By Molly Merrill

The Certification Commission for Health Information Technology on Tuesday launched a new modular certification program called Preliminary ARRA 2011, which will focus solely on ‘meaningful use’ objectives and accompanying standards needed to qualify for federal stimulus funding.

The modular certification process was released along with the CCHIT’s updated certification program, called CCHIT Certified 2011.

“Our decision to move forward instead of waiting has been met with a very positive response,” said Alisa Ray, CCHIT’s executive director. “The ‘Get Certified’ workshop on October 1 exceeded our attendance expectations, drawing over 310 people, with strong interest in both programs. Today, we are opening both of our 2011 programs for certification applications from vendors and developers.”

The commission has introduced a new label, called “Certification Facts,” to help physicians and hospitals understand the differences in the EHR technology certified under the two separate programs. Each certified product or technology listed at the commission’s Web site will have a link to a page describing its qualifications.

For EHRs in the CCHIT Certified 2011 Comprehensive program, the Certification Facts label will indicate not only the domain – ambulatory, inpatient, emergency department or ePrescribing – and options – cardiovascular medicine, child health and advanced interoperability – but also the meaningful use objectives supported by the product.

In addition to the Certification Facts label, that page will include – for CCHIT-certified products only – an optional Usability Rating, as well as information about the product and company. The commission says these features will become searchable in November or December as EHR products complete the 2011 inspection process and are announced.

For technology certified in the Preliminary ARRA 2011 program, the Certification Facts label will only indicate which of the meaningful use objectives are supported by the technology. The label will allow eligible providers and hospitals to understand which product – or products in combination – can support all the necessary objectives to qualify for incentive funding contained in the American Recovery and Reinvestment Act of 2009.

Above article published on - http://www.healthcareitnews.com/news/cchit-offers-modular-program-focusing-meaningful-use

By Wendy Johnson

Although HHS has yet to publish its criteria for “meaningful use” of EHRs, the Certification Commission for Healthcare Information Technology is pushing forward with a new certification program that opened Wednesday.

“We don’t want to lose time,” Dr. Mark Leavitt, CCHIT chairman, told AHIMA Conference attendees Monday in Grapevine, Texas. To date, CCHIT is the only body recognized by the federal government to certify EHRs to qualify for ARRA funding. “We’re skating toward where the puck is going to be rather than waiting for it to move,” Leavitt said.

CCHIT now offers two types of EHR certification. Both would likely expire on Dec. 31, 2012:

• CCHIT Certified 2011–Maximum assurance that it has comprehensive, integrated EHR capabilities and that it meets or exceeds ARRA standards. This certification is tailored to specific uses, such as ambulatory clinics, child health, e-prescribing, inpatient settings and emergency departments.

• Preliminary ARRA 2011 Certification–Maximum flexibility in meeting ARRA standards. This option is designed for vendors, developers and providers to ensure they will meet the 2011 certification requirements when HHS finalizes the rules next spring. This “chocolate and vanilla” certification is designed for vendors to give them the “thumbs up on the ARRA side,” Leavitt said.

The commission will add a third, site-specific program for healthcare providers around June 2010, including for long-term care, post-acute care, behavioral health and other settings, he said.

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Diana Manos, Senior Editor

The Centers for Medicare and Medicaid Services is now releasing healthcare IT funding from the stimulus package to state Medicaid programs.

According to a CMS letter mailed Wednesday to state Medicaid directors, the American Recovery and Reinvestment Act enables the government to pay a 100 percent federal financial participation (FFP) match to states that help Medicaid providers adopt, implement or upgrade certified electronic health record technology to demonstrate meaningful use.

It will also pay a 90 percent FFP match to cover a state’s administrative costs for running an HIT Medicaid incentive program. States may now request the 90 percent FFP match for administrative planning activities, according to the letter.

Medicaid directors should contact their CMS regional office for further guidance and maintain ongoing communication while initiating planning activities. State health IT incentive programs should be part of larger statewide efforts to promote healthcare IT use and exchange.

CMS advised states who plan to apply for a FFP match to plan how they will audit their healthcare IT incentive payment programs for errors.

CMS is working on a final rule, due by the end of the year, with more information on how Medicaid providers will have to show meaningful use to qualify for health IT incentive payments.

