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CCHIT Town Hall at HIMSS

Posted on March 5, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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 must admit that I’m so happy to be home from HIMSS. It was a fantastic couple of days, but it’s always nice to be at home. Not to mention, posts are so much more fun on a regular keyboard with 2 monitors. Of course, my email box is full of the notes that I took during the various interviews I did at HIMSS. So, you can expect a lot more posts talking about the things I learned and saw at HIMSS. Not to mention a video series of innovative and interesting products at HIMSS (Sponsored by Practice Fusion).

For my first post after HIMSS, I decided that I couldn’t help but post about the CCHIT town hall at HIMSS. I really said a lot of what I thought on my twitter account, but I’m sure that many missed it. So here’s a short summary of my thoughts with some other commentary on Mark Leavitt’s swan song at HIMSS.

The first thing that bothered me most is what has bothered me about CCHIT for a long time. However, this time I could document first hand the things that CCHIT was saying that was confusing doctors about what the CCHIT EHR certification was all about. Here’s what I recorded them saying (usually on their powerpoint too) that really doesn’t tell the whole story:
“Maximal assurance of comprehensive, integrated EHR capabilities”
Maximal assurance of what? That the EHR is comprehensive? No doubt doctors will see this as saying that a certified EHR will have all of the EHR features that they need. However, how does CCHIT know that it will have all the features all of the various types of practices need? Of course they don’t. They would even admit that it doesn’t. It just is able to run their test scripts based on a list of requirements. That’s where they confuse doctors.

“EHR with all necessary functionality”
and
“Everything you need in an EHR if you do the comprehensive certification.”
Same principle as the previous comment. How can they know what’s necessary? They don’t.

As I sat there listening to this, I wondered if I should get up and ask them a question. I wasn’t sure that me asking a question would be of any value. Then, I decided that I should at least try and help those in the audience to understand the real benefits (or lack thereof) of CCHIT certification. So, I got up and asked the following question (more or less):

What type of assurance does CCHIT offer to doctors? Does it offer better patient care? Are certified EHR more likely to be implemented successfully? What assurance can you offer beyond just talking about the process you went through to create the criteria?

They both (Mark Leavitt and Alisa Ray) kind of looked like they didn’t quite understand the comment. However, Mark basically responded that CCHIT doesn’t make any guarantee of increasing successful EMR implementations or improve patient care. He said that he didn’t think anyone could make that guarantee. CCHIT assures doctors that it meets the criteria that has been created.

Many people wonder what I have against CCHIT. I actually don’t really have any real ties to CCHIT (see my previous post). It just really bothers me when doctors get the wrong impression based on a miscommunication. I don’t like it when EMR salespeople confuse doctors through EMR sales miscommunications and I don’t like when doctors don’t understand what they’re really getting from a certified EHR.

The real problem is that even writing this post, far too few people will get the real message about the benefits (or lack thereof) that are provided by CCHIT certification. Although, I was pleased by all the people I’d never met before stopped me around the conference and told me that I asked a very important question at the CCHIT town hall.

Enough of that for now. Here’s some of the other items that I tweeted about CCHIT (some additional comments in italics):
CCHIT to certify Oncology and Women’s health(Obstetrics and Gyn). Will doctors care? EMR vendors might.

CCHIT had 23 comprehensive and 23 modular EMR cert applications.
46 brave EMR vendors. Although, I think this number is a little misleading. I talked to one of the EHR vendors that has the comprehensive certification and they said that there are only 2 that really have the comprehensive EHR certification. All the rest are “provisional.” I didn’t check those facts, but that says something if indeed it’s true.

CCHIT has announced site certification, but we don’t yet know if HHS will recognize an EHR site certification, no?
After the ONC town hall we now know that ONC will be fine with this as a secondary method of certification if the EHR certifying bodies see it as appropriate.

Nice to see that Mark Leavitt’s recommendations all use CCHIT products. I have a few other options people might consider that don’t.
Mark also referred to not going after a certification to be like gambling. Coming from Vegas I’m not sure I like his gambling reference. However, I really do think there are other options to CCHIT certification. Drummond Group and a third one I learned of at HIMSS which I’ll be writing about shortly too. Although, it certainly makes sense why Mike wouldn’t have acknowledged the other bodies. Although, isn’t CCHIT a non profit? Shouldn’t they just want the best interest of the industry?

