Real Purpose of EHR Certification

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I figured I’d round out my recent posts about the new CCHIT EHR certifications before moving on to meaningful use. There’s just so much to say about both issues.

Taking a step back for a moment, I tried to remember why it was that we wanted to have an EHR certification in the first place. Certainly the reason we’re having this discussion today is because “certified EHR” is an important aspect of the ARRA EHR stimulus money. That’s taken what was previously kind of a side conversation in regards to EHR and launched it into the spotlight (only overshadowed by meaningful EHR use).

So, let’s try and get into the heads of our politicians (scary thought I know) and think about why we might want an EHR certification and how the various proposed EHR certification paths can help solve these issues.

Certifying EHR Compliance with ARRA Ideals
One certain motivation for having an EHR certification is certifying compliance with the ideals espoused in ARRA. If this is the case, then the new EHR-S certification proposed by CCHIT should be sufficient to achieve this goal. It could possibly be used in combination with EHR-M, but EHR-C would not be needed to accomplish this goal.

EHR Certification’s Impact on Successful EHR Adoption
Let’s say that the goal of EHR certification is about increasing the successful adoption of EHR systems. Sadly, none of these certifications has been shown to decrease EHR implementation failures. In fact, some people (like myself) have argued that it may in fact increase the number of EHR implementation failures. The facts are that none of the EHR certifications ensure the usability of the EHR.

It is true that CCHIT does seem to instill some confidence (false as it may be) in doctors selecting an EHR. The question is whether this will backfire if a bunch of doctors implement unusable EHR software that ends up getting scraped or will enough of them choose the good EHR-C software that the other failures won’t matter. This one we’ll have to wait and see.

Final Thoughts
Wow, I’m a little surprised I could only think up two reasons why they might want to have an EHR certification. Are there others that I’m missing? I just think it’s healthy to try and look at the goals and purpose of EHR certification. Let’s not try and make it more than it needs to be or was intended to accomplish. Hopefully the people at ONC and HHS are keeping these perspectives in mind.

Now time to turn my posts attention to the draft meaningful use document. I’m sure later next week I’ll come back and discuss more about CCHIT’s attempt to add usability measures to their EHR certification along with EHR user ratings to the EHR certification process as well. Until then, time to enjoy a weekend of meaningful use.