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Digging Into the Details of “Certified EMR” & Tips For Buying an EMR

Steps to digging under the meaning of EMR certification: 

Cocker Spaniel digging

Image via Wikipedia

  1. Click to see the most recent alphabetical list (by product name not company) of all products certified here.
  2. Find the company or companies you are using or are considering using.
  3. Check that the exact name of the product is what you have or might purchase.
  4. Check to find out if a module or part of the product is certified or if the complete product is certified.
  5. Check to make sure the version of the product is the version you have or will have.

If you have questions about each company’s exact criteria met, you are in luck!  On the ONC site here, you can click on each company’s detail (“View Criteria”) on the far right column labeled “Certification Status” to see what they have and don’t have.  Compare this to how you are anticipating using your EMR to meet meaningful use.  The more check marks a company has, the better-equipped they are (and more flexible) to meet your practice needs and to qualify for the stimulus money.

The ONC site with the Certified Health IT Product List (CHPL) is Version 1.0.  Version 2.0 is now being developed and will provide the Clinical Quality Measures each product was tested on, and the capability to query and sort the data for viewing. The next version will also provide the reporting number that will be accepted by CMS for purposes of attestation under the EHR (“meaningful use”) incentives programs.

You can tell ONC what you think would be helpful in the new version by emailing your ideas to ONC.certification@hhs.gov, with “CHPL” in the subject line.

If you’d like a list of just outpatient/medical practice EMR products or just inpatient / hospital products, I’ve split the big list into two smaller printable lists here:

Medical Practice / Outpatient

Hospital / Outpatient

Tips On Buying An EMR

To-do list book.

Remember that meeting meaningful use does not tell the whole story – if you are shopping for an EMR be prepared to go beyond a product’s certification status to consider:

  • Flexibility – does it make the practice conform to it or can it conform to the practice? How?
  • Templates and best practices – are you starting from scratch in developing protocols, templates and cheat sheets for your practice, or does it have a storehouse of examples to choose from or tweak?
  • Built for the physician, or the billing office, or the nurses, but doesn’t really meet the needs of all three? Make sure the functionality is not too skewed to one user group, but if it is, it should be somewhat skewed to the provider.
  • Interface and integration with your practice management system. Does the information flow both ways? Do you ever have to re-enter information because one side doesn’t speak to the other?
  • Interface with other inside and outside systems: Labs, imaging, hospital systems, ambulatory surgical center systems?
  • Built-in Resources: annual upgrade of HCPCS and ICD codes, drug compendium (Epocrates), comparative effectiveness prompting?
  • Mobile applications – EMR on your providers’ phones?
  • Data entry systems – laptops, notebooks, tablets, iPads, smartphones, voice recognition?
  • Hosting – in your office? at the hospital? at the vendor’s data center? in the cloud of your choice?
  • What’s the plan for ICD-10? Will they provide practice support and education for the change or will they just change the number of characters in the diagnosis code field?
  • Price, including annual maintenance and additional costs for training, implementation, on-site support during go-live, and additional licenses for providers or staff.



The First 2011/2012 Certified EHR List: Is Your EHR on the List?

holding my breath until I turn invisible

Image by qwrrty via Flickr

Everybody has been holding their breath to see which EHR software will pass the ONC-ATCB (Office of the National Coordinator for Healthcare IT – Authorized Testing & Certification Body) 2011/2012 certification.  Some will buy a system based on this information, and others will continue on with their system feeling a great sense of relief that the system they’ve already paid for is now certified.  Still others will wonder if their system of choice has applied and failed, or not applied yet.  All this and more information is available on the websites of the three companies that have been approved via the Temporary Certification Program for Health Information Technology.
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The companies are:
  1. CCHIT (Ed. Note, CCHIT has ceased operations)
  2. Drummond
  3. InfoGard
CCHIT and Drummond announced their first group of certified systems October 1, 2010 and InfoGard has yet to make an announcement.
*
EHR software companies “…are required to provide complete information on the details of their ONC-ATCB 2011/2012 certification, including company and product name and version, date certified, unique product identification number, the criteria for which they are certified, and the clinical quality measures for which they were tested, and any additional software a complete EHR or EHR module relied upon to demonstrate its compliance with a certification criteria,” states the CCHIT website.  This information should be available on the product websites, the certifying body website and the ONCHIT website.
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As you are reviewing the bolded product names below, notice that the information is split into separate categories for providers and hospitals, is divided based on the company that certified the EHR and is also broken into complete EHRs software versus software modules.