With the government program we don’t create the criteria anymore. -Mark Leavitt of CCHIT

CCHIT site certification will be hospitals first. Ambulatory site EHR certification later?
Makes sense that CCHIT would go where the money is, but not a happy thing for the small doctors offices.

“We’re doing EMR usability at a kindergarten level and some EMR vendors don’t pass that.” -Mark Leavitt
This is a really sad fact. It’s nice of Mark to acknowledge it. One other person I talked to at HIMSS suggested to me that CCHIT shouldn’t be doing EMR usability testing at all. However, I’m really not sure what it says about an EMR that can’t pass the simple usability tests that CCHIT does do.

I’m always amazed at how little connection CCHIT has with ONC/HHS. Seems like a telling thing that they don’t.

Search for New CCHIT Chair

Posted on December 3, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

Now that Mark Leavitt announced that he was leaving CCHIT, it’s going to be interesting to see who will replace him as the Chair of CCHIT. Healthcare Informatics has an interview with CCHIT search committee chair and CCHIT trustee, Frank Trembulak (Geisinger Health System EVP and COO) that’s worth reading to understand more about CCHIT plans to search for Mark’s replacement. This is going to be an interesting change to CCHIT. Or will it be a change at all?

What do you guys think, should I apply?

Mark Leavitt Leaves CCHIT

Posted on November 13, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

Today the big news was that Mark Leavitt is leaving his role as chairman of CCHIT. Healthcare IT news reported on the announcement:

“The board accepts Mark’s decision with reluctance but appreciates his commitment to overseeing a seamless transition,” said H. Stephen Lieber, chairman of the board of trustees and president and CEO of the Healthcare Information and Management Systems Society (HIMSS).

Lieber said CCHIT trustee Frank Trembulak, executive vice president and chief operating officer of Geisinger Health System, will chair the search committee for Leavitt’s replacement, and that a firm has been retained to conduct the search.

“Having the privilege to launch and lead this volunteer-based, nonprofit organization has been one of the most rewarding and educational experiences of my life,” said Leavitt. “Now it is time for me to keep a promise I made to myself and my family when I first took on this role five years ago, knowing that I will leave it in the hands of an exceptional group of volunteers and a highly capable and knowledgeable staff.”

It seems like there’s some mixed reaction to the departure of Mark Leavitt from CCHIT. Some spelling the end of CCHIT, and others saying that it could be a good thing. I personally think that CCHIT isn’t going anywhere anytime soon. I hope they ditch their main CCHIT EHR certification path and just stick to ARRA EHR certification, but time will tell for that.

Personally I want to say that I think Mark Leavitt always came off as a very sincere guy who was trying to do good. I certainly differed with him in many areas, but I think he was just trying to do his job the best he could. I can admire that and I don’t blame him for stepping down. Things around EHR certification are going to heat up and become even more political than it’s been.

Cost of New CCHIT EHR Certifications

Posted on September 14, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

Time to take a look at the costs associated with the 2011 CCHIT Certification programs. If you’re not sure which programs I’m talking about, you need to go read my post about Preliminary ARRA Certified 2011 and CCHIT Certified 2011.

The following are the costs that CCHIT plans to charge for their 2011 EHR certifications:
CCHIT Certified 2011 Ambulatory EHR – $37,000 with a $9,000 annual renewal
CCHIT Certified 2011 Inpatient EHR – $49,000 with a $9,000 annual renewal
CCHIT Certified 2011 Emergency Department – $37,000 with a $9,000 annual renewal
CCHIT Certified 2011 ePrescribing – $18,000 with a $9,000 annual renewal

Preliminary ARRA Certified 2011 1-2 modules – $6,000 with a $1,000 annual renewal
Preliminary ARRA Certified 2011 3-5 modules – $10,000 with a $2,000 annual renewal
Preliminary ARRA Certified 2011 6-10 modules – $15,000 with a $3,000 annual renewal
Preliminary ARRA Certified 2011 11-20 modules – $24,000 with a $4,000 annual renewal
Preliminary ARRA Certified 2011 >20 modules – $33,000 with a $5,000 annual renewal
*These are estimates subject to final approval

Of course, the ones that matter most are the CCHIT Certified 2011 Ambulatory EHR for $37,000 and the Preliminary ARRA Certified 2011 >20 modules for $33,000. Why? These are the two certifications that most people care about. If you’re an EHR vendor, then you’re going to want to do one of these two options (Assuming you’re going to go with CCHIT certification. More on that later.). These are the two options which should eventually be recognized as the certified EHR requirement for the ARRA EHR stimulus money.

