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CCHIT Certification and SHOVEL

Posted on March 25, 2006 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 reading quite a bit of discussion about a new CCHIT certification that is being created for EMR companies. I really think these medical certifications are interesting since you really have no requirement to be certified and certification really doesn’t mean you are necessarily better. However, with the number of EMR companies out there a consumer certainly will be looking at certification as some means of proof that an EMR has features that they will need or want. Too bad this isn’t necessarily the case. Either way, the CCHIT certification is coming whether you like it or not. Here’s a link to the CCHIT certification requirements. You have until March 31st for public comments.

Many of the smaller/free EMR companies out there are really frustrated with the certification process proposed by CCHIT and they’ve been making their frustration clear in an EMR forum called EMRUpdate. Theit frustration from my point of view lies mainly in the enormous cost to be CCHIT certified including a large yearly royalty fee and the requirement to code a bunch of useless enhancements just for certifications sake. I can’t say I disagree with these 2 items.

I also think the certification process is wrong because it is an all or nothing certification. That means if you are missing one feature then you would not be certified. This really doesn’t make sense. An EMR company should receive a grade instead of a certification. This would allow each EMR vendor the ability to justify why they got the grade that they did. Not only would this be fairer, but it would also give more information to doctors evaluatin an EMR.

A group at EMRUpdate have put together a letter that they are sending to CCHIT about flaws found in the CCHIT certification process. Any of those interested in participating in these recommendations can sign their name at EMRUpdate Draft Letter to Dr. Mark Leavitt, MD, Ph.D. You can see the thread that created this letter here.

Depending on the response to this letter, many of the people who participated in creating the content for this letter have talked about creating a new Certification sponsored by EMRUpdate.com. They’ve termed it SHOVEL – Software for Healthcare Organizations EMR Voluntary Ligitamacy and I better give some props to AlBorg who has done a significant amount of work on this idea. I like the idea, but as stated in the thread creating the idea, I think it will probably take 30-40 EMR vendors coming on board to make it work.

I guess we’ll see how much power an online group of vendors, consultants, doctors and EMR lovers are able to do. Let me know what you think of the certification process and SHOVEL.

SnoMed and RxNorm

Posted on 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.

Why would an EMR company not want to use these databases (or at least ones like them)?

I’ve recenly come accross SnoMed and RxNorm. I honestly don’t know too much about them, but my impression is that at a minimum these 2 databases list all the ICD9 codes and standardize the listing of Rx’s using the NDC number. Lists like these would have made my life so much easier. When I first implemented an EMR I really didn’t know what I was doing at all. I was learning the medical side as quickly as I could so I would know how to configure the software. I guess I could have sat back and said I’d be happy to just install the server, install the software and let the doctors deal with the medical side of it. However, if I did that I think that we wouldn’t be anywhere near an EMR implementation. So, I jumped in head first and tried to learn what needed to be uploaded to our new EMR system. I found myself having to upload all the ICD9 codes and find a way to add all the medications we wanted to prescribe into the EMR system. Anyone that has looked at these lists knows how much fun this was. Having access to some databases like SnoMed and RxNorm would have made my life so much easier. Even more important is that an EMR vendor should have this standard.

Ok, don’t start flaming this thread(although maybe I should encourage comments since this is a subject I don’t know that well), but there are some challenges for EMR companies wanting to implement it. I’m sure if you list every drug every created then I’m going to start complaining about that too. Not to mention every ICD9 code. At least you have to plan a way for me to sort through the lengthy list. Also, I don’t think it’s just a flip that is switched to turn this type of integration on or off. I also will give those older EMR companies a little slack since it’s going to be a definite challenge integrating these databases if you haven’t been using them in the past. However, it’s not impossible.

I think the biggest reason to implement some type of database like SnoMed and RxNorm is because of the potential integrations that can be done in the future. RHIO is a hot topic, but if we don’t all speak the same language as far as ICD9 codes and drug names then it will be difficult to integrate. The whole CCR initiative will be so much better if we have a standard language that we all use.

Ok, so I apologize for my primitive understanding on the topic, but I figured I had to start somewhere. More information to come.