CCHIT to Test EHR and HIE Interoperability

CCHIT Q&A on Interoperability and Stage 2

Our attendance at MGMA12 gave us an opportunity to meet up with many of our colleagues in the health IT industry.  One making news recently was the Certification Commission for Health Information Technology (CCHIT).

CCHIT was recently selected to test and certify the computer systems used by health information exchange organizations and their users as part of  a coalition led by Healtheway, the newly formed public-private partnership of the eHealth Exchange, to help get interoperability up and running in the New York eHealth Collaborative (NYeC) network.

We recently asked Alisa Ray, Executive Director for CCHIT, about this news as well as answer a couple of other Stage 2 questions.

Q. News broke recently that CCHIT has been selected as a compliance testing body for certifying interfaces between health information technology and health information exchanges for consistency across multiple states and systems. How is this a game changer in the goal of realizing interoperability?
A. Currently, a lack of uniform implementation-level standards, testing specifications and testing policies requires that a custom interface be negotiated and developed from each electronic health record (EHR) to each health information exchange (HIE) and between HIEs.  The development of the interface and negotiation of point-to-point agreements represents a significant expenditure of cost and time for all stakeholders (physicians, HIEs, and vendors), limiting adoption and utilization of HIE. These are challenges that limit providers, states, health information organizations (HIOs) and federal agencies from expanding HIE beyond their current geography, organization or domain.

An effort to address these challenges by setting a unified target for interoperable interfaces is being jointly led by the EHR/HIE Interoperability Workgroup, a New York eHealth Collaborative (NYeC)–led consortium of states and vendors; and HealtheWay, the newly formed public-private partnership of the eHealth Exchange, a network of 34 public and private organizations representing hundreds of hospitals, thousands of providers and millions of patients across the country.

The goal of the joint IWG/eHealth Exchange effort is to remove the optionality presented by many current standards and assure that there is common way of building interfaces that can be used across many states and HIEs. The compliance testing program will enable organizations to test once and have a reasonable assurance of being able to securely exchange information with others, without additional custom development and testing.

Q. There have now been 5 waves of Certification Criteria Test Procedures. Is CCHIT commenting and will they share their issues, concerns, or agreements? 
A. The release of the ONC test methods in successive waves follows the methodology for review and public comment used by NIST in the 2011 Edition implementation. Now, as then, CCHIT staff reviews the proposed test procedures and applicable test tools, and submits our comments. We publish all of our comments on our web site at We encourage our vendor customers to do the same.

Q. What does CCHIT see as the biggest hurdle smaller vendors, that have 2011 certification, will have in actually getting 2014 certification for their products? 
A. We believe the biggest hurdle for some vendors in achieving 2014 Edition certification will be a raised bar for interoperability.  In the new criteria, there is a push for data-element level (i.e., semantic) interoperability, meaning EHR technology must consume a CDA and demonstrate how the data is integrated into the system.  In the 2011 Edition, by comparison, a vendor can show how the patient information is incorporated in a more general way, akin to an attachment.

Alisa Ray, MHA, joined CCHIT in January 2006, as its first Executive Director. Ms. Ray supports the work of CCHIT’s Boards of Trustees and Commissioners, and its work groups, manages CCHIT’s business operations, and develops staff and resources to allow CCHIT to provide high quality services and programs to the HIT industry’s many stakeholders.