Health IT: More certification groups could speed stimulus-related spending

A federal advisory group has recommended that multiple organizations be able to test and certify vendor systems to meet the economic stimulus law's requirements for electronic health records.

The Health and Human Services Department (HHS) would set criteria for certification of health information technology and authorize multiple organizations to test whether vendor systems meet that criteria under a plan offered by a federal advisory workgroup.

The initial recommendations presented by a workgroup of the Health IT Policy Committee on July 16 appear to create a more limited role for the existing vendor-led Certification Commission for Healthcare Information Technology.

The CCHIT, formed in 2004, currently is the only organization recognized by HHS as a certifying organization for health IT. Under the proposals offered by the Certification/Adoption Workgroup, multiple organizations, presumably including the CCHIT, would test and certify health IT systems.

“Multiple organizations should be allowed to perform HHS certification testing and provide certification,” the workgroup said in its presentation to the policy committee. The workgroup and policy committee are inviting feedback on the recommendations before the policy committee’s next meeting on Aug. 14.

One of the reasons cited by the workgroup for modifying the CCHIT’s role is to avoid the appearance of too-close ties to vendors and vendor groups.

The certification workgroup is led by Paul Egerman, chief executive of eScription Inc., a health IT vendor, and Marc Probst, chief information officer of Intermountain Healthcare, a care providers group. It outlined several benefits of the current certification approach under CCHIT, including transparency and fairness in judging panels.

However, the workgroup also said CCHIT’s certification approach has been marred by too much detail and may have the appearance of conflicts of interest.

“There is a feeling that the certification process is excessively detailed,” the workgroup stated in its PowerPoint presentation. “ There is too much attention to specific features and functionality.”

The workgroup also noted problems with alleged conflicts of interest. “There has been criticism that CCHIT is too closely aligned with [Healthcare Information and Management Systems Society] or with vendors,” the workgroup said. “While we did not see any evidence that vendors were exerting undue influence on CCHIT, we also understand that the appearance of a conflict is important to address.”

Under the current approach, CCHIT sets the criteria for certification and tests products for certification. Under the proposed new approach, HHS would set the criteria, and CCHIT and other groups would test and perform the certifications.

The HHS certification efforts are expected to dovetail with recommendations being developed by the Health IT Policy Committee to achieve “meaningful use” of health IT.

Under the economic stimulus law, HHS will distribute more than $17 billion to doctors’ offices and hospitals that purchase and meaningfully use certified electronic health record systems, starting in 2011. Under the initial recommendations of the policy committee, the meaningful use criteria will likely include patient data collection and exchange to achieve goals including improved health outcomes and better health care quality.

The Certification/Adoption Workgroup recommended the following definition for HHS Certification: “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 workgroup also recommended increased focus on privacy, security, transparency and an improved certification process that allows for self-developed and open-source health IT products.

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