How Important is Cchit Certification to Physicians in the Electronic Health Record Selection Process?

Your EMR / EHR – Does it have to be CCHITbooks.
certified?What does certification really fetch?
What is CCHIT?EMR is a long-term investment and providers
CCHIT or Certification Commission for Healthcaremust be careful in choosing the right solution. Most
Information Technology was founded in 2004 bypractices have very limited time and resources to
three industry associations (HIMSS, AHIMA andevaluate every detail of every product of
the Alliance) and is an independent non-profitinterest.
private sector initiative that certifies EMR / EHROn the other hand, certification can help with the
software (used interchangeably in this article)evaluation and selection process by narrowing
solutions based on a specified set of parameters.down the initial set of solutions because CCHIT
Its mission is to accelerate the adoption of robust,certification assures implementation of basic
interoperable health information technology byfunctionality. This should allow a Practice to focus
creating a credible and efficient productmore upon performing due diligence about a
certification process.companies’ track records in meeting individual
The purpose behind CCHITpractice’s special needs, ease of use,
There are hundreds of EMR software solutions onimplementation success, financial viability, and
the market, each differing in feature functionality,after-sales service and support, and financial
and it is easy for providers to get lost in thestability of the EMR vendor.
cacophony of vendors especially, considering thatThe flip side to this approach, insisting on
Providers are not IT experts and often find itcertification will potentially cut out a significant
difficult to properly assess and select an EMRpopulation of more powerful (a better mousetrap)
solution that will best meet their current andsolutions from smaller vendors, who cannot
foreseeable needs.  CCHIT certification wasafford the certification costs. Just because a
intended to reduce the risks of physicianproduct is not certified does not necessarily mean
investment in EMR / EHR products, while achievingthat it will not meet the specific requirements of
the following:a. Facilitate interoperability of EMRthe Practice. At the same time, a Practice may
products with the emerging national healthnot really need the 300+ features mandated and
information network, sometimes called RHIOsb.evaluated by CCHIT. The real question of the day
Enhance availability of EMR adoption incentivesc.is, do you need a Rolls Royce when a Toyota
Ensure that EMR products protect the privacy ofCorolla might serve the purpose?
personal health informationWhat must a Practice do?
EHR / EMR Certification CriteriaRather than getting fixated on CCHIT certification,
The main category of certification deals witha Practice would do well to create a checklist of
products designed to be used in physician officesfeatures that are important to it. This list should
and clinics and commonly referred to asinclude:
Ambulatory EMR.  CCHIT certified EMR products1. Does it support the specific requirements of the
were required to demonstrate compliance withspecialty? (CCHIT acknowledges that its criteria
116 criteria in 2006. Another 96 criteria weremay not be suitable for settings such as
added in 2007 and in 2008, 19 new criteria werebehavioral health, emergency departments, or
added to the certification requirements focusingspecialty practices.)
on the following:a. Additional electronic prescribing2. Does it allow the Practice to share information
features including access to the patient'selectronically with other physicians, hospitals,
medication history, formulary, and eligibility.b.pharmacies, laboratories, radiology groups, and
Better and safer medication dosing, adjusted forothers? (from a technical viewpoint, any system
patient weight and other factors.c. Better ability tothat has HL7 interface, inbound and outbound, will
prevent adverse reactions due to drugbe able to interoperate with other systems.
interactions or allergies.d. Use of standard formats3. Does it enable you to measure and report the
to exchange basic patient information forquality indicators, needed to satisfy payment
continuity of care.e. Enhanced ability to viewincentive programs that are based on levels of
X-rays and other diagnostic images.f. Betterperformance?
management of patient consents and4. Does the vendor have the reputation of
authorizations.g. Increased use of standardproviding outstanding customer support?
formats when receiving and storing laboratory5. Are there any references of the same size
results.practice, specialty, and type in the local market
How much do vendors spend for certification?who can vouch for the ease of use of the
The initial cost of certification is about $28,000,selected product?
which provides a three-year certification. Vendors6. Does it help monitor potential adverse drug
then pay an additional $4,800 in each of thereactions?
second and third years to cover marketing and7. Does the EMR interface with the Practice
licensing fees. An EMR is certified for three years,Management or Billing software? You should also
but if a product is significantly reengineered orfind out if you need an integrated system with a
re-architected before the end of the three-yearcommon database.
period, it must be recertified.  Minor updatesThese are only a few of the foundational
usually do not need re-certification.questions, as there are many non-functional
As of January 2009, certified EMRs include therequirements that need to be addressed to
following:a. Ninety-two EMRs that have receivedensure successful implementation of an EMR/EHR
certification under the 2006 Ambulatory EHRsolution. These requirements are focused around
criteria (latest certifications made on 30th Aprilpeople (commitment, volunteers, etc.), capital
2007).b. Fifty-five EMRs (including multiple versions(cost, ROI, initial cost vs. annual costs), technology
of the same product by the same company) that(server-based vs. ASP, tablets or laptops, etc.)
have been certified under the 2007 criteria.c.and organization (stakeholders, selection and
Fifteen EMRs that have been certified under theimplementation leaders).
2008 criteria. These include a number of productsIf all this seems too time consuming or
that have been further certified for Child Healthoverwhelming, the Practice must find a good
and Cardiovascular Medicine.independent EMR/EHR and Practice Management
Compare these numbers against the 300+ EMR /Solutions Firm who can assist in the initial needs
EHR solutions available on the market and it isassessment phase, vendor evaluation and
clear that the smaller niche players, offeringselection process. These days you can find good
cost-effective products, have neither the time norConsultants who will do all of the up-front leg
the financial resources to spend on certificationwork for you at no cost to your practice.
and especially, on re-certification every time theyTherefore it would be wise to think twice before,
make any significant updates. This certificationemploying a company wanting to charge hefty
process is stifling competitors in the freeup-front retainers and steep per hour consulting
marketplace and will only lead to higher prices andfees ranging from $100 to $200 per hour.
in turn, negatively impact Physicians’ pocket