ELIGIBLE PROVIDERS

Complete EHRs for Eligible Providers (CCHIT)

  1. ABEL Medical Software, Inc. for ABELMed EHR – EMR/PM, version 11
  2. Allscripts, Allscripts Professional EHR, version 9.2
  3. Aprima Medical Software, Inc. for Aprima, version 2011
  4. athenahealth, Inc. for athenaclinicals, version 10.10
  5. CureMD Corporation for CureMD EHR, version 10
  6. The DocPatientNetwork.com for Doctations, version 2.0
  7. Epic Systems Corporation for EpicCare Ambulatory – Core EMR, version Spring 2008
  8. GE Healthcare for Centricity Advance, version 10.1
  9. gloStream, Inc. for gloEMR, version 6.0
  10. Intuitive Medical Software for UroChartEHR, version 4.0
  11. MCS – Medical Communication Systems, Inc. for iPatientCare, version 4.0
  12. Medical Informatics Engineering for WebChart EHR, version 5.1
  13. meditab Software, Inc. for IMS, version 14.0
  14. NeoDeck Software for NeoMed EHR, version 3.0
  15. NextGen Healthcare for NextGen Ambulatory EHR, version 5.6
  16. Nortec Software Inc for Nortec Ambulatory EHR, version 7.0
  17. Pulse Systems for 2011 Pulse Complete EHR, version 2011
  18. SuccessEHS for SuccessEHS, version 6.0

EHR Modules for Eligible Providers (CCHIT)

  1. Allscripts for Allscripts Peak Practice, version 5.5
  2. eClinicalWorks LLC for eClinicalWorks, version 8.0.48
  3. NexTech Systems, Inc. for NexTech Practice 2011, version 9.7
  4. nextEMR, LLC for nextEMR, LLC, version 1.5.0.0
  5. Sammy Systems for SammyEHR, version 1.1.248
  6. Universal EMR Solutions for Physician’s Solution, version 5.0
  7. Vision Infonet Inc., for MDCare EMR, version 4.2
  8. WellCentive for WellCentive Registry, version 2.0

Complete EHRs for Eligible Providers (Drummond)

  1. ChartLogic, Inc for ChartLogic EMR 7, version not noted

EHR Modules for Eligible Providers (Drummond)

  1. ifa united i-tech Inc. for ifa EMR, modules 170.302.A-J, 170.302.M, 170.302.O-V (specialized to ophthalmology)
  2. QRS INC. for PARADIGM, version 8.3, modules 170.302.A-W, 170.304.A,  170.304.C-J

HOSPITALS

Complete EHRs for Hospitals (CCHIT)

  1. Epic Systems Corporation for EpicCare Inpatient – Core EMR, version Spring 2008

EHR Modules for Hospitals (CCHIT)

  1. Allscripts for Allscripts ED, version 6.3
  2. Health Care Systems, Inc. for HCS eMR, version 4.0
  3. PeriGen for PeriBirth, version 4.3.50
  4. Prognosis Health Information Systems for ChartAccess, version 4
  5. T-System Technologies for T-SystemEV, version 2.7
  6. Wellsoft Corporation for WellsoftEDS, version 11



FAQ on HITECH, Meaningful Use, Eligible Providers, and the Stimulus Money

NOTE: Read my latest post on how to register and attest for the EHR Incentive Programs here.

Where Did the Idea of Meaningful Use of Electronic Medical Records Come From?

The American Recovery and Reinvestment Act of 2009 was signed by President Obama on February 17, 2009.  The Law includes the Health Information Technology for Economic and Clinical Health Act or the HITECH Act.  The HITECH Act establishes programs under Medicare and Medicaid to provide incentive payments for the Meaningful Use of Certified Electronic Health Records technology.