Which CCHIT Certification Should I Do?
The question an EHR vendor has to make is which of these two certifications make sense. Will having CCHIT Certified 2011 help you to sell more EHR software than just being Preliminary ARRA Certified? I’m guessing that it probably won’t. Most people I’ve seen really just want to make sure they get the ARRA stimulus money to pay for their EHR. Plus, with either certification you’ll be able to honestly tell a clinic that you have a “certified EHR.” Most doctors won’t know or care about the difference in the certification types.

Many might think that it’s only a $4,000 difference between the Preliminary ARRA 2011 certification and the CCHIT Certified 2011 so why not just get the later. It is interesting that the costs are so close to each other. However, remember that this isn’t the only cost associated with becoming certified. One EMR vendor I talked to put the software development costs to become CCHIT Certified in the six figures. We won’t know for sure until CCHIT publishes the final certification criteria, but I project that the CCHIT Certified requirements will number close to 300 while the Preliminary ARRA requirements will be close to 100. That’s a huge difference in development costs to meet 200 more requirements which your customers may or may not find useful.

Some might use the CCHIT Certified 2011 to try and assure potential buyers that they’ll have a more successful EMR implementation because of this certification. Many might actually believe it, but unfortunately there’s no evidence to prove this is actually the case.

EHR vendors should also be aware that CCHIT is looking at doing a site certification as well. This might be a better option for some EHR vendors who work with people who have few people actually interested in the EHR stimulus money.

Other EHR Certification Options Beyond CCHIT
It’s still too early to know for sure if other EHR certifying bodies are going to be created to handle the HHS certification requirements for EHR. However, I’m willing to bet that at least a couple will be created.

Basically, CCHIT has set the price for EHR ARRA certification at $33,000 with a $5,000 annual renewal. I could be wrong, but that seems like a lot of money to certify a piece of software. I’m guessing that some entrepreneurial folks will find a way to do it for cheaper. Could you certify 100 EMR vendors for less than $3.3 million? We’ll see what ONC/NIST requires from a certification organization, but seems like a pretty nice business model to me.

For EMR vendors, this is important because competition amongst certifying bodies will most certainly drive the cost of EMR certification down. Then, the PR battle between CCHIT and the new certifying bodies will begin. Basically, this could be really interesting to watch if someone else decides to join the EHR certifying fray.

Preliminary ARRA Certified and CCHIT Certified

Posted on September 12, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

As promised, here’s my look into the two certifications that CCHIT is currently pursuing. I got most of the details of what they’re talking about from this CCHIT presentation. Basically, CCHIT plans to offer two forms of EHR certification starting October 7, 2009: CCHIT Certified 2011 and Preliminary ARRA 2011.

CCHIT Certified 2011 is basically just a continuation of the certification that they’ve been doing for a number of years now. I won’t go into all the details about why this is a waste of money, development time and provides no improvement an EMR implementation success rates, but a quick search through my posts on CCHIT will be good place to start if you’re interested. Of course, the one difference between the 2011 CCHIT EHR certification is that they’ve tried to add all the other necessary requirements to meet ARRA’s certified EHR requirements.

Preliminary ARRA 2011 – Basically, this is CCHIT’s attempt to certify just the meaningful use requirements. They’ve broken it down into 21 meaningful use components with about 100 requirements (as best I can tell). CCHIT’s plan is for this certification will become the ARRA EHR certification program that will be eventually recognized by HHS.

Now let’s take a look at the timeline for each of these EHR certifications:

September 24, 2009 – CCHIT publishes certification criteria and test scripts for both CCHIT Certified 2011 and Preliminary ARRA 2011

October 7, 2009 – CCHIT starts accepting applications for both certifications

Spring 2010 – CMS publishes final rule

Spring 2010 (after CMS rule published) – CCHIT offers incremental testing for both EHR certifications to cover any gaps between the certification criteria published on September 24, 2009 and the final rule published by CMS. At this time CCHIT will also introduce the site certification option (this could be really interesting).

