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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.

CCHIT Certified EHR Becoming ARRA Certified EHR

Posted on August 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.

Alfred from Infomd.net recently made the following comment:
If the product you use is CCHIT certified, it is a pretty safe bet to say that they will be certified under the Meaningful Use rule. Meaningful Use is but a subset of what it takes to become CCHIT certified

Here’s my response to Alfred:
Alfred,
I don’t think that the new certified EHR is a subset of CCHIT. There are some similarities and concepts, but it’s not a subset.

However, I think you’re right that many CCHIT certified vendors will become ARRA certified. Mostly because the EHR vendor that has the CCHIT certification has chosen to make EHR certification a priority for their company. So, they’ll likely make the ARRA certification a priority as well.

It is worth asking if you want to be tied to an EHR company that focuses so much on certification. One could make the argument that an EHR vendor that focuses so much on EHR certification might not be focusing enough on the customer’s needs. These 2 focuses will obviously create very different EHR products.

See Also this post: EMR Stimulus Q&A: Do You Have to Use a CCHIT Certified EHR Vendor?

Crazy Legislative Process

Posted on August 27, 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 I came across some really crazy news that one of the senators that helped write the healthcare reform bill hadn’t ever even read the entire bill. Here’s a section of the article:

During the debate over what later became the health care bill that was recently signed into law by President Obama, a number of federal representatives and senators both admitted that they had not read it. Some, including Rep. John Conyers (D-Mich.) even boasted of this fact. House Speaker Nancy Pelosi (D-Calif.) famously stated that “we have to pass the bill so that you can find out what is in it.”

Presumably the actual people who wrote the bill might have at least some idea what was in it. Unfortunately that isn’t the case with Max Baucus (D-Mont.), lead sponsor of the Senate bill that became law. He admitted as much Monday during a constituents meeting in the small Montana town of Libby, as reported by the Flathead Beacon, a local newspaper.

According to Baucus, the idea of him reading a bill allocating nearly $1 trillion of federal funds is “a waste of time:”

There’s just something that feels really wrong about the idea that even the senator that helped write the bill hasn’t read it all. Although, it’s not really all that surprising.

I’ve thought that the same thing happened with the HITECH Act. No doubt it was thrown together by a few people and the majority of senators had no clue what it really included or meant.

Can’t you imagine it? They kind of throw together this EHR certification term tey’ve heard. Yeah, certification sounds good. Also, let’s make them accountable by making sure they’re using the EMR. Ok, the rest of the details are up to you.

I’m sure that no senators or even junior staff actually thought much about the impact of requiring a certified EHR and how they might measure a doctor’s use of an EHR.

Of course, why should they “waste their time” on a mere $20-30 billion. They can’t waste their time on a trillion dollar ill, so why would they waste it on a so much smaller amount?

One Way Of Measuring Meaningful Use Productivity Loss

Posted on August 26, 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 think I better just invite BobbyG to join me as a blogger since he’s often contributing essentially great blog posts in the comment. I just have to highlight them. So, here’s one comment that BobbyG offered that talks about the potential productivity loss that a clinic could see if they focus too much on meaningful use and not enough on the business case for implementing an EHR. I think we all know where I stand on this issue. If you don’t, then you should be reading EMR and HIPAA more often;-)

One of my concerns regarding a “stimulus focus” (i.e., an incentive money fixation) in lieu of a broader “business case focus” goes like this, if you will permit what may be a simplistic example:

ASSUME

[1] an average 2 minutes additional MU documentation burden per chart (that’s only 6 seconds on average to navigate to/”touch”/verify/enter each of the requisite 20 measures as needed for each patient during the attestation period);

[2] 100 patients seen per week, 50 weeks per year, or 5,000 charts touched annually;

[3] That’s 10,000 minutes, or ~167 hours;

[4] Multiply by a blended, fully G&A cost-multiplied FTE rate of $40/hour;

[5] 167 hrs/yr x $40/hr x five years = $33,400 MU labor,

exclusive of the FTE burden associated with the additional CQM reporting (“Clinical Quality Measures”). Now, recall that the max provider Medicare MU incentive reimbursement over the 5 years is $44,000 (and that money will be taxable income).

Worth it? Draw your own conclusions. Play with the input assumptions.

Now, obviously, the task (from my REC Adoption Support perspective) is to so effectively re-design workflow as to totally mitigate/eliminate any additional MU documentation burden while streamlining workflow ops more broadly, so that the MU incentive money is neither effectively erased nor appreciably diminished by all of this, and the provider is better off both financially and in terms of care quality and patient satisfaction.

We shall see, I guess.

While my illustrative scenario proffered above is rather simple and to a degree hypothetical, it is nonetheless based to a degree on my own playing around, stopwatch at the ready, in a “sandbox” e-MDs login provided us by the vendor, noting the navigation paths to the various MU “money field” target destinations.