The goal of the HITECH legislation is to improve healthcare outcomes, to facilitate access to care and to simplify care.  It is believed that the installation of electronic health records in medical practices is only the beginning.  The goals of HITECH will be met when the EHR is used in a meaningful way.

What is Meaningful Use (MU)?

There are three  identified components of Stage I Meaningful Use.  They are:

  1. Use of a certified EHR in a meaningful manner such as e-prescribing.
  2. Use of Certified EHR Technology for the exchange of health information (exchange data with other providers of care or business partners such labs or pharmacies)
  3. Use of Certified EHR Technology to submit clinical quality and other measures.

The first stage of Meaningful Use is capturing and sharing the data.  Meaningful Use Stage II is advanced clinical processes and Stage III is starting to look Meaningful Use of an EHR in the context of improved healthcare outcomes.

There are 25 specific criteria for MU Stage I listed in this article in Healthcare IT News:

[1] Objective: Use CPOE (Computerized Physician Order Entry)
Measure: CPOE is used for at least 80 percent of all orders

[2] Objective: Implement drug-drug, drug-allergy, drug- formulary checks
Measure: The EP (Eligible Provider) has enabled this functionality

[3] Objective: Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®
Measure: At least 80 percent of all unique patients seen by the EP have at least one entry or an indication of none recorded as structured data.

[4] Objective: Generate and transmit permissible prescriptions electronically (eRx).
Measure: At least 75 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

[5] Objective: Maintain active medication list.
Measure: At least 80 percent of all unique patients seen by the EP have at least one entry (or an indication of “none” if the patient is not currently prescribed any medication) recorded as structured data.

[6] Objective: Maintain active medication allergy list.
Measure: At least 80 percent of all unique patients seen by the EP have at least one entry (or an indication of “none” if the patient has no medication allergies) recorded as structured data.

[7] Objective: Record demographics.
Measure: At least 80 percent of all unique patients seen by the EP or admitted to the eligible hospital have demographics recorded as structured data

[8] Objective: Record and chart changes in vital signs.
Measure: For at least 80 percent of all unique patients age 2 and over seen by the EP, record blood pressure and BMI; additionally, plot growth chart for children age 2 to 20.

[9] Objective: Record smoking status for patients 13 years old or older
Measure: At least 80 percent of all unique patients 13 years old or older seen by the EP “smoking status” recorded

[10] Objective: Incorporate clinical lab-test results into EHR as structured data.
Measure: At least 50 percent of all clinical lab tests results ordered by the EP or by an authorized provider of the eligible hospital during the EHR reporting period whose results are in either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data.

[11] Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach.
Measure: Generate at least one report listing patients of the EP with a specific condition.

[12] Objective: Report ambulatory quality measures to CMS or the States.
Measure: For 2011, an EP would provide the aggregate numerator and denominator through attestation as discussed in section II.A.3 of this proposed rule. For 2012, an EP would electronically submit the measures are discussed in section II.A.3. of this proposed rule.

[13] Objective: Send reminders to patients per patient preference for preventive/ follow-up care
Measure: Reminder sent to at least 50 percent of all unique patients seen by the EP that are 50 and over

[14] Objective: Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules
Measure: Implement five clinical decision support rules relevant to the clinical quality metrics the EP is responsible for as described further in section II.A.3.

[15] Objective: Check insurance eligibility electronically from public and private payers
Measure: Insurance eligibility checked electronically for at least 80 percent of all unique patients seen by the EP

[16] Objective: Submit claims electronically to public and private payers.
Measure: At least 80 percent of all claims filed electronically by the EP.

[17] Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request
Measure: At least 80 percent of all patients who request an electronic copy of their health information are provided it within 48 hours.

[18] Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies)
Measure: At least 10 percent of all unique patients seen by the EP are provided timely electronic access to their health information

[19] Objective: Provide clinical summaries to patients for each office visit.
Measure: Clinical summaries provided to patients for at least 80 percent of all office visits.

[20]  Objective: Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
Measure: Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information.