Now the question is which of the two EHR certifications you should consider or should you not worry about any of the above certifications? Unfortunately, I can’t really answer that question properly until we talk about the money involved in getting the above EHR certifications. I’ll cover that in a post on Monday.

CCHIT Town Hall Meeting on Preliminary ARRA Certified EHR

Posted on September 11, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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’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.

Marginalization of CCHIT EHR Certification

Posted on July 22, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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 for any time, you know that I’m not a big fan of CCHIT. Certainly, I can’t argue that CCHIT EHR certification isn’t a great marketing tool for EHR vendors. However, I strongly believe that the CCHIT certification gives doctors a false hope that the CCHIT certified EMR that they select will somehow have a higher implementation success rate than another EMR. If this were true, CCHIT would be certain to be proclaiming it from every channel possible. Instead, there’s no data that this is true and it’s sad that so many doctors think it’s the case.

With that background, I was quite happy to see that the HIT Policy Committee basically marginalized CCHIT into a certifying body as opposed to a EHR certification criteria creator. I’m a little disappointed that this news hasn’t gotten more play by the various news sources and blogs. Even John Halamka basically just linked to the EHR Certification presentation with no discussion on his blog about the implications of such.

Of course, CCHIT has so far gone quiet on their blog and twitter accounts. I’m sure that pretty soon we’ll be hearing some public statements from CCHIT trying to save its certification methodology. I expect they’ll start touting their certification as better, more complete and more effective than whatever criteria HHS comes up with to satisfy ARRA’s “certified EHR” criteria.

According to Iroman on EMR Update, CCHIT did send out the following email to their list of EMR vendors:
“For providers and hospitals to have any chance of meeting ARRA incentive requirements in 2011, certified EHR technologies must be promptly available,” said Dr. Leavitt. “To do that, we will launch preliminary HHS/ARRA EHR technology certification programs in less than 90 days, drawing upon our inspection and certification experience and marketplace knowledge. Our HHS/ARRA certification will be available to modular, open source, and self developed technologies as well as comprehensive EHRs. Our current, very comprehensive certification programs — though no longer the sole route to government certification — will become even more robust to serve EHR purchasers who want maximal assurance of EHR completeness and integration.”

I bet Dr. Leavitt had to run that last line by the lawyers. I think it’s pretty clear the direction CCHIT is headed. Unfortunately, we haven’t heard the last of CCHIT EHR certification.

One other interesting anecdote about CCHIT comes from PedSource who attending the recent CCHIT meeting.

Bill Zurhellen got up and said something which drew a round of applause. “If our goal is to certify to get ARRA payments, we’re doing the wrong thing. We should be focusing on improving health care.” ML replied, “We should consider changing the mission statement to reflect healthcare outcomes and improvement…” because, right now, the mission statement is focused solely on improving HIT use.

CCHIT Town Halls and CCHIT Comments on New Jersey Bill

Posted on June 10, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

For those that participated in the CCHIT town hall meetings at HIMSS, it seemed like the writing was on the wall that CCHIT needed to offer some more town hall meetings. There was certainly a lot more to discuss. CCHIT just announced 2 more web “conferences” where the public will have a chance to comment on CCHIT.

The first conference, “New Paths to Certification: Dialog with the Open Source Community,” will take place on June 16 at 1 p.m. EDT and focus on technology. It will address outlying concerns on certification of solutions that are licensed under open source models. Leavitt and Dennis Willson, the commission’s technology director, will be the moderators.

The second conference, “New Paths to Certification,” will take place on June 17 at 11 a.m. EDT and be more geared toward a generalized audience, with dicussion focused on new CCHIT programs.

I think it’s good that they’re having another open source EHR session. I’m just not sure why they would have it before the general session. That means that the open source discussion is going to not be as focused since many people will want to discuss the general issues with CCHIT certification during the open source session.

I’ve made my views on open source and CCHIT certification pretty clear. So, it will be interesting to hear what CCHIT could change to avoid some of the problems I’ve suggested. There’s just not the right motivations for open source EMR to certify. I’ll publish more details on these meetings as they become available.

