More than Just Meaningful Use

While everyone was waiting patiently for the revised recommendations on meaningful use, the real drama was going on with the Certification and Adoption workgroup. Two days before the Policy Meeting, the workgroup had meetings and testimonies on July 14th and 15th to consider a list of questions concerning criteria and the certification process. We have no doubt there was no surprise when the wounds were reopened and the lines were drawn on the elephant in the room, CCHIT.

A little background for those who are just tuning in. The Certification Commission for Healthcare Information Technology (CCHIT) was established in 2004 by HIMSS, AHIMA, and NAHIT from a request by the then ONC, David Brailer. It has been largely funded by the government and is currently the only organization recognized by HHS to certify systems in health IT. Currently, CCHIT sets the criteria for certification and tests products for the certification. Dr. Mark Leavitt is the chairman of CCHIT and has been since its beginning.

So what’s the beef? Some believe that CCHIT is too close to HIMSS and that in turn means too close to the vendors. Weather they are close or not, HIMSS likes them enough to lobby the new administration just last May to consider CCHIT as “the” certifying body for all EHR systems. And then there is the “set the criteria and test that criteria” problem. You know, who’s mining the store anyway? And on the criteria and certifying process, the detail in features and functionality does not lead to new and innovative solutions for today’s problems.

Now back to the workgroup’s meeting. Dr Leavitt testified on behalf of CCHIT saying that the fact that the HITECH Act calls for certifying systems is an endorsement for CCHIT. And also how he believes that certification has encouraged smaller companies to enter the Health IT market. And it did not appear that he or CCHIT were concerned with their critics. Did he know they would be following him? It was then open fire from their critics, everything from Leavitt’s previous employment at HIMSS to development companies just ignoring CCHIT not getting certified. Leavitt’s ultimate response was that he sympathized with the workgroup’s assignment.

The workgroup did present its initial recommendations to the HIT Policy Committee at the July 16th meeting. The recommended definition for HHS Certification is; “HHS Certification means that a system is able to achieve government requirements for security, privacy and interoperability, and that the system would enable the meaningful-use results the government expects. HHS Certification is not intended to be viewed as a ‘seal of approval’ or an indication of the benefits of one system over another.”

The recommendations:

  1. Focus Certification on Meaningful Use
  2. Leverage Certification process to improve progress on Security, Privacy, and Interoperability
  3. Improve objectivity and transparency of the certification process
  4. Expand Certification to include a range of software sources: Open source, self-developed, etc.
  5. Develop a Short-Term Transition plan

The Public comment period is now open on the recommendations.