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ICSA Labs Questions Strength of ONC Certification Rules

Posted on August 11, 2011 I Written By

You’ve undoubtedly heard the argument before: EHR certification is about assuring that systems meet minimum requirements for functionality and interoperability, but the certification process falls way short in terms of usability, privacy and security. But have you heard the argument from one of the ONC-authorized certification bodies?

This is an excerpt from an e-mail I received today:

Meaningful Use criteria have become a massive EHR certification driver for healthcare organizations. Hospitals and other providers rely on the criteria to ensure that their health IT systems meet minimum government-specified functionality and interoperability requirements to support Stage 1 of Meaningful Use.  Achieving Meaningful Use also ensures a health care organization qualifies for reimbursement under the American Recovery and Reinvestment Act as a way to incent adoption of e-health processes among health organizations. The ultimate goal is to improve our nation’s healthcare system by leveraging technology to allow greater access to important health information and empower patients to securely access their own health information.

However, as one of only five organizations authorized to test both complete and modular EHRs by the Office of the National Coordinator (ONC) for Health IT, ICSA Labs questions whether EHR certifications are enough as the criteria represents only minimum requirements. Amit Trivedi, healthcare program manager at ICSA Labs, believes providers should take further steps to heighten the security and privacy of their health IT systems. He also suggests vendors should look beyond the current regulations to address and improve usability, data portability, and information exchange in their products.

That’s right, ICSA Labs, one of five organizations currently authorized to test and certify complete EHRs on behalf of the Office of the National Coordinator for Health Information Technology, seems to think that the standards it tests EHRs against are inadequate, which is something that critics of certification—particularly critics of the Certification Commission for Healthcare Information Technology—have been saying for years. Critics of many of the larger vendors have been saying that, too. But it’s shockingly refreshing to hear this from an actual certification body.

In fact, the publicist for ICSA, a unit of Verizon Business, has offered interviews with executives of two lesser-known vendors,  Health System Technology and Design Clinicals, to talk about how they are going beyond the minimum certification requirements. Deadlines beckon, so I didn’t really have time to wait for the publicist to try to find me an schedule opening for one of the executives, but here’s a statement from a March 30 ICSA press release that is somewhat telling:

“This year we are expanding our certification programs into health IT, a much-needed area of focus to help modernize today’s health care system,” said George Japak, managing director for ICSA Labs. “With our new focus on safeguarding patient information within electronic health records, we are committed to helping accelerate the adoption of health IT.”

We don’t hear too much about security in the context of certification from too many other camps, so it’s nice to hear that at least one certification organization is critical of the rules it is under contract to follow. Perhaps we’ll see tougher usability, privacy and security standards in the permanent certification program ONC needs to have in place by the beginning of 2012 to support the forthcoming Stage 2 “meaningful use” requirements from CMS.

Wishful thinking?

Permanent EHR Certification Program

Posted on January 5, 2011 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.

Looks like the people at HHS and ONC have been working hard. On Monday this week they published the Permanent EHR Certification Program Final rule. You can find the press release about the Permanent EHR Certification final rule on my new EMR News website (if you have other EMR news, please let me know).

You can download the full Permanent EHR Certification final rule here (Warning: PDF). Although, I must admit that I found the permanent certification fact sheet very interesting. Here’s my summary:
*Testing and certification is expected to begin under the permanent certification program on January 1, 2012 (with an exception if it’s not ready)
*NIST (through its NVLAP) will continue with accrediting organization to test EHR and to work with ONC to create test tools and procedures
*A new ONC-Approved Accreditor of ONC-AA will be chosen every 3 years
*All ONC-ATCB (those bodies certified under the temporary) must apply to be ONC-ATB (permanent certification bodies)
*ONC-ACB have to renew every 3 years
*Gap Certification will be available for future EHR certification criteria.

The most interesting part to me was that ONC will be selecting an ONC-AA (Approved Accreditor) through a competitive bid process. So, they’re going to accredit an accreditor to accredit the certifiers? I think you get the gist. I can see how ONC saves so much by only having to have to deal with one ONC-AA and not the 6 ONC-ATCB (that was in the sarcasm font if you couldn’t tell).

It does make sense to have a gap certification so that EMR vendors that are already certified don’t have to certify against all the criteria every time. I guess in theory changes an EHR vendor has made could have caused issues with their previous functions, but that’s pretty rare. Especially since their users will need it to be able to show meaningful use (which is why EHR certification has little meaning beyond it being required for EHR incentive money).