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http://www.healthcareitnews.com/news/states-can-now-apply-health-it-medicaid-funding-cms-says

Although the federal economic stimulus package allocates billions of dollars to support health IT implementation, it remains to be seen whether the funding will improve health care quality or simply boost sales for health IT vendors, the Dallas Morning News reports.

Under the stimulus law, hospitals and physicians who demonstrate “meaningful use” of electronic health records can qualify for federal incentive payments.

The Obama administration contends that EHRs will allow physicians to better coordinate patient care, reduce medical errors and avoid duplicate testing. Medical errors alone cost the U.S. about $37.6 billion annually, according to the Institute of Medicine.

However, some advocates are concerned that health care providers will be unable to achieve the administration’s goals if meaningful use criteria tie stimulus funding to simply purchasing software.

They caution that such action could benefit health IT software companies at the expense of achieving interoperability and improved patient outcomes.

Conflict of Interest?

The federal stimulus package requires health care providers to purchase certified EHR systems to qualify for incentive payments.

In the past, certification responsibilities fell to the Certification Commission for Healthcare IT, which was founded by the trade group Healthcare Information and Management Systems Society.

Some critics argue that CCHIT is too closely linked with the health IT industry to be designated as the sole certifying body for EHRs.

However, leaders of the commission say CCHIT maintains its independence from health IT firms.

Although commission officials acknowledged that certification thus far has failed to promote EHR interoperability, they said the group is working to support system compatibility. In addition, CCHIT leaders say the commission is beginning to focus on alternative health IT systems and not just those developed by large software vendors (Michaels/Roberson, Dallas Morning News, 7/14).

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http://www.ihealthbeat.org/Articles/2009/7/15/
Questions-Raised-About-Stimulus-Law-Benefits-for-Health-IT-Vendors.aspx

By Joseph Conn / HITS staff writer

Part two of a two-part series (Access part one):

The Certification Commission for Healthcare Information Technology has put on hold the rollout of its new sets of completed testing criteria for multiple health IT systems while it waits for HHS to release its plans for certifying IT under the American Recovery and Reinvestment Act of 2009, also called the stimulus law.

Earlier this month, CCHIT announced it had completed work on updated versions of test scripts and criteria for use in the 2009-10 round of testing and certification.

The commission also announced it will publish in either June or July an updated certification handbook explaining the testing and certification process. But CCHIT Chairman Mark Leavitt said that it won’t be taking applications from IT vendors for testing and certifying their electronic health record and other systems until HHS acts

Leavitt said that CCHIT will defer launch of its 2009-10 testing programs until its people have had a chance to look at the initial batch of HHS-approved criteria under the stimulus act. The law mandates the creation of an HIT Policy Committee and an HIT Standards Committee to develop and review IT certification criteria as well as health information transmission standards and implementation specifications.

“The policy and standards committees have some very tight deadlines,” Leavitt said.

“HHS has to take it through a public rulemaking and then it goes to OMB,” Leavitt said, referring to the White House’s Office of Management and Budget.

To keep the whole process on schedule, the policy and standards committees have to be done with their work by Aug 21, Leavitt said. “Since we want to conform our process to what those committees’ recommendations are, we want to hold our process,” until the committees’ work is completed. “They may want to add or subtract something. This will give us a chance to adapt the 2009-2010 process” to the stimulus act.

Initially, CCHIT certification lasted for three years, but testing was updated annually. Going forward, Leavitt said, he’s guessing certification will be on a two-year cycle.

CCHIT has been criticized in some quarters for certifying systems only on functionality, but not ease of use. Leavitt said that CCHIT is “beginning to investigate how to test usability.”

“There are a number of ways to do it, but we have to look for ways that are objective, that we can repeat,” Leavitt said.

One way, Leavitt said, would be to “look for the most common tasks and then count the number of clicks to do those tasks.” Those would include what Leavitt, himself a physician, calls “the speed-dial tasks in a physician’s office,” including refilling a prescription or taking a history on a new patient.

“You test that part of the product and you literally time it,” Leavitt said. Vendors could be asked to bring in their systems and their best user and test them on these common tasks. “If it takes 150 clicks and 10 minutes, you have a big problem.

“The other end of the spectrum is you survey users,” Leavitt said. “We ask the vendors for 10 sites. We want to see at least one that’s measuring quality, or using (the system) to manage chronic disease. Or even do a survey as part of the reimbursement payment process.”

