CCHIT to Leave the ONC Certification Business

Update: Multiple people sent me the email that was sent to CCHIT certified EHR vendors that details this decision. In the email, along with what’s detailed below, CCHIT suggests a transition to ICSA Labs for EHR certification and talks about a new allegiance with HIMSS to provide new programs and policy guidance including a series of summits and events to support that work. I’m still waiting for an official response from CCHIT and will update the post if they respond.

Update 2: Here is CCHIT and HIMSS press release about the change and also ICSA Labs comments on the change. Drummond Group also issued this response.

I recently got word from a source close to the EHR certification world (yes, that could be just about any EHR vendor or EHR consultant) that CCHIT is about to announce they are leaving the ONC Certification business. I was told that CCHIT will test those that are already in the pipeline, but will not continue as an ONC EHR certifying body. I’d still classify this as a solid rumor for now (I emailed them for comment, but still haven’t gotten a response. I’ll update the post if I do.), but it comes from a reliable source. Plus, CCHIT did just cancel their weekly webinar series. No point in doing the webinar series if you’re not going to be certifying EHR anymore.

Whether the rumor is true or not, it’s worth considering the EHR Certification bodies and what would happen if any of them decide to not go forward with EHR certification. It will likely have a major impact on the meaningful use program.

I don’t think we should be surprised by this decision if indeed it is the case. CCHIT was started years before ARRA and meaningful use. They were created with a cost structure that was higher because they were charging a lot more for their EHR certification when they started. Once ARRA hit, CCHIT was marginalized and as EHR certification was commoditized and codified, CCHIT became irrelevant. Plus, with three new competitors certifying EHR, the prices for EHR certification dropped dramatically.

Furthermore, I think that all of the EHR certifying bodies are finding that 2014 EHR Certification is much more complex and time consuming than the 2011 certification. Yet the price to certify is basically the same. To me, the economics of the EHR certification business were never good.

Think about the business. Let’s say you get paid about $30,000 per EHR certification. There are only 600 customers (at the time we thought it was closer to 300) for your entire business and many of those don’t even pay the full $30k. Enter in 3 competitors and you’re now sharing a market of less than $18 million or $4.5 million per certifying body. Not to mention the stimulus is for only 5 years with many of the EHR vendors likely to consolidate, stop certifying, or go out of business. Plus, EHR certification is not a high margin business and requires expensive government certification. The economics just aren’t that exciting as an entire business.

This rumor is also interesting when paired with the comments I’ve heard that the EHR certification bodies have a backlog of EHR vendors that are trying to get 2014 certified. They’re having to schedule their testing day months out. If CCHIT gets out of the EHR certification business, then that will only increase the delay in 2014 EHR certifications. I wonder if this will lead to another call for a delay in meaningful use stage 2. Can it be delayed now that some have already started MU stage 2?

I’ve never been a fan of EHR certification. I think it represented a lot of cost and very little value to the EHR industry, doctors and patients. I’ll never forget when I asked Marc Probst, Intermountain CIO and member of the ONC committee that worked on EHR certification, why we needed EHR Certification if people had to show meaningful use of the requirements. If you can show meaningful use of a requirement, then the software can certainly do that requirement, no? He answered, “I lost that battle.”

Whether this rumor is true or not, the next couple months are going to be really interesting months for EHR vendors. How many will get across the 2014 EHR Certification line in time? How many will fail in the process? Will the ONC-CHPL be able to keep up? If CCHIT does leave ONC EHR certification behind, what will they do next? Can CCHIT do something to make themselves relevant again?