Part one of a two-part series (Access part two):If not at the gaming tables, at least at the woof and warp of government regulation, physician Mark Leavitt is a betting man.
And, in effect, Leavitt, the soon-to-be-retired chairman of the Certification Commission for Health Information Technology, is asking the healthcare software industry and, potentially, thousands of purchasers of electronic health-record systems to bet along with him.
The bet is that CCHIT will eventually re-ingratiate itself to its one-time backers at HHS and that both vendors and providers will continue to value and seek CCHIT certification even though, now, there is a certain amount of added risk involved in doing so. CCHIT was created in 2004 at the behest of the Bush administration, but recently its close ties to HHS have been cut.
That's because neither Leavitt's not-for-profit organization nor the criteria against which it will test and certify EHR systems going forward have been officially “recognized” as relevant to the American Recovery and Reinvestment Act's EHR subsidy programs.
As Leavitt sees it, however, the alternative risk may be even greater for vendors and their provider customers if they don't seek CCHIT certification soon, but wait for the government to complete its work on how it will go about officially recognizing healthcare IT software testing and certification organizations under the ARRA, also known as the stimulus law.
Meanwhile, time is of the essence for both EHR vendors and providers.
Vendors, for example, to ensure that their products are qualified and certified and thus good enough for federal subsidies under the stimulus law, must pick a certification body recognized by the Office of the National Coordinator for Health Information Technology, submit their EHR systems to it for testing, have the EHR pass muster against criteria that only recently were committed to writing and may yet be revised, advertise that their EHR systems are certified and, finally, sell them to providers.
Meanwhile, hospitals, office-based physicians and other providers eligible for federal EHR subsidy payments under the Medicare branch of the program, must select, buy, install, implement and then “meaningfully use” a qualified and accredited EHR system for at least 90 days before October 2011 in order to qualify for maximum overall reimbursements