I’ve been meaning to post about the HIT Policy Committee meeting for a month or so now. The reason I didn’t is that when I post about things like this, I like to make sure that I’ve had a chance to digest the information and provide some thoughtful analysis and commentary on what’s happening. Of course, thoughtful analysis and commentary takes a lot more work and time and so thus the delay. Enough about me…

Yes, on August 14th the HIT Policy Committee met to mostly talk about what certified EHR will mean under ARRA. You can see the full powerpoint from the presentation here. Luckily, CCHIT (I guess they have an interest in the topic) wrote a pretty good summary of what was said about EHR certification at the meeting (with a few of my own modifications):

• There will be a new form of certification. The Policy Committee recommended the term HHS Certified. (The labeling could change if there are issues.)
• The criteria for HHS Certification are recommended by the Standards Committee to ONC, then submitted for a formal approval process at HHS. As an experienced certifying body, CCHIT is offering suggestions and advice during the comment process, just as other stakeholders are.
• The Policy Committee recommended that ONC work with NIST to develop an accreditation process for certifying bodies and not place a formal limit on the number of entities that can be accredited.
• The Committee recognized the importance of leveraging work to date and maintaining momentum. For the near future—until the accreditation process is developed and operational — the Policy Committee recommended that CCHIT certification should be leveraged and that granting Preliminary HHS Certified status for EHR technologies should be done so as not to slow EHR adoption as the final HHS Certification criteria is approved.
• The Policy Committee recommended that HHS Certification be offered to modular products and that there be flexible approaches for non-vendor software.
• The Policy Committee recommended that HHS certification requirements focus on meaningful use.

While I still think that CCHIT has been marginalized to some extent, there’s no doubt that this meeting brought CCHIT and their criteria back into the fold to some degree. What will be interesting is to watch how much of the CCHIT certification criteria is accepted and used by HHS in developing the HHS EHR Certification.

In response to this, CCHIT sent the following materials (zip file) to HHS. I believe the excel file included in that zip file will turn out to be a crucial document in HHS’s development of the HHS EHR certification. I expect they’ll make some changes (it’s government after all), but I also expect it will form the basis of the HHS certification to at least some extent. I’m planning to do a full analysis of the document in a future blog post.

The question is when will we know what HHS has determined as an HHS Certified EHR and which bodies will become the certifying bodies for that HHS Certification? Here’s the timeline as best I can make of it:

• ONC Interim Final Rule by 12/31/09 – 60 day public comment period might not be required for EHR Certification. Don’t ask my why they wouldn’t do it since they’re doing it for meaningful use.
• Spring 2010? – ONC/NIST Definition of new accreditation Process for certifying bodies
• Fall 2010? – Completed accreditation of EHR certification bodies

The x factor in the schedule is how HHS plans to deal with preliminary ARRA certification. The HIT Policy committee recommended that HHS do a preliminary certification so that certification bodies wouldn’t have to wait to get started on EHR certification. CCHIT is moving forward full bore on doing preliminary ARRA certification. Maybe I don’t understand the process completely, but I haven’t seen where HHS/ONC has acknowledge that they’re going to go forward with this recommendation from the HIT Policy Committee. If they do, then we’ll start seeing some preliminary EHR certifications this year. If they don’t it looks like we’ll be waiting until next Fall to know for sure.

For those that attended the meeting, was there anything else important that I missed?

I’ll be honest with you. For my own health I took off the last month from reading about CCHIT. I guess the birth of my third child made a difference as well. However, I’d been getting some comments and emails lately about CCHIT’s new certification programs and so I had to go and take a look at what was going on. Well, let’s just say that CCHIT has yet to disappoint me. They are so full of CCHIT that it’s not even funny. The conclusions they come to are crazy. Ok, now that I’ve made my bias clear, take a look at some of the things they’re saying.

One of CCHIT’s first conclusions made (in this blog post) after doing some polling at a CCHIT town hall meeting of vendors (mostly) is as follows:

Only a small fraction intend to wait until final ARRA certification is available. This appears to support our contention that we can’t afford to wait – products must be available, and providers must get started right away in order to have a chance of achieving meaningful use in 2011-2012.

I love how they switch the vendors desire to get the preliminary ARRA certification with a providers desire to have the same. Of course, EMR vendors want to be able to say that they are ARRA certified. EMR vendors (most) aren’t selling product right now and so they want anything they can get that will help convince providers to actually buy product instead of waiting for all the ARRA certification details. This is a vendor desire. It’s not a provider desire. Providers want HHS to move faster with their HHS Certification details.

Now on to what Mark Leavitt calls the “bottom line:”

What’s the bottom line? Well, it looks like these new programs have a good chance of delivering what is needed from certification to support an accelerated adoption of health IT in the ARRA environment.

I really don’t get how they draw these conclusions. The town hall meeting showed that EHR vendors have an interest in becoming certified. I didn’t need to have a meeting for that. I just needed to dangle $36 billion of stimulus money and say you have to be EHR certified to know that many EHR vendors will want to get certified.

It also might be probably is true that $36 billion of stimulus money will accelerate EHR adoption. However, there’s no proof that CCHIT certification or HHS certification or any EHR certification for that matter will actually accelerate adoption or the more important goal of successful adoption of EMR software.

Here’s a link to the best chart from the CCHIT town hall meeting with vendors. What that chart tells me is that 60% of those attending only really want certification to get the ARRA stimulus money. 24% of the EMR vendors don’t know the difference between the CCHIT Certified and the Preliminary ARRA Certified and so they don’t know what they want. That leaves about 16% (probably those who are already CCHIT Certified) that want the full CCHIT Certified. Sounds right. Most EHR vendors just want to find a way to sell more product and get access to the EHR stimulus money, right?

Point being. Let’s not kid ourselves about what CCHIT is really trying to accomplish. The results from the polls on the CCHIT blog post describe well that CCHIT is about the EHR vendor and not the doctors, clinical practices, or improving the quality of healthcare.

That feels better. Now I better write my post about the difference between CCHIT Certified and Preliminary ARRA Certified and the road map ahead for CCHIT. I’ll post that tomorrow.