Whether you agree or disagree with EHR certification (I think you know where I stand), you have to give ONC credit for pushing out the EHR certification program so that there are plenty of certified EHR software out there to choose from. Looks like they’re well on their way to implementing the permanent EHR certification as well.

Another Possible ONC-ATCB EHR Certifying Organization

Posted on October 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.

One of my more interesting meetings at AAFP was with a company called SLI Global Solutions. The meeting was so interesting, because SLI Global Solutions plans to apply to become an ONC-ATCB organization very soon. This coming after the announcement of the first ONC-ATCB certified EHR from Drummond Group and CCHIT along with the announcement of InfoGard as an ONC-ATCB and Weno Healthcare’s plans to become an ONC-ATCB.

We obviously had a long conversation about the EHR certification, but suffice it to say that SLI Global Solutions is going full steam ahead to become an ONC-ATCB. It sounds like they’ve been doing a number of other certifications previously. They’ve even done some consulting work in healthcare.

When I asked SLI Global Solutions what they thought would help them to differentiate themselves from the other ONC-ATCB, one response was that they were really good at providing feedback and helping organizations through the certification process. I personally think that many EHR vendors and other healthcare organizations that need to certify for the EMR stimulus money are nervous about the unknown issues related to certification. If SLI Global Solutions can provide them a feedback loop then it could go a long way to relieving the nerves. This is the main suggestion Jim Tate makes in his post about selecting an ATCB.

I asked SLI Global Solutions how much they planned to charge for the EHR certification. Here was their response, “We have not finalized the pricing yet because we are contemplating ancillary services pre and post certification but we will likely be in the $20,000 USD ballpark.”

With SLI Global Solutions, that would make 5 ONC-ATCB and I’m guessing there are other companies like this that will become certifying bodies as well. I’m all about competition and so the more ONC-ATCB the merrier.

It does make me wonder how many ONC-ATCB the market can support. Not to mention, there’s the interesting question of whether they’re a bit late to the party. I guess time will tell.

33 More ONC-ATCB Certified EHR

Posted on October 1, 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.

Today, CCHIT announced their first ONC-ATCB certified EHR a day later than Drummond Group’s ONC-ATCB announcement. Although, CCHIT is announcing 33 EHR vendors (21 complete ONC-ATCB certified EHR and 12 module certified). No real surprises on this list. They were the previously CCHIT certified EHR companies. That gives us 36 total ONC-ATCB EHR right now (or 24 if we’re talking complete EHR certification).

Here’s the list of Complete ONC-ATCB certified EHR:
ABEL Medical Software Inc.
ABELMed EHR – EMR / PM

Allscripts
Allscripts Professional EHR

Aprima Medical Software, Inc
Aprima

athenahealth, Inc
athenaClinicals

CureMD Corporation
CureMD EHR

The DocPatientNetwork.com
Doctations

eClinicalWorks LLC
eClinicalWorks

Epic Systems Corporation
EpicCare Inpatient – Core EMR

Epic Systems Corporation
EpicCare Ambulatory – Core EMR

GE Healthcare
Centricity Advance

gloStream, Inc.
gloEMR

Intuitive Medical Software
UroChartEHR

MCS – Medical Communication Systems, Inc.
iPatientCare

Medical Informatics Engineering
WebChart EHR

Meditab Software, Inc.
IMS

NeoDeck Software
NeoMed EHR

NextGen Healthcare
NextGen Ambulatory EHR

Nortec Software Inc
Nortec EHR

Prognosis Health Information Systems
ChartAccess

Pulse Systems
2011 Pulse Complete EHR

SuccessEHS
SuccessEHS

Here’s the list of module ONC-ATCB EHR Certifications:
NOTE: CCHIT does make a comment that some of these may become complete EHR certifications later.
Allscripts
Allscripts ED

Allscripts
Allscripts PeakPractice

Health Care Systems, Inc.
HCS eMR

NexTech Systems Inc.
NexTech Practice 2011

nextEMR, LLC
nextEMR, LLC

PeriGen
PeriBirth

Sammy Systems
SammyEHR

T-System Technologies, Ltd.
T SystemEV

Universal EMR Solutions
Physician’s Solution

Vision Infonet Inc.,
MDCare EMR

WellCentive
WellCentive Registry

Wellsoft Corporation
Wellsoft EDIS

First ONC-ATCB Certified EHR – Drummond Group Wins

Posted on September 30, 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.

Drummond Group just posted the news of the first 3 EHR vendors which have been officially certified EHR for the ARRA EHR stimulus money. Looks like Drummond Group won the race to be the first to certify an EHR.