A few seconds here or there, annualized, adds up quickly.

EMR Billing Matters

Posted on August 25, 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.

My previous post about imagining an EMR that didn’t include billing certainly has driven a lot of conversation. Actually, that was the purpose of the post. I indulge in great conversation with multiple perspectives. It’s the beauty of blogging and of life.

However, please don’t let that post confuse you. Billing is an absolute essential part of an EMR software. There’s a very good reason why most EMR software out there amounts to little more than a big billing machine. The demand for healthcare software was initially to solve the challenges associated with medical billing. Markets are great at satisfying demands and that’s why the EMR software is the way it is today.

This means that EMR vendors CANNOT ignore billing. Rightfully so, doctors want to get paid for their work.

Of course, the point of the previous post was to try and expand the conversation beyond billing. Basically, the goal was to try and imagine an EMR software world where patient care was the focus instead of billing. What kind of good could we accomplish if this was our goal?

This follow up post was prompted by this somewhat disturbing email I received:
“I have built just such an EMR product for the iPhone and iPad. I am struggling with financing it because everybody wants billing. They really don’t care about the quality of the EMR.”

I’d make one qualification. No one cares about the quality of the EMR, if you don’t satisfy their billing needs too. Reminds me of HIPAA. No one would purchase an EMR that didn’t meet the HIPAA standards. However, once they hear it meets those standards, they move on to other things like the quality of the EMR.

EMR vs EHR

Posted on August 24, 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.

Many of you have likely noticed that I like to use the terms EMR and EHR almost synonymously. In fact, it’s kind of a game for me now. I generally try to stick with one term for a certain blog post, but I even break that rule on occasion. I guess the thing is that it really doesn’t matter to me at all.

I don’t like to debate the meanings and definitions of words since it doesn’t matter how you define a term. Instead, I just try and communicate the substance of the issues. Words matter as part of that communication, but whether I call it an EMR or an EHR doesn’t change the value of what I’m trying to communicate (at least 99% of the time).

There are a few rare cases when I do differentiate. For example, I would likely never say that you need a “certifed EMR” to get the available HITECH Act stimulus money. I wouldn’t do so because the legislation specifically says “certified EHR” and so I’d respect the verbiage. Although, these cases are few and far between.

Plus, I try to be the voice of the physician. I’d bet if you asked most physicians the difference between an EMR and EHR they’d likely laugh, walk away or know what an EMR was but ask you to define the term EHR. I, like most physicians, don’t care what you call it. They (and I) care more about the substance of selecting, implementing, using, maximizing, enjoying and even sometimes enduring an EMR or EHR.

EMR Vendor Recommendations

Posted on August 23, 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.

Every couple months I get someone asking me if I could recommend any good EMR vendors. It makes complete sense why someone would ask this question. They want to try and narrow their search down from the 300+ EMR vendors that are out there. That’s an incredibly daunting number to consider and so everyone’s trying to narrow down their EMR vendor search (see also my previous top rated EMR companies post).

The problem with this question, is that the answer is different for every clinic. Why? Because every clinic has very different needs and every EMR vendor has very different capabilities. The key is to be able to match the capabilities of the EMR vendor with the needs and culture of the clinic.

EMR software is not like email. I can easily recommend that a business who wants an email system sign up for the free Google Apps email. That email (essentially gmail) blows every other email out of the water (especially with the free price tag). EMR software isn’t like that. There are a few dozen (at least) EMR vendors that have really amazing software depending on your clinics needs. For me to recommend an EMR vendor without knowing more about your clinic would be a tremendous disservice.

I would recommend those interested in selecting an EMR to purchase my EMR selection e-Book. It walks someone through the process of selecting an EMR based on their own clinical needs and business requirements. Plus, it educates the reader on the various EMR options so that they can assess which type of EMR software would be right for their clinic.

I guess this is why I get all worked up when RECs create a “preferred EMR vendor” list. It’s just ridiculous that they think they can do an RFP or some other EMR vendor evaluation that can somehow take into account the thousands of different clinical practices that exist in their area.

Of course, I haven’t resolved the need that people have to narrow down the list of 300+ EMR vendors. The full answer is in my EMR selection book I linked above. One part of that answer is to use an EMR selection website like Medical Software Advice or EMR Consultant.

Neither of those services are perfect at finding matches either, but it’s a decent place to start in narrowing down your EMR vendor list. At least they try to understand your clinic before making EMR recommendations. Plus, just because they provide you a list of 5 EMR vendors doesn’t mean that you can’t look beyond the list. Treat those lists as a good starting point for evaluating EMR vendors. Then, if there’s still not a good match you can keep looking.

