Challenges and Forces Driving Adoption

Of Health Information Technology and

Electronic Healthcare Records

Michael D. Paquin, FHIMSS

www.mdpgrp.com

In this segment on Electronic Healthcare records, being sponsored by Physicians Office Resource, we will look at:

CCHIT 

Certification Commission for Healthcare Information Technology

You may be frustrated and confused by EHR industry claims. Perhaps you are ready to invest in and implement an EHR, but find it difficult to judge product suitability, quality, interoperability and data portability, and security. The CCHIT Certified^® designation sets the bar for EHR products. CCHIT’s certification program has the potential to reduce buying risk for purchasers while opening up the flow of HIT incentives from payers and purchasers. See the latest certified products, CCHIT Certified 08 Ambulatory EHR, CCHIT Certified 08 Inpatient EHR, CCHIT Certified 08 Emergency Department EHR, CCHIT Certified 08 Enterprise EHR, and CCHIT Certified products that qualify for the Stark exemption see all of these at CCHIT.Org.

What is the Certification Commission?

The Certification Commission is a private nonprofit organization with the sole public mission of accelerating the adoption of robust, interoperable health information technology by creating a credible, efficient certification process.

What is the Organization?

The Commission operates with a nine-member volunteer board of Trustees, 21 volunteer Commissioners who represent all sectors of health IT and provide strategic guidance and oversight for the certification process and criteria, and 170 volunteers who serve on 15 workgroups and bring their expertise to the process of creating the certification criteria.

Frequently Asked Questions (FAQ)

How was CCHIT formed and funded?  

The Certification Commission for Healthcare Information Technology (CCHIT^SM) was formed in July 2004 by three leading industry associations in healthcare information management and technology - American Health Information Management Association (AHIMA), Healthcare Information and Management Systems Society (HIMSS), and The National Alliance for Health Information Technology (Alliance). These associations provided initial funding and staff.

In 2005 additional funding was supplied by the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Physicians (ACP), the California HealthCare Foundation (CHCF), Hospital Corporation of America, McKesson, Sutter Health, United Health Foundation, and WellPoint, Inc.

Is CCHIT now a part of a government agency? 

No. CCHIT is an independent, nonprofit organization.

In October 2005, CCHIT was awarded a contract by the U.S. Department of Health and Human Services (HHS) to develop, create prototypes for, and evaluate the certification criteria and inspection process for electronic health records (EHRs). The HHS funding is transitional, designed to support certification development, testing, and assessment, after which CCHIT will transition to a self-sustaining model.

What is CCHIT's charter under the HHS contract? Has its original mission changed? 

No. CCHIT's mission is unchanged. It is to accelerate the adoption of robust, interoperable healthcare information technology throughout the United States by creating an efficient, credible, sustainable mechanism for the certification of healthcare IT products.

Certification is an important part of HHS vision for transforming the health care system, in part through the widespread adoption of interoperable HIT - allowing EHRs to be linked through a system that protects privacy while ensuring care providers have the data they need to deliver care of the highest quality with safety, cost-efficiency, and convenience. Certification will help increase the transparency of the EHR marketplace and reduce risk for physicians and hospitals that purchase and implement HIT.

To accomplish this goal, CCHIT will collaborate with the newly created American Health Information Community (AHIC), and those organizations awarded HHS contracts for standards harmonization, prototype development for a national health information network (NHIN) architecture, and assessment of privacy and security laws and practices. CCHIT will also consider how existing certification processes work and collaborate with the Department of Commerce's National Institute of Standard and Technology (NIST).

Has CCHIT's stakeholder participation been expanded under the HHS contract?

Yes. In executing the work under the HHS contract, CCHIT has expanded its inclusive governance process that engages multiple stakeholders to ensure an objective, open, and consensus-driven process and credible result. Stakeholders will include:

• Clinicians and provider organizations who purchase health IT products;
• Safety net providers who purchase or receive health IT products;
• Vendors who develop, market, install and support health IT products;
• Payers or purchasers who are prepared to offer incentives for health IT adoption;
• Health care consumers;
• Quality organizations;
• Public health agencies;
• Clinical and health-services researchers;
• Standards development organizations;
• Federal agencies and coordinating bodies representing various Federal agencies as identified by the National Coordinator.

Is the CCHIT Organization all Vendors?

CCHIT's current organization plan calls for 15-20 core staff members including the CCHIT chair. However, the work will be accomplished with the help of many others, including the Commissioners, Work Group and Expert Panel members who serve on a voluntary basis, industry liaisons and subject matter experts, subcontractors, consultants and others.

How can we get involved in CCHIT activities? How can we stay informed of new announcements and work progress?

There are several ways to be involved with CCHIT:

• Review draft materials and provide comments during any of our Public Comment periods;
• Attend one of the Town Hall in-person meetings, Town Call teleconferences or conference presentations;
• Monitor Commission and Work Group activities through our meeting minutes;
• Submit an application during calls for Commissioners and Work Group members;
• Serve as a juror for CCHIT's commercial certification program.
• The most reliable source of information on CCHIT work and progress is www.cchit.org. Sign up for CCHIIT eNews to stay up-to-date on new developments.

Does CCHIT publish a calendar of its activities and meetings?

CCHIT maintains a list of planned activities (e.g., scheduled public comment periods and test pilot periods, Town Halls and Calls, etc.) and participation in healthcare industry events on its Web site.

How are the Commissioners and participants of the Work Groups and Expert Panels selected?

The CCHIT Commissioners are individuals whose perspective and contribution is critical to the success of the certification program. Each Commissioner is an experienced executive who combines an industry-wide perspective with knowledge and experience about the operations and issues of their constituency. While serving in this capacity, Commissioners are expected to represent their constituency and the interests of healthcare rather than those of their organization.

Commissioners serve staggered one and two-year terms on a voluntary unpaid basis. Annually, the CCHIT Nominating Committee meets to review applications and fill vacating positions on the Commission. Solicitation of candidates for participation on the Commission is made by a public announcement and application process, in which applicants supply detailed information regarding their experience and qualifications to serve. The CCHIT Nominating Committee - with a balance of internal and external members - makes a recommendation of a slate of new Commissioners which is approved by the full Commission. Rotation of Commissioners is conducted annually in the fall.

The Commission appoints twelve to eighteen members and two co-chairs for each of the Work Groups and Expert Panels, for one-year, renewable terms. They, too, serve on a voluntary unpaid basis. Qualified participants have extensive healthcare industry experience, practical experience in implementing healthcare IT and EHRs and previous contribution to a large industry work group, committee or standards project. Solicitation for participation is also made by public announcement. Rotation of Work Groups is conducted annually in the spring.

When are the CCHIT Commission and Work Group meetings? Are they open to the public?

The Commission meets monthly. The Commission meetings are not open to the public but meeting minutes are published on the CCHIT Web site.

Work Groups meet by teleconference bi-weekly. Meetings are not open to the public but meeting minutes are published on the CCHIT Web site.

Expert Panels meet when needed or when asked to join regular Work Group meetings.

Does CCHIT set standards? How is CCHIT different from a Standards Development Organization (SDO)?

CCHIT develops criteria based on commonly available standards. In the case of the EHR, where there have been competing standards, more than one might be referenced as supporting the recommended functionality. CCHIT looks to the American National Standards Institute's Health Information Technology Standards Panel (ANSI-HITSP) to harmonize those standards as part of their charter from HHS. As they do that, CCHIT's criteria will reference those common standards selected or adapted by ANSI-HITSP.