The interesting thing for me is the list of 3 EHR vendors that became the first certified EHR:
PARADIGM (QRS Inc.)
ifa EMR (ifa united i-tech Inc.)
ChartLogic EMR (ChartLogic, Inc.)

I consider myself pretty well informed about EMR vendors, but I only realy knew 1 of the 3 and I’d maybe heard of one other, but just by name. As all the ONC-ATCB certified vendors start completing their EHR certification, I think we’re going to learn about a WHOLE lot of EMR vendors that very few people knew about previously.

I also find it interesting that all 3 EHR vendors have already updated their website in some way to represent the new ONC-ATCB EHR certification.

Note: We need a new way to identify the certified EHR. ONC-ATCB just doesn’t have the right ring to it. I might work on this problem.

EHR Certification Testing Dates Scheduled into November

Posted on September 14, 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 can’t remember when or where I saw it, but at some point I saw someone reference Jim Tate from EMR Advocate as the expert on EHR certification. I’d known Jim electronically for quite a while having followed his writings online and on Twitter. I even haphazardly bumped into Jim where we both looked at it each other and recognized our pictures from Twitter.

After Jim stopped by to comment on my previous EHR certification post, I emailed Jim to ask him if he wanted to do a guest blog post for EMR and HIPAA. He is busy with 3 stage 1 EHR certifications this week, but did send the following info which I found interesting and useful. I’m also looking forward to taking a look at his manual on meaningful use. I hear it’s highly targeted at doctors and clinical practices which fits in line with my style too.

The HHS/ONC Authorized Certification Program has really broken loose. We were in the eye of the storm, but the eye has passed and the windows are being blown out. Vendors are desperately trying to get a testing date in October and not Novemenber or later. The ability to get Stage 1 Certified and listed on the ONC website is now a giant business issue. A two month’s delay in being able to market and sell certified technology is a handicap. We will see the effect that decisions made over the past year by vendors will play out in the market. Those that applied for the CCHIT Preliminary IFR Stage 1 test are sitting pretty as their can choose test dates based on their application date. Those vendors that elected to wait may pay a price in delayed certifications. Of coursethere are presently 2 organizations authorized to test and certify and I expect maybe 2 more in coming weeks. That may help the crunch. The Drummond Group is charging $23,500 for all Stage 1 testing for EPs and has begun accepting applications for testing. Information about their program is available at: http://www.drummondgroup.com/pdfs/EHR_Testing_and_Certification_Guide_Rev_A.pdf (PDF). A number of my vendor clients have applied and have been given test dates in mid to late November. CCHIT will hold a Town Call next Monday at 1 PM ET: http://www.cchit.org/about/towncalls/CCHIT-Town-Call-Authorized-HHS-certification-program. The fees for their Stage 1 testing will be announced at that time and applications will begin to be accepted that date. Vendors who had already applied for CCHIT’s Preliminary Stage 1 Testing will begin testing against the CMS Final Rule next week. By the end of this month we will Certified Technology listed on the ONC website.

Due to the complexities of the CMS EHR Incentive Program for EPs I have written a manual, The Incentive Roadmap, to help guide medical practices through the process. It is being updated continually to reflect the changes in the incentive program. It is being sold at HITECHAnswers.

Existing EHR Vendors with CCHIT Certification

Posted on September 13, 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.

As I mentioned in my previous post about the race to be the first EHR certified (and the first ATCB to certify an EHR), there’s a lot more going on in the battle amongst the EHR certifying bodies.

The first interesting detail surrounds the previous CCHIT certified EHR vendors. This turns out to be a really great move by CCHIT. A quick look at CCHIT’s website has 49 EHR products (or modules of products) that have been certified for either the CCHIT 2011 certification or for the Preliminary ARRA certification. That’s 49 pieces of EMR software (a few less since some are different versions of the same product) have paid $22k+ in order to be certified by CCHIT.

I’ve talked to one of these EHR vendors and they said that CCHIT did a call with all current vendors and said that they will be honoring their previous commitment to provide the real ARRA certification at no additional cost to these providers. This turns out to be really smart if it means that many of the big EHR players like GE, Elipsys/Allscripts, NextGen, Epic, Athena, Pulse, Cerner, etc all decide to continue forward with CCHIT.

Many would ask why they would pay another $20k to someone like Drummond Group if they could get the EHR certification for free from CCHIT. Turns out their is a possibility if CCHIT isn’t able to deliver their certification in a timely manner and Drummond Group is able to do it much quicker.