The survey results could provide data on how many customers of a given system have applied for reimbursement under the “meaningful use” standard in the stimulus act vs. how many have qualified under that standard.

Leavitt said that the new certification criteria for 2009-10 have “a big focus on interoperability, including a requirement that EHRs be able to input and store data using the Continuity of Care Document format developed by standards development organizations Health Level 7 in collaboration with ASTM International.

Another test area—an option, not a requirement this year—will be whether the systems incorporate the interoperability specification approved by the federally supported Healthcare Information Technology Standards Panel that deals with querying another data source, such as a health information exchange, for the existence of patient records.

“If they do it, we give them a gold star and everyone will know it, but if they don’t, they’ll still get certified,” Leavitt said.

Another testing requirement that was on the CCHIT road map for inclusion in future certification criteria was that all EHRs be able to link the diagnosis code with an electronic prescription and be able to communicate the diagnosis code and prescription information together in a single electronic prescription sent to a drugstore or pharmacy benefit manager outside the physician’s practice.

The American Medical Association has a long-standing and oft-reaffirmed policy against any requirement to include diagnosis codes on prescriptions “to protect patient confidentiality and to minimize administrative burdens.”

According to a grid of CCHIT testing criteria posted on the organization’s Web site, the specific listing of this testing requirement “will be removed in 2009 when the corresponding Foundation criterion is tested.” The requirement itself isn’t being eliminated, however.

Leavitt said that by requiring EHRs be able to combine prescription data with a patient’s diagnosis doesn’t mean physicians will be forced to do so.

“The AMA doesn’t want you to provide it. Fine. Don’t provide it,” Leavitt said. “That’s a policy decision, so go ahead and fight that one out.”

But there are safety benefits, Leavitt said, allowing a second set of eyes to review the applicability of the prescription for the specified diagnosis. “It’s a potential way to reduce errors.” And there are financial considerations. “For some medications, in some prescribing situations, you’re required to do it. I believe it has to do with health plans qualifying patients to be on a medication.”

Another controversial requirement that was originally proposed as a separate line item in the 2009 criteria would require building into EHRs a back door to allow access by insurance companies for fraud control. The requirement would make EHRs conform to a recommendations in the 2007, HHS-funded report by RTI International “Recommended Requirements for Enhancing Data Quality in Electronic Health Records Systems,” which, despite the title, primarily dealt with the issue of medical billing and payment fraud control.

According to CCHIT spokeswoman Sue Reber, that specific testing criterion also was de-listed—but not eliminated—sometime before the first draft of the 2009 criteria was published “because it is redundant with existing security criteria in the area of ‘access control.’ ”

Above article published on

http://www.modernhealthcare.com/article/20090529/REG/305299991

In an interview with Modern Healthcare, Mark Leavitt, chair of the Certification Commission for Healthcare IT, discussed CCHIT’s current work and its potential role in developing certification criteria for determining which electronic health record systems will be eligible to receive funding under the economic stimulus law.

Although the federal stimulus law calls for the national coordinator for health IT to identify “a program or programs for the voluntary certification of health IT,” it does not specifically endorse CCHIT.

Because the economic stimulus package includes substantial federal subsidies for health care providers who adopt health IT, CCHIT’s certification criteria seek to ensure that “taxpayers’ money is not being wasted,” Leavitt said. He added, “Certification is basically a protection for the taxpayer.”

Leavitt said that he believes a single certification organization can best accomplish this task, because “the more organizations there are, the more likely it is” that substandard technology will gain approval.

Leavitt also discussed CCHIT’s future plans, which include releasing criteria for add-on features of EHRs used in child care and cardiology. The commission also aims to test and certify “stand-alone” electronic prescribing systems for the first time. Leavitt added that CCHIT will develop testing and certification programs “as fast as we can” for applications used by medical specialists.

Although some representatives from the open-source software community have questioned the compatibility of CCHIT’s certification program with open-source systems, Leavitt said the commission plans to work with open-source technologies to ensure that such systems are “not at a disadvantage” (Conn, Modern Healthcare, 5/28).

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CCHIT-Chair-Discusses-Groups-Future-Role-Federal-Stimulus-Funding.aspx