your issue with CCHIT?” I was happy to answer that I thought they misled the industry (doctors in particular) by saying that the CCHIT certification provided an assurance that the EHR was a good EHR. They never came outright and said this, but that’s what EMR sales people would communicate during the sales process.

In fact, EHR certification was incorrectly seen by many doctors and practice managers as the stamp of approval on an EHR being of higher quality, more effective, easier to use, and was more likely to lead to a successful EHR implementation. EHR certification today still has some of these issues. However, the fact is that the EHR certification doesn’t certify any of the great list above. If EHR certification of any kind (CCHIT or otherwise) could somehow assure: a higher implementation success rate, a better level of patient care, a higher quality user experience, a financial benefit, or any other number of quality benefits, then I’d support it wholeheartedly. The problem is that it doesn’t, and so they can’t make that assurance.

So, yes, I do take issue with an EHR certification which misleads doctors. Even if it’s the EHR salespeople that do the misleading.

I still remember the kickback I got on this post I did where I said CCHIT Was Marginalized and the post a bit later where I said that the CCHIT process was irrelevant. Today, I came across an article on CMIO with some interesting quotes from CCHIT Chair, Karen Bell. Here’s a quote from that article.

In addition, the Office of the National Coordinator for Health IT’s (ONC) new program has provided two new reasons for certification: proof that an EHR can do the things that the government wants it to do, and to enable eligible providers and hospitals to get EHR incentive money.

“The idea is not to assure the product will do all things that are desired for patient care, instead, the idea is to stimulate innovation,” said Bell. As a result, the program is considered a major success because more than 700 certified health IT products are now on the ONC website. “The idea was to get a lot of new products started. This is a very different reason for certification than what we began doing several years ago,” she said.

However, just because CCHIT or another ONC-Authorized Testing and Certification Body (ONC-ATCB) doesn’t test and certify for a particular ability, that doesn’t mean the EHRs don’t have it. “It’s just up to [the provider] to make sure the vendors have it,” said Bell.

I first want to applaud Karen Bell and CCHIT for finally describing the true description of what EHR provides a clinic assurance that:
1. The EHR does what the government wants
2. You are eligible for the EHR incentive money
Then, she even goes on to say that it’s up to the providers to make sure the vendors have the right capabilities for their clinic.

I imagine Karen and CCHIT would still probably say that the CCHIT “complete” EHR certification provides assurance that…< fill in the blank >, which the ONC-ATCB EHR certification doesn’t provide. The happy part for me is that even if CCHIT says this, no one is really listening to that message anymore.

Yes, CCHIT has essentially become irrelevant.

I can’t remember anyone in the past year asking me about CCHIT certification. From my experience, many people care about ONC-ATCB EHR certification, but they really couldn’t care less if it comes from CCHIT, Drummond Group, ICSA Labs, SLI Global, or InfoGuard (That’s all of them right?). Have any of you had other experiences?

I also do enjoy the irony of this post coming right after my post about differentiation of EMR companies (Jabba vs Han Solo). CCHIT is the reason that I know so much about the challenge of EHR differentiation. CCHIT’s efforts provided some very valuable (and lengthy) discussions over the past 5 years about ways to help doctors differentiate between the 300+ EHR vendors. As you can see from my comments above, I was just never satisfied with CCHIT being the differentiating factor. As you can see from my post yesterday, I’m still searching for a satisfactory alternative for differentiating EHRs. Until then, we’ll keep providing an independent voice a midst all the noise.

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.

12 Comments

  • The only reason CCHIT became relevant was that their certification was going to provide healthcare providers with safe harbor from Stark regulations, allowing us to sell our EHRs to community physicians at less than market rates. The government give, and the government take away.

    Remember when we were all gearing up to provide EHR services to community physicians? Now we are too busy chasing after EHR Incentives and preparing for ACOs and other forms of healthcare.

    Sometimes I think our industry, and the bodies that regulate us, have the attention span of puppies.

  • Will,
    Thanks for the great perspective. I didn’t realize that was a Stark regulation. I do definitely remember all the hospitals trying to figure out how they’d provide EHR services to community physicians and I haven’t seen a story like that lately.

    It seems like an ACO is going to require the community physicians to be connected to the hospital EHR system, no? Or are you seeing most hospitals satisfying the ACO requirements by acquiring the community physician practices?

    Short attention span, maybe. If they just set a regulation and didn’t create more, they’d have nothing to do…lol

  • Some sort of certification is a necessary evil when the Gov starts handing out checks.

    Without a certification, you could string together Word & Excel and call that an EHR. Quite frankly, the fact that you can get the full incentive while using a free EHR is a travesty.

    The problem comes down to the Gov trying to make a free market issue happen.

    Can anyone cite profitable Gov run entities/industries?

  • Oh, and the best part of this is when you work for a segment of the industry who must use a certified EHR, but the providers determine that the EHR incentive is purely for them, and they don’t want to put any of that incentive towards the vendor’s costs of offering said EHR features. After all, the specific language of the incentive puts the dollars squarely in the decision-making authority of the provider, who can keep all of it if they want to.

    Nobody seems to ever mention that fact – that’s one of the main places this interferes with the free market – EHR vendor competition. And look at the RECs – do they recommend the little guys?

    Thanks government, for adding even more cost for smaller vendors developing EHR software. The same little vendors who will bend over backwards most of the time to add features the customer really needs, but who can’t do the impossible. Unfunded mandate?

  • The CCHIT criteria, at least for EDISs (the area I am interested in), guarantee klutzy and feature-bloated software. They actually require hard-stops and other elements that frustrate end-users. Instead of raising the bar, their criteria have actively stifled innovation and lowered quality for everyone.

  • John:

    Some comments on relevance.

    CCHIT is happy to see our pioneering certification efforts mature into a broader federal program that incents providers to purchase and implement EHRs – a goal we have championed since our inception. We have a more competitive market place as a result. Providers have more choices of EHRs meeting basic requirements at more price points than ever before. Yes, they still have to shop smartly among these certified products. And the majority of vendors entering the market, since certification began leveling the playing field in 2006, would qualify as small businesses.

    By this standard, we’re signing up to become “irrelevant” again. While we will continue to offer our more rigourous CCHIT Certified programs, CCHIT is ready to move on to new challenges as healthcare evolves. We hope we can continue to stimulate change that will benefit providers, vendors and, of course, patients. If we’re doing our job, we’ll get to repeat this cycle over and over again.

    Sue Reber, CCHIT

  • Sue,

    Your response makes sense and the irrelevance has come none too soon. CCHIT’s certification criteria have trouble seeing the forest through the trees. Instead of focusing on the goals of the system, whatever form it takes, we get overly specific commands to “provide end-users the ability to search for medications by therapeutic class…” In 11 years of practice I have never heard of anyone ordering meds this way. So we end up with feature-bloated clunky software, usually thrown together in visual basic, all assuming we are using PCs for our work. It’s time to think clearly about what we want for our EMRs and stop looking to the first generation EMRs (Epic, Meditech etc) for guidance.

  • Some good discussion. Thanks for joining in on the conversation Sue. I’ll definitely be interested to see if CCHIT can morph itself in ways to affect the EHR industry again. Do you have ideas in mind?

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