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EHRVA members weigh in on CCHIT criteria

A majority of members of the Electronic Health Record Vendors Association surveyed recently indicated they expect the Continuity of Care Document, or CCD, standard will likely appear as a criterion for testing of their systems for interoperability in 2008 by the federally supported Certification Commission for Healthcare Information Technology.

The EHRVA is an affiliate of the Healthcare Information and Management Systems Society and represents more than 40 developers of EHR systems. Twenty-eight members of the EHRVA responded to the survey. CCHIT recently closed a public comment period on what it calls an "environmental scan" of potential candidate interoperability testing criteria for inclusion in the 2008 testing cycle. The candidates were selected by an expert panel formed in July.

According to a summary of the CCHIT environmental scan, clinical documentation of patient summary information is listed among nine categories of proposed areas of focus and will be vying for priority with coded terminologies for medications and allergies, electronic prescribing, cross-enterprise document sharing, laboratory, imaging, reporting, ambulatory practice-management software integration and inpatient functional integration.

But 76% of EHRVA members indicated they expect the CCD to be included in the 2008 CCHIT criteria.

The CCD is a compromise worked out between two standards development organizations that had been working on competing standards for patient summaries, Health Level Seven, Ann Arbor, Mich., which had developed the Care Record Summary, and ASTM International, West Conshohocken, Pa., developer of the Continuity of Care Record, or CCR, which ASTM produced in conjunction with the Massachusetts Medical Society.

The CCD is in effect a CCR implementation within HL7's Clinical Document Architecture. The CCD was approved by HL7 in January. HL7 has since dropped work on its own Care Record Summary. Adoption of the CCD standard by EHR vendors would allow providers using different systems to "support transitions of care without requiring a regional health information exchange to be in place," said Dan Michelson, chief marketing officer for EHRVA member Allscripts, in a news release.

Don Schoen, president and chief executive officer of EHR developer MediNotes and the EHRVA chairman, explained the organization's position is an attempt to buttress the CCD.

"The other one that is still out in the industry is the CCR, and that seems to keep getting pushed by some individuals," Schoen said. "It (CCD) is the defacto thatís out here," but there are some vendors with personal health records that have chosen CCR.

"It doesnít make any sense," Schoen said. "Letís go down the CCD road and be done with it."

The full adoption by the vendor community of the CCD also will afford synergy, according to Schoen, since CMS has mandated its use for electronic claims attachments in 2009.

EHRVA members also listed as a top priority that the association assist them by providing educational sessions for vendors on implementing the CCD, including tools, templates and hands-on demonstrations.

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