[21] Objective: Perform medication reconciliation at relevant encounters and each transition of care.
Measure: Perform medication reconciliation for at least 80 percent of relevant encounters and transitions of care.

[22] Objective: Provide summary care record for each transition of care and referral.
Measure: Provide summary of care record for at least 80 percent of transitions of care and referrals.

[23] Objective: Capability to submit electronic data to immunization registries and actual submission where required and accepted.
Measure: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries.

[24] Objective: Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice.
Measure: Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies (unless none of the public health agencies to which an EP or eligible hospital submits such information have the capacity to receive the information electronically).

[25] Objective: Protect electronic health information maintained using certified EHR technology through the implementation of appropriate technical capabilities.
Measure: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1) and implement security updates as necessary.

Have the Details of MU been finalized?

The comment period for the NPRM (Notice of Proposed Rule Making) for Meaningful Use is currently open but will close on March 15, 2010. You can read the NPRM here.  Many individuals and organizations have expressed concern that the timeline for implementing EHR and meeting MU criteria is too short for the majority of providers. The American Academy of Family Physicians (AAFP) recently sent a 7-page letter to acting CMS Administrator Charlene Frizzerathat included the following concerns:

  1. The administrative burden of reporting computerized physician order entry measures “is excessive to the point of being unachievable for most eligible providers.”
  2. The rule could require manually entering results from laboratories that don’t have an interoperable interface with the physician’s electronic health record.
  3. The term “health information” is used throughout the proposed rule, but is never defined.
  4. A requirement that a patient’s health information be shared with that patient within 48 hours doesn’t take in account that physicians or their staff may not be able to process the information if that 48-hour period includes weekend days.
  5. There is no incentive for physicians who meet less than 100% of the proposed requirements, so it is an all-or-nothing approach.

The Medical Group Management Association recently surveyed (see Modern Healthcare story here) 445 physician practice administrators in February 2010 with the following feedback:

  1. Nearly all are aware of the upcoming incentive programs for meaningful use of electronic health records, but fear the programs will reduce physician productivity.
  2. 68% of respondents expect physician productivity will decrease if all 25 proposed meaningful use criteria are implemented.
  3. Nearly one-third believe the decrease in productivity will be greater than 10 percent.
  4. Almost 25% of practices without an EHR doubt some of their providers will ever attempt to qualify for incentives.
  5. Among practices with an EHR, nearly 84 percent believe some of their physicians will attempt to qualify for Medicare or Medicaid incentives by the end of 2011.

How Do I Comment on the MU Standard?

You can submit your comments on the NPRM on MU here.

You can read comments already submitted here.

How Do I Know if My EHR is Certified?

No EHRs have been certified for the CMS Incentive Program and the certifying bodies have not yet been announced.  It seems reasonable that CCHIT will be one certifying body, but there are expected to be others.  If your vendor tells you that his EHR is certified before the rule has been finalized and the certifying bodies have been announced, ask him “For what?”

What Does it Mean to Be Eligible? (description courtesy of Everything HITECH)

This term encompasses three general types of payers to establish eligibility: 1) Medicare Fee For Services (FFS), 2) Medicare Advantage (MA) and 3) Medicaid.

For hospitals to be eligible, they can be acute care (excluding long term care facilities), critical access hospitals, children’s hospitals.

For providers, these include non-hospital-based physicians who receive reimbursement through Medicare FFS program or a contractual relationship with a qualifying MA organization. The Act defines the term “hospital based” eligible professional to mean an EP such as a pathologist, anesthesiologist,or emergency physician, who furnishes substantially all of his or her Medicare covered professional services during the relevant EHR reporting period in a hospital setting (whether inpatient or outpatient) through the use of the facilities and equipment of the hospital, including the hospital’s qualified EHR’s (Fed Reg p. 1905). The determining factor is the site of service as to whether the service is hospital based or not. If the EP provides at least 90 % of their services in a hospital inpatient, hospital outpatient or hospital emergency room setting (Point of Service codes 21, 22, 23), then they are considered a hospital based EP and not eligible for EHR incentive payments (i.e. providing substantially all of his or her Medicare covered professional services).

