Webinar: CCHIT's Bell warns 'buyer beware' for EHR purchases
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In September, CCHIT was designated as an Office of the National Coordinator for Health IT (ONC) Authorized Testing and Certification Body (ACTB) to test and certify complete EHRs and EHR modules. The Chicago-based CCHIT’s ONC-ATCB 2011/2012 certification program tests and certifies that EHR technology is capable of meeting the 2011/2012 criteria approved by the Secretary of Health and Human Services (HHS).
Bell noted the federal government's rapid development of the certification program, from the January announcement of the interim final rule of EHR standards and certification to the July final rules listing for standards and certification.
According to Bell, everyone wishing to apply for the meaningful use incentives provided under the HITECH Act's provisions will have to take these steps:
- Adopt certified EHR technology;
- Achieve meaningful use; and
- Apply for payment.
The difference between Complete EHRs and Qualified EHRs needs clarification, she said: “This is one of the areas where there is a lot of confusion … In order to be eligible for meaningful use criteria, one must have a Qualified EHR, meaning it has [been] certified by an ONC-ATCB and that it is complete. The alternative to a Qualified EHR is to have EHR Modules,” said Bell.
She cited federal definitions for these terms:
- Complete EHR: An EHR that can perform, at a minimum, all of the applicable capabilities required by certification criteria adopted by the Secretary, and thereby as providing eligible professionals or eligible hospitals with the technical capabilities they need to support their achievement of meaningful use of certified EHR technology.
- Qualified EHR: An EHR of health-related information on an individual that includes patient demographic and clinical health information, such as medical history and problem lists, and has the capacity to provide clinical decision support; to support physician order entry; to capture and query information relevant to healthcare quality; to exchange electronic health information with, and integrate such information from, other sources.
- EHR Module: Any technical service, component or combination thereof that can meet the requirements of at least one certification criterion adopted by the Secretary.
- Bundled Modules: Multiple technologies addressing up to nine criteria which are certified as a “bundle,” precluding each individual technology from claiming individual certification status.
All ONC-ATCBs must certify products to federal regulations and under the National Institute of Standards and Technology (NIST) testing procedures, Bell said.
There are seven security criteria plus one optional criterion (accounting for disclosures). There are multiple scenarios for hospitals to address the criteria, including:
- If you have a certified vendor product that covers all criteria, that covers the requirement;
- If you have several certified vendor products that covers all criteria, that covers the requirement; and
- If you have certified vendor products covering some of the criteria plus some self-developed modules, each self-developed module will be assessed independently and a determination will be made.
“We know there are limits to vendor certification,” Bell said. “Most hospitals or hospital systems are complex and rarely deploy one vendor’s system exclusively.” Because EHRs are often a mix of commercial and self-developed software, CCHIT is offering the EHR Alternative Certification for Hospitals (EACH) program, an alternative certification to ONC-ATCB 2011-2012 certification for hospitals, she said.
The EACH program hopes to close the gap for hospitals with self-developed, customized or partially certified software. The certification contains self-assessment, community of practice and testing and certification components in a three-part instructional program.
The EACH program is on target to launch in November, said Bell. The self-assessment tool is under development, the online session is being integrated with assessment and testing tools, and pilot testing is being conducted with hospitals of varying size and location.
The testing and certification process is evolving, Bell concluded. ONC has retained the right to change certification criteria at any time, including NIST upgrades and additions to its published test procedures.
“The more you stay ahead, the better,” said Bell.
She suggested the following websites for more information: ONC's Certified Health IT Products List; and CCHIT's Find Products website.
The webinar was sponsored by Siemens Healthcare.