EHRs: Certification doesn’t mean much to most small practices

Certifying EHRs is supposed to help doctors pick the best products. But small medical practices generally don’t put much stock in this stamp of approval, according to KLAS, a firm that researches healthcare information technology.

The federal Department of Health and Human Services contracts with the Certification Commission for Healthcare Information Technology—a private industry group—to certify EHRs that meet criteria deemed fundamental for digital medicine. So far, CCHIT has blessed more than 90 programs.

However, a KLAS report titled Ambulatory EMR Perception finds that only 24 percent of practices with one to five doctors consider CCHIT certification essential in selecting an EHR. The report, published in February, notes that some smaller practices are highly specialized and may not require all the firepower of a certified EHR. “Overall, it seems that CCHIT has had minimal or inconsequential impact on the smaller physician practices,” the report states.

In contrast, a tad more than 50 percent of groups with more than 100 physicians say that certification is a key criterion in purchasing an EHR. The KLAS study states that larger practices must ensure that their EHR will work in a more complex environment requiring linkage to other computer systems—hence the need for a more sophisticated product.

Price isn’t mentioned in the KLAS report, but it helps explain why most smaller practices look past CCHIT certification—products with this imprimatur generally cost a lot more.

Certification advancing at faster rate than last year

Certification of healthcare information technology is advancing at a faster rate than last year, according to Mark Leavitt, chair of the Certification Commission for Healthcare Information Technology. Market acceptance of certification has increased, Mark Leavitt said.
Last year in the first four quarters of the Commission’s existence, it certified about 10 percent of the ambulatory healthcare IT product market per quarter. Now, in certifying the hospital market, the commission has so far certified six inpatient products out of 24 possible vendors. “This is about a quarter of the inpatient market, so we are ahead of last year,” said Mark Leavitt.
At a meeting hosted by the Department of Health and Human Services Monday, HHS Secretary Michael Leavitt praised CCHIT’s leadership. “We are making serious progress here and in large measures,” the secretary said.
Mark Leavitt, who gave a report before the HHS American Health Information Community, commended the six vendors recently certified for inpatient electronic health record products for  stepping up and being leaders. “This is a tough test we asked them to pass,” he said. “The test actually drilled deep. We had six applicants and all six passed so I can assure you that they prepared long and hard.”
{Comment: “It’s a sad day when a consumer representative praises a process to certify electronic health technology products that deny consumers control of personal health information. Regarding the Certification Commission for Healthcare Information Technology (CCHIT) process for certifying electronic medical records, Nancy Davenport-Ennis said, “Thank you for keeping the patient at the center of your universe.”  CCHIT-certified EHRs (electronic health records) are not held to any standards of privacy—ie consumer control of access to data. CCHIT has really placed consumers at the center of the bulls-eye for data mining. CCHIT certifyies products that actually violate patients’ privacy rights under strong state and common law and medical ethics. Today, consumers are in GREAT danger because the majority of EHR and PHR products contractually grant vendors ownership and/or use of the data. Consumers should ask hospitals and clinics: Does your electronic record system give ownership and use of the data to the technology vendor who built your system? Think about it—it’s outrageous for consumers to have to worry about who is stealing their health information when they are sick.”~ Dr. Deborah Peel, Patient Privacy Rights}

Vendors, privacy activists speak out on report

The RTI International recommendations got split reviews from Don Schoen, president and chief executive officer of MediNotes, a West Des Moines, Iowa, developer of EHR systems for ambulatory care, and chairman of the Electronic Health Record Vendors Association, a trade group affiliated with the Chicago-based Healthcare Information and Management Systems Society.
Schoen said that he supported some of the recommendations, particularly one that calls for vendors to not build into their systems prompts that suggest physicians could add more documentation to the record of a patient encounter to obtain a higher-paying evaluation and management code.
“I can’t speak for every product that’s out on the market today, (but) most members don’t have products that prompt docs at a certain level,” Schoen said. “Most measure what doctors have reported in their note and tell them this is the code that qualifies. The last thing the doctors want as well as the companies themselves is to stand under scrutiny to commit any kind of fraud. We’re out there to help our clients get paid for what they honestly and justifiably should.” But he also took issue with some of the procedures of the RTI work group that produced the report, including a lack of vendor participation and the short public comment period, both of which compared unfavorably with practices by CCHIT, he said.
“Not one of our vendors that we know of has been on that panel,” he said, adding that during the two-week comment period, on average only about 63 respondents voted in favor of the 14 recommendations, a response rate he called “ludicrous.”
{“The federal government (HHS) proposes to open up all our electronic health records to insurers and others to detect fraud. Guess what the cause of fraud is? Access to medical records by people we would never want to see them. Congress must restore our longstanding rights to control access to our personal health records that HHS eliminated in 2002. HHS has been out-of-control for years—–first it eliminated Americans’ rights to control who can see and use their medical records, now it wants insurers and others to have open access to our entire health records to stop fraud. Allowing even MORE unwanted users to have access will not stop fraud, it will increase fraud. The RTI report commissioned by HHS concludes that fraud will be greatly enhanced by today’s electronic records systems. It certainly will—unless patients once again control access to personal health records. HHS doesn’t want the exponential increase in fraud that will result from building a digital health system with no privacy rights to dampen enthusiasm for electronic health records. But who pays when the wrong people have open access our medical records for fraud, for identity theft, and for medical identity theft? We do—taxpayers and patients. We will pay the costs and suffer from the thefts—-yet we could easily PREVENT the wrong people from seeing our medical records and PREVENT fraud, if Congress restores the right to give consent before anyone can access our personal health information. The irony is ‘smart’ technology exists today that can easily give us the power to control all access to personal health information, no matter where it is stored. We have to demand that this ‘smart’ technology—called independent consent management tools—-be required throughout the electronic healthcare system. ~ Dr. Deborah Peel, Patient Privacy Rights”}

CCHIT names trustees, moves toward nonprofit status

The Certification Commission for Healthcare Information Technology (CCHIT) announced Monday the establishment of a new board of trustees, bringing it one step closer to becoming a fully independent, nonprofit organization.
According to Sue Reber, spokesperson for CCHIT, the new board of trustees won’t change how CCHIT functions. “Little change should be seen immediately,” she said.
Last month, the Department of Health and Human Services deemed CCHIT an officially “Recognized Certification Body,” able to provide inspection and valid certification to electronic health records networks and how they interoperate.
“CCHIT is under a contract with HHS and is required to become a self-sustaining organization with a fiduciary board at the end of its three year HHS funding period,” Reber said. “Establishing a new trustee board is part of that compliance.”