There is a difference between Medicare and Medicaid when it comes to defining an eligible professional for EHR incentive payment purposes. Medicare defines an eligible professional as (Fed Reg p. 1996):

 

  1. doctor of medicine or doctor of osteopathy
  2. doctor of dental surgery or dental medicine
  3. doctor of podiatric medicine
  4. doctor of optometry
  5. chiropractor

Medicaid, on on the other hand, defines an eligible professional as (Fed Reg p. 2001):

  1. physician
  2. dentist
  3. certified nurse-midwife
  4. nurse practitioner
  5. physician assistant practicing in a Federally Qualified Health Center (FQHC) or a Rural Health Clinic, led  by a physician assistant.

What are the Guidelines for Providing Patients With Their Medical Records Electronically?

Under HIPAA, patients currently have the ability to access their medical records.  Meaningful Use does not change HIPAA in that regard.  You may charge patients for the expense related to providing paper or electronic medical records.  Each state has its own schedule for charging for medical records (state-by-state schedule here.)

Do Eligible Providers Have to be Participating With Medicare to Receive the Incentive Money?

No, the eligibility requirements only relate to the benchmarks for the percentage of Medicaid patients you have, or amount of allowed Medicare charges you have.

Can Eligible Providers Work at Locations Other Than Hospitals and Private Practices and Receive the Incentive Money?

The location where the provider works is not the issue.  The issue is whether or not the provider meets the requirements, either for Medicare or Medicaid, to be considered eligible for the program.

It doesn’t matter where the provider accesses the certified EHR.  If they meet the eligibility criteria, and they are using a certified EHR, they can collect on the stimulus money.

What Are Health Provider Shortage Areas?

Physicians practicing in determined “health provider shortage” (detailed info here) areas will be eligible for a 10% bonus payment.

How Does This Incentive Relate to ePrescribing or PQRI?

If the PQRI Program is extended in its current form, practices can participate in both PQRI and an EHR Incentive Plan.

If the EP chooses to participate in the Medicare EHR Incentive Program, they cannot participate in the Medicare eRx Incentive Program simultaneously.  If the EP chooses to participate in the Medicaid EHR Incentive Program, they can participate in the Medicare eRx Incentive Program simultaneously.

Also, e-prescribing penalties sunset after 2014, so that no physician will be subject to penalties for failing to both e-prescribe and use an EHR!

How Do EPs Get Paid For Meaningful Use of a Certified EHR?

For the first payment year only, all an EP or hospital has to do is to be a “meaningful user” for a continuous 90-day period during the payment year. Hospitals’ payment year is October 1 to September 30 and EPs’ payment year is the calendar year.  You must start and complete the 90-day period within the payment year with no overlapping.

 

Also, if  you can qualify as a Medicaid Eligible Provider (or Hospital), are in the process of adopting, implementing or upgrading your EHR  and your Medicaid patient volume is at least 30% (Pediatricians only need 20% minimum and Hospitals need 10% minimum), you can collect your incentive money without meeting Meaningful Use criteria.

Attestation forms and forms of other types are most likely the way that EPs will provide information to apply for the incentive funds, although the details have not yet been released.

What Does it Mean to Transition From One Program (Medicaid or Medicare) to Another?

EPs who meet the eligibility requirements for both the Medicare and Medicaid incentive programs will be able to participate in only one program, and will have to designate which one they would like to participate in.  After their initial designation, EPs are allowed to change their program selection only once during payment years 2012 through 2014.


To Recap:

How Do I Get My EHR Stimulus Money?

  1. Decide whether you are an eligible provider for any of the programs.
  2. If you are, buy a certified EMR (once certification has been defined.)
  3. Use your EMR in a way that demonstrates your meaningful use of the product.
  4. Pass “GO” and collect your money.