Remember the list above are HUGE EHR vendors where $20k is basically a drop in the bucket. It’s kind of scary to consider that, but that’s the reality for most of the EHR vendors. Sure, it’s not what they’d like to spend if they don’t have to, but when did large corporations start worrying about wasteful spending? Ok, that might be a slight exaggeration, but you get the point.

The good thing for Drummond Group is that there are still 300+ EMR vendors that will need to be certified. In fact, many of the non CCHIT certified EHR companies are likely moving to Drummond Group for EHR certification since CCHIT is giving priority to their existing EHR vendors.

Yes, that’s right. Over the next month and half CCHIT will spend all its time doing a bunch of free EHR certifications while Drummond Group will be making just under $20k for each EHR certification that they do.

One final thought about the fun that is EHR certification. When I recently talked to an EHR vendor that is CCHIT certified and will likely be getting their now free EHR certification, I found it really interesting to learn who from their company was on the CCHIT call. In this case, the EHR vendor’s VP of Marketing was on the call with CCHIT.

Of course, this begs the question why the VP of Marketing would be on a call about EHR certification standards and compliance. Shouldn’t the clinical director be the one that wants to be on that call? I think it sends a compelling message that I’ve been preaching on EMR and HIPAA for a long time. EHR certification is not a benefit to the doctor. EHR certification is not a benefit to the patient. EHR certification is a means for EHR vendors to market their EHR software.

EHR Certification – The Race for First

Posted on September 9, 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 have a lot more to say about EHR certification and the battle we’re about to see between Drummond Group and CCHIT for EMR vendors, but I’m about to leave for an interesting conference on meaningful use, EMR and HIE. Although, I did want to just start the conversation on becoming a certified EHR.

It seems like the battle is just beginning to try and secure EHR vendors under a certain certification. One of the competitive differences right now is about speed. Which EHR certification body will be the first to certify an EHR under the ARRA guidelines. It will be a big PR move for the first EHR vendor and should benefit Drummond Group or CCHIT to be first.

From the dates that I’ve heard, Drummond Group seems like they’ll be accepting applications for certification first (near the end of this month). CCHIT will be doing it at the beginning of October. It will be interesting to see how quickly Drummond Group will be able to turn around the EHR certification results.

Plus, one other wrinkle in this area is that CCHIT is giving priority to the EHR vendors that are already CCHIT Certified or Preliminary ARRA certified. This means the other 250+ EHR vendors are being treated as second class citizens. You can guess where that larger part of the EHR market is going for their certification: Drummond Group.

Drummond Group and CCHIT Become First Official ONC EHR Certifying Bodies

Posted on August 31, 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.

We finally now have the first ONC approved EHR certification bodies (Officially ONC-ATCB or ATCB or ONC Authorized Testing and Certification Body). The first 2 ONC-ATCB are very familiar names that we’ve been talking about on EMR and HIPAA for a long time: Drummond Group and CCHIT.

In an HHS and ONC press release they also noted that “Applications for additional ONC-ATCBs are also under review.”

Drummond Group has already posted information on their website about their EHR certification and testing plans. The most useful item is this 10 page EHR Testing, Pricing and Certification guide (PDF).

Lots of interesting information in the PDF which I’ll likely talk about later. The pricing however is worth noting now. It’s on page 8 of the PDF document and has certification set at $19,500 for the Complete Remote EHR certification and $23,500 plus travel for the Onsite EHR certification tests. There’s also pricing for the modular certification.

I haven’t found any published prices on CCHIT certification, but in the past the CCHIT EHR certification costs were $37,000 for the complete CCHIT certification and $33,000 for the Preliminary ARRA certified EHR.

Looks like we might have a bit of an EHR certification price way on our hands. $20k is still a lot of money for EHR certification, but $10-15k difference is quite a bit of money.

Here’s a short quote from the CCHIT press release about their time frame for accepting EHR certification applications and when we might see the first certified EHR.

CCHIT plans to launch its authorized HHS certification program on September 20 at 1:00 PM Eastern time with a Town Call Web-cast describing its application and testing process. CCHIT will take new health IT developer applications immediately after at http://cchit.org and the first group of HHS certified complete EHRs and EHR modules will be announced within weeks of that launch. More information about the Town Call will be available at http://www.cchit.org/towncalls. The call will be recorded for later viewing.

It will be interesting to see if Drummond Group of CCHIT can produce the first officially certified EHR vendor and which vendor will hold that distinction.

UPDATE: Weno Healthcare looks to be another potential ONC-ATCB (if they get approved) and their EHR certification pricing looks to be in the $14k-$18k range.