“I’m not against CCHIT, but it would be a shame if we have such an unequivocal standard that no one would be able to innovate or start in the market without a huge amount of capital,” he says.

Leavitt argues that the $28,000 fee to apply for initial certification should not be a barrier for even small vendors.

“We believe the fees are quite modest compared to what other types of certification might cost and also compared to the benefits,” he says.

For Bertman, whose systems sell for a modest $1,000, recouping the commission’s application fee would mean finding 28 new clients. While he fumes about the certification process and its costs, he says he’s resigned to apply for certification. He’s already adding several commission-desired features to his system, which he expects will increase its price.

“I believe CCHIT certification is a good thing, and I think a large part of the marketplace today agrees,” says Bruce Kleaveland, a Seattle-based health IT consultant and coauthor of “The Tech Doctor” column in Physicians Practice. “But there’s no question that CCHIT represents a certain view of the world — and it is also the government’s view — which is that, one, more people should have electronic health records; two, electronic health records should interoperate with each other; and, three, electronic health records should easily provide data to third parties, like the government and payers, so they can assess cost and quality.”

What it isn’t

Think of the certification commission as more comparable to the Underwriters Laboratory, which sets pass/fail standards, than to the Consumers’ Union system of rating products.

“User friendliness is not possible to rate fairly now, and perhaps never [will be],” Kleaveland says. “Ultimately, the market is what measures a system.”

CCHIT also does not investigate or rate an applicant’s financial viability or after-sales service.

Lazarus cautions that even the latest CCHIT-issued functionality requirements may not reveal whether you are buying what he considers a fully functional EMR. For example, systems certified in 2006 and 2007 were not judged on whether they interface with the billing system to check coding, though CCHIT will call for more of those functions in the near future.

Besides, says Lazarus, “just because something is certified doesn’t mean it is the right system for your practice. It reduces the risks but doesn’t eliminate them.”

Rosemarie Nelson, an IT consultant with the Medical Group Management Association, suggests becoming a smarter shopper. Get the scripted scenarios the commission uses to test vendors and modify the scripts to give the vendors on your shortlist a better workout, she says.

“Create a scripted patient exam for the vendor to follow when they demo the product,” she says. “Otherwise, it becomes just a show of bells and whistles instead of showing you how it would work in your practice.”

No argument on that from Joel Andersen, who is vice president of marketing and business development for Purkinje, whose CareSeries EMR has been certified.

“Infuse yourself into the vendor’s Web demo and into using the software,” says Andersen. “Don’t let them just do a canned demo. Take control of the situation.”