ARRA (Stimulus Bill) Acronyms

”¢ A/I/U ”“Adopt, implement or upgrade
”¢ CAH ”“Critical Access Hospital
”¢ CCN ”“CMS Certification Number
”¢ CDS ”“Clinical Decision Support
”¢ CMS ”“Centers for Medicare & Medicaid Services
”¢ CY ”“Calendar Year
”¢ EHR ”“Electronic Health Record
”¢ EP ”“Eligible Professional
”¢ eRx ”“E-Prescribing
”¢ FFS ”“Fee-for-service
”¢ FY ”“Federal Fiscal Year
”¢ HHS ”“U.S. Department of Health and Human Services
”¢ HIT ”“Health Information Technology
”¢ HITECH Act ”“Health Information Technology for Electronic and Clinical Health Act
”¢ HITPC ”“Health Information Technology Policy Committee
”¢ HIPAA ”“Health Insurance Portability and Accountability Act of 1996
”¢ HPSA ”“Health Professional Shortage Area
”¢ IFR ”“Interim Final Rule
”¢ MA ”“Medicare Advantage
”¢ MCMP ”“Medicare Care Management Performance Demonstration
Ӣ MITA-Medicaid Information Technology Architecture
”¢ MU ”“Meaningful Use
”¢ NPI ”“National Provider Identifier
”¢ NPRM ”“Notice of Proposed Rulemaking
”¢ OMB ”“Office of Management and Budget
”¢ ONC ”“Office of the National Coordinator of Health Information Technology
”¢ PQRI ”“Medicare Physician Quality Reporting Initiative
”¢ Recovery Act ”“American Reinvestment & Recovery Act of 2009
”¢ TIN ”“Taxpayer Identification Number

For more information who is eligible and for how much, read my post ARRA Eligible Providers: Who Is Eligible to Receive Stimulus Money and How Much is Available Per Provider?”




Quick Reference for Acronyms and Buzzwords of ARRA and HITECH

certification @Sgame/Dreamstime.comARRA: American Recovery and Reinvestment Act of 2009, also called “The Stimulus Package” or “The Stimulus Bill.”  Of the $850B in the bill,  $51B is pegged for the health care industry and $19B of that will be used to incent medical practices to adopt EMRs/EHRs.

CCHIT: the Certification Commission for Health Information Technology is a private organization that certifies EMRs and EHRs based on 475 criteria spanning functionality, interoperability and security.  CCHIT does not evaluate ease of use of products, financial viability of the company offering the software; or the quality of customer support offered by the software vendor.  Whether or not CCHIT will be THE certifying organization to approve “qualified EMRs” will be announced at the end of the year.  (Can be pronounced “SEA-CHIT” or each letter can be pronounced as in “C.C.H.I.T.”)

Comparative Effectiveness: Comparative Effectiveness Research (CER) compares treatments and strategies to improve health.  For CER, HITECH provides $300M for the Agency for Healthcare Research and Quality, $400M for the National Institutes of Health, and $400M for the Office of the Secretary of Health and Human Services.

EHR: The aggregate electronic record of health-related information on an individual that is created and gathered cumulatively across more than one health care organization and is managed and consulted by licensed clinicians and staff involved in the individual’s health and care.

EMR: The electronic record of health-related information on an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from a single organization who are involved in the individual’s health and care.

HITECH: The HIT components of the stimulus package ”” collectively labeled HITECH are:

  1. Funding to the Office of the National Coordinator of HIT (ONCHIT)
  2. HIT adoption incentives through Medicare and Medicaid reimbursement
  3. Comparative effectiveness research for the Agency for Healthcare Research and Quality (AHRQ)
  4. Funding for the Indian Health Service
  5. Construction funds for the Health Resources and Services Administration (HRSA) for community health centers
  6. Funds for the Social Security Administration to upgrade HIT systems
  7. Funding for the Veterans Administration
  8. The Department of Agriculture will receive telemedicine funding
  9. Funds to the National Telecommunications Administration for broadband to enable telemedicine.

Interoperability (hospitals): (as defined by HIMSS- Health Information and Management Systems Society)not yet defined for ambulatory care

Meaningful Use: To qualify as a “meaningful user,” eligible providers must demonstrate use of a “qualified EHR” in a “meaningful manner.” ARRA defers to the secretary of Health and Human Services (HSS) to set specific guidelines for determining what constitutes a “qualified EHR”; however, it does specify that e-prescribing, electronic exchange of medical records, and interoperability of systems will be determining criteria.  Starting in 2011, providers deemed to be “meaningful users” of EHR systems will be eligible to receive $40,000 – $60,000 in incentive payments paid out over five years in the form of increased Medicare and Medicaid payments.