In a different CCHIT issue, CCHIT has made a comment on the New Jersey bill I’ve written about previously. Here’s the part of their comment that really matters:

First, I do not believe this is an appropriate use of health IT certification. Our goal, stated in almost every presentation I’ve given, and to which I’ve adhered in my leadership of the Commission, has always been to unlock positive incentives for health IT adoption. Bridges to Excellence provides a role model for integrating health IT into outcome-based, pay for performance incentives. Successfully executed, ARRA might too. But the New Jersey bill is nowhere near that. Making software purchases illegal, like dangerous substances? Let’s “just say no” to that idea.

Second, neither I personally, nor CCHIT as an organization, have lobbied, advocated, sponsored, or had anything to do with that bill. We were unaware of it until it started showing up on listserves Friday. The bill has never been mentioned in any of our Trustee, Commission, or staff meetings.

Kudos to Mark Leavitt and CCHIT for making these comments. Underscores my previous feelings that Mike Leavitt and CCHIT really sincere in his desire to help. It’s just that they’re going about it the wrong way.

CCHIT and Open Source HIMSS Meeting – Audio and Powerpoint Slides

Posted on April 24, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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’ve been meaning to post about the CCHIT and open source meeting at HIMSS for a while now and just haven’t ever gotten around to it. I did post my twitter thoughts on the CCHIT/Foss meeting, but I think there’s plenty more that could be said about that meeting.

For those of you that missed it, you can find the audio of the meeting on the CCHIT website and I’ll embed the powerpoint presentation from the meeting below:


My biggest complaint from the meeting was a slide that Mark Leavitt used to describe why he feels that CCHIT isn’t excluding the little guy. Basically it talks about the size and market share of the EHR vendors that have applied for CCHIT certification (you can see it as slide 12 above).

I can’t quite place why this measure feels wrong, but it does. Maybe it goes back to something one of my professors taught me when doing research analysis. He basically said, that when first looking at the numbers does it feel right. Considering what I know about the EHR and EMR market and CCHIT certification in particular, I know that something doesn’t feel right. Let me explain a few reasons and hopefully someone else smarter than me can comment on what else is wrong with this measurement.

First, the graph showing practice sizes served is misleading. I don’t know specifically how they found out which size practices a certified EHR vendor served, but I’m guessing it was self reported by the EHR vendor itself. If this is the case, most EHR vendors will say they can work in any practice size. So, that basically makes the data pretty useless. Possibly you could look at the size of the practices using the EHR system, but even then you get into trouble because how do you define “using” the system. A few EHR vendors can claim tons of purchases of their EHR software, but then you find out that very few if any of those purchases are actually implemented.

The second part of the slide shows a nice pie chart of the size of EHR vendors that are certified. The challenge I have with this chart is that it may just illustrate how small the EHR industry really is right now. The revenues of EHR companies are spread out over 300-400 EHR companies. Considering 5-15% (depending on where you look) adoption, that means that the majority of EHR companies are all small businesses with very low revenue.

I bet if we did a percentage of EHR vendors that did CCHIT certification for each of their annual revenue classifications you’d see something like this:
> $100 million – 100% CCHIT certified
$21 – 100 million – 90% CCHIT certified
$11 – 20 million – 50% CCHIT certified
$1 – 10 million – 15% CCHIT certified
< $1 million - 3% CCHIT certified I'm just pulling these numbers out of the air, but I think you can see the principle of how CCHIT certification is being adopted by large EHR vendors and not as many small EHR vendors. CCHIT's measure is just wrong. It should be percent in that EHR size category that are getting certified. It's not the percentage of all CCHIT vendors that are doing it. Reminds me of the common phrase that statistics can tell you anything you want to know. Something for all you EMR and EHR fans to chew on over the weekend.

CCHIT Head Mark Leavitt Interviewed at HIMSS

Posted on April 15, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

This is basically the second part in a 3 part series of video interviews by Matthew Holt. This interview was at HIMSS of the heat of CCHIT Mark Leavitt. This video is a little long and dry, but it gives you a feeling of Mark Leavitt and his motivations with CCHIT.

To read my comments on CCHIT, then just read this whole blog. My short takes from the video:
CCHIT is looking at ways to measure usability.
CCHIT is looking at ways to measure successful EHR implementations.
My comment: Only took 4 years to start looking.

Mark Leavitt did state that CCHIT’s goal was to “reduce the risk of buying an EHR.” If that’s the goal, I’m a little surprised they aren’t measuring the results of this. Where’s the data that implementing a CCHIT certified EHR is any less risky than a non-certified EHR?