Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

HITECH Basically Excludes Open Source EHR If They Select CCHIT

Posted on February 26, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m a major proponent of the open source software movement. In fact, pretty much everything that I use to run this website is open source (WordPress, Linux, MySQL, PHP, Apache, etc). Wow, I didn’t even include all the software tools I use to publish EMR and HIPAA. Anyway, I’m a firm believer in what open source can accomplish. You may have read my previous posts about the Free and Open Source in Healthcare Un-conference this summer or possibly what I think is the right open source EMR model. I’ve also cautioned about whether “free EMR” is really free. Ok, I could go on for a while covering all the posts I’ve done, but here’s 2 links to all my free EMR posts and my open source EMR posts.

My point is that I believe in open source can do and I think it could have a major impact in health care. In fact, I sincerely hope that it will have an impact. The problem is that if HHS decides to use CCHIT as the certification criteria for the EHR stimulus, then the HITECH act will basically be excluding open source EHR and EMR packages from being part of the “certified EHR.”

Sure, I guess a community of users behind an open source EHR could pool together enough money to pay for CCHIT certification, but realistically I don’t see this happening. In fact, the thought of paying so much money to CCHIT is almost counter to the open source movement. I just don’t see why any open source EHR would make CCHIT a priority in their development life cycle.

Yes, I do know that HITECH includes a provision (if that’s the right term) that allows HHS to provide an open source package. Does that also mean that HHS will provide an exception for the government provided open source EHR package? Will users of that open source EHR be able to get the medicare and medicaid bonuses? I’m not sure that HHS even has the authority to do this. However, even more important is that they’d still be excluding the dozen of other open source EHR software programs out there.

This is just one more reason why HHS should not use CCHIT and should consider creating their own set of certification criteria. Looking at my recent CCHIT As The HITECH Certification Criteria Poll it looks like at least the majority of my readers would prefer a different certification criteria as well.

HHS Secretary MIA

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

If you’ve read this blog, then I’m sure you know that Tom Daschle withdrew his nomination for HHS secretary. Some people have suggeste Howard Dean to be a nice replacement for Tom Daschle as HHS secretary, but unless I missed something in the midst of the HITECH act mania nothing’s been officially announced by Obama.

All of this means that HHS is without a secretary to implement the HITECH act along with the $2 billion of discretionary funds, choosing an EHR certification criteria, and defining meaningful EHR use.

I can’t imagine the people at HHS are just sitting on their hands, but I sure wonder what impact not having an HHS secretary will have on Obama’s health care reform.

The Problems with CCHIT Certification

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a really thoughtful post on HISTalk, Dewey Howell MD, PhD, Founder, CEO Design Clinicals, Inc. wrote a n article called “The Real Problem with CCHIT Certification.” In it, Dr. Howell basically makes the case against CCHIT, because it doesn’t take into account all of the various specialized EHR which only need to do a few things really well. His example was an EMR for “ambulatory, inpatient, and emergency settings.”

These arguments remind me when near the beginning of the CCHIT certification process it included such things as growth charts. Sure, growth charts are essential to a pediatric EMR, but not so much so for other EMR companies. Luckily, the vetting process did remove this criteria and what CCHIT ended up with was much better than what they started to create. Unfortunately, it’s still an onerous process for a specialized EHR to be CCHIT certified.

Dr. Howell also provides this really interesting insight:

Another deficiency of the current certification process is the lack of requirement for certification of results or outcomes. How do we certify and validate that the system actually delivers the outcomes that we are trying to achieve? The current process encourages vendors to throw a button or screen into their application that produces a specific action or display. But, there is no accountability to the patient and quality of care delivered with the tool. It encourages technology for technology’s sake, presuming that outcomes will be “better” just because a product is certified, instead of really validating results. Maybe this is a much tougher nut to crack, but it is considerably more important than things like, “The system shall provide the ability to allow users to search for order sets by name.”

I like how he described the need to measure results or outcomes. We’ve often mentioned on this blog CCHIT’s biggest problem is actually measuring usability, but results and outcomes are another way to look at the challenge of certification.