ONCHIT: Office of the National Coordinator for Health Information Technology.  In 2004 the position was created by by Presidential Executive Order.  In March 2009, President Obama appointed David Blumenthal, M.D., M.P.P. to the position. The primary purpose of this position is to aid the Secretary of HHS in achieving the President’s goal for most Americans to have access to an interoperable electronic medical record by 2014 (from the HHS.gov website.)

PHR or ePHR: An electronic, cumulative record of health-related information on an individual, drawn from multiple sources, that is created, gathered, and managed by the individual. The integrity of the data in the ePHR and control of access to that data is the responsibility of the individual.

David Blumenthal, M.D., M.P.P.:Selected by President Obama as his choice for National Coordinator for Health Information Technology Dr. Blumenthal will lead the implementation of a nationwide interoperable, privacy-protected health information technology infrastructure as called for in the American Recovery and Reinvestment Act.




What is CCHIT and Should My EMR/EHR Be Certified?

medicalrecords

An excellent article on EHRs and CCHIT was pointed out to me recently and I thought I’d pass it along to my readers.  To answer the question “What is CCHIT?”, the site SoftwareAdvice says this:

CCHIT is a private, non-profit organization formed to certify EHRs against a minimum set of requirements for functionality, interoperability and security. It was founded in 2004 by three industry associations ( HIMSS, AHIMA and the Alliance (no longer in operation.))  It was subsequently funded further by the California Healthcare Foundation and a group of payers (e.g. United HealthGroup), providers (e.g. HCA) and software vendors (e.g. McKesson). In 2005, CCHIT was granted a $2.7 million contract by the Department of Health and Human Services (HHS) to support its mission. A number of other medical associations have since supported CCHIT. Despite the HHS contract, CCHIT is not an extension of the federal government.

As of March 2009, Eighty-some ambulatory EHRs received certification against the 2006 CCHIT criteria, sixteen EHRs received certification against the more rigorous 2007 criteria and twenty have achieved CCHIT certification for the 2008 Ambulatory EHR criteria. We estimate this equates to roughly 30% of all ambulatory EHRs being certified, while additional EHR vendors are currently pursuing certification for their systems.

In the article, SoftwareAdvice’s founder and owner, Don Fornes, also goes on to answer the questions:

  • What are the benefits of CCHIT?
  • Why does CCHIT generate some controversy?
  • Why doesn’t every vendor just get certified?
  • What are the criteria used by CCHIT to certify EHRs?
  • What important criteria does CCHIT not evaluate?
  • Does CCHIT evaluate specialty EHRs or templates for specialists?
  • Will CCHIT result in higher prices for EHRs?
  • Will a CCHIT-certified EHR improve my practice’s income?
  • Do I need a CCHIT-approved EHR to participate in my local HIE?

and ends with conclusions, recommendations and five key takeaways for helping you determine your path with EHRs and CCHIT.

Because I had never come across the SoftwareAdvice site before, I spoke with Houston Neal from Software Advice to understand what the site is and how it works.  Houston told me that the company has been helping healthcare entities choose practice management and electronic medical records software for almost 2 years and that the goal of the service is to help physicians develop a short list of vendors specific to their specialty and software needs.  There is no charge to the physician, but the software companies pay a referral fee to Software Advice.  Not all software vendors are represented on the site, but the company is working to get all vendors on board, and their representatives may discuss non-participating vendors if the needs of the physician warrant it.  Although I’ve not tried their service, it seems like a win/win situation if practices can get free software vendor recommendations based on a needs analysis.  I’d be interested in knowing if anyone out there has used SoftwareAdvice and what your feedback is.

By the way, in case you’re wondering, Houston confirmed for me that the way to pronounce “CCHIT” is either “SEA-CHIT” or :C.C.H.I.T.”  Thought you’d like to know!