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For physicians, the government's potential promise of over $40,000 for the implementation of an EHR has caused many who have stood on the brink to finally take the plunge.
For physicians, the government’s potential promise of over $40,000 for the implementation of an EHR has caused many who have stood on the brink to finally take the plunge. But why has the government decided to throw this money at EHR implementation?
With the current discussion on healthcare reform hinging on “budget neutral,” the government’s focus is on controlling cost. Unfortunately, duplicate and unnecessary testing is done with great frequency, which only drives up healthcare costs.
The fix? Electronic health records. Computer systems can measure the quality of patient care, and can communicate that information so that all providers have accurate clinical information at their fingertips. Then only the care that is needed will be done, and costs will drop while quality goes up. Or so the theory goes.
The problem is that the EHR market is immature, with hundreds of products trying to solve problems in different ways. None of the systems talk to each other and no standard way of measuring quality exists. Some systems are robust and complex, while others are little more than glorified word processing programs.
To fill this void the Certification Commission for Health Information Technology or CCHIT has developed a set of evolving standards for EHR. The goal of CCHIT, a private nonprofit organization, is to standardize EHR systems so that they meet quality standards and eventually become interoperable. CCHIT was mandated by the Bush administration to accomplish four goals:
1. Reduce the risk of healthcare information technology (HIT) investment by physicians and other providers;
2. Ensure interoperability (compatibility) of HIT products;
3. Assure payers and purchasers providing incentives for EHR adoption that the ROI will be improved quality; and
4. Protect the privacy of patients’ personal health information.
CCHIT is composed of a mix of people from various sectors, representing the government, the EHR vendors, physicians’ groups, and insurance industry representatives.
For those who have tried to buy an EHR product, having some way of determining the legitimacy of that product is welcome. So far there have been four criteria for certification - one each year since 2006. Each year the criteria get more stringent and fewer EHR products get certified. Certification for the 2009 criteria has not yet occurred.
What does this mean to you? Here’s the bottom line regarding CCHIT:
1. The general consensus is that only CCHIT-certified products will allow you to claim the money offered by the government for EHR adoption. This means you should only use products that are CCHIT certified. For an independent analysis, you can visit the HITECHAnswers Web site.
2. CCHIT certification is not all or none; some companies have certified their products in 2006, but not since then. Ask your vendor what its plans are regarding future certification.
3. Keep track of the government’s plans with EHR certification. A good place to start is the EHR section of HIMSS.
Robert Lamberts, MD, who is board certified in internal medicine and pediatrics, practices in Augusta, Ga. His practice won the 2003 Davies Award for outstanding application of IT in a primary-care setting, and he has lectured extensively on EHR. He also writes the popular medical blog "Musings of a Distractible Mind" (distractible.org). Dr. Lamberts can be reached at firstname.lastname@example.org.