The message of this post is to be wary of anyone that tries to recommend a specific EMR when they know nothing about your individual clinical needs.

Full Disclosure: Both Medical Software Advice or EMR Consultant advertise on this site, but they don’t know I wrote about them on this post. I just suggested them since I think they provide a good service.

Imagine an EMR without Billing

Posted on August 22, 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.

For today’s weekend post, here’s a thought provoking comment:

Imagine what EMR software would look like if it didn’t have to worry about billing, insurance and reimbursement. Would we then see much higher quality EMR software in regards to patient care and physician workflow?

I look forward to reading your thoughts.

Selecting an EMR Vendor

Posted on August 20, 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 know that sometimes people don’t like the analogy’s I make on this site. However, I just can’t help but make them. I find them instructive and there’s nothing wrong with people disagreeing with me. In fact, that’s often where I learn the most.

In the comments of a previous post, I was discussing some of the common issues with large EMR vendors (I like to call them Jabba the Hutt EMR vendors). Namely: backlog of training and setup, slow EMR support response times, HUGE up front costs for the EMR, etc etc etc. I’m sure that many of you are familiar with these subjects. For example, you pay a HUGE up front fee, get to wait 6 months to get trained on the EMR (EMR backlog?) and then once you implement your support calls take forever to get responses from the EMR vendor. Unfortunately, this is far too common.

What I don’t get is why people continue to go through this pain.

A few years back I was talking with someone about eating out at restaurants in Las Vegas. Someone was complaining about the wait times at a restaurant to get a table. Then, a long time Las Vegas resident commented that her husband and her NEVER wait for a table in Las Vegas. She then explained that there are SOOO many restaurants in Las Vegas, that if one has a wait they would just go to another one.

Obviously, the comparison to an EMR isn’t perfect, but the number of EMR choices is plentiful and you do have a choice to go with another solution. Sure, your EMR is an absolutely critical decision. You don’t want to make it lightly. However, that’s exactly why I don’t understand users that want to take a $50k-100k+ risk on an EMR software which can barely even support their implementation in the first place.

Is there EMR product really that much more compelling than the other 300+ EMR vendors?

There are plenty of low cost monthly alternatives that have exemplary support out there. The phrase “Buyer be ware” was never more true than with the purchase and selection of an EMR vendor. Don’t be swayed by great marketing and sales people. Take your time and find the right EMR and the right EMR vendor.

Costs of EMR Certification for Meaningful Use And Impact on EMR Vendors

Posted on August 19, 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.

Long time readers will know that I’m not a fan of EMR certification. It seems quite pointless since it provides no assurance to the doctor of anything of value. EMR Certification doesn’t ensure a higher implementation success rate. EMR Certification doesn’t improve patient care. EMR Certification doesn’t improve doctor’s bottom line.

With that said, we’re still stuck with the term “certified EHR” in the HITECH Act EMR stimulus money legislation. So, EMR certification is going to be around for the foreseeable future.

CEO Mike from Medscribbler EMR posted an interesting look at the cost of CCHIT EMR Certification and the impact that it could have on EMR vendor selection and long term viability of EMR vendors. I’ve included his comments below:

Note: See my post about whether you have to use a CCHIT Certified EMR vendor before reading Mike’s comments.

Using the CMS’s own data and report a CCHIT EMR will spend between $125,000 to $350,000 in programming costs to be certified (add at least $20,000 for actual certification) An existing EMR not CCHIT certified they predict will spend $175,000 to $700,000 to meet the standards (plus the $20,000.)

Certification has to be done for each year, for three, so a 2011 certification does not guarantee MU certification for 2012.

Self certifying for Open Source are not exempt from requirements so it stands to reason they will have the same expense.

What does this mean:

1. Forget collecting MU with Open Source software.

2. If you are using no CCHIT software it is unlikely the software will be qualified by the vendor.

3. Even fewer EMR vendors will certify than those that did so for CCHIT.

4. Innovation is dead if MU certification becomes generally why an EMR is purchased as this will also set the preception of useability. Vendor design resourcess will go to MU not useability.

5. If MU EMRs fail to get widespread purchase, those EMRs who certify are dead (including some current larger market share ones, as they will undoubtably spend a ton on marketing to maintain their share.) The MU EMRs will also then presummably be left behind by the innovators for useability.

6. Certifying bodies, especially CCHIT may be in trouble because there will be fewer takers, or they will charge a lot more pushing EMR prices up.

7. Regardless everyone is going to pay a lot more for an EMR making the MU payment mote.

Medscribbler could be certified, we are still evaluating this, because there are a lot of CCHIT EMRs now dead in the water – certification is no guarantee of success – we believe useability is – and how do we balance useablity which will guarantee success with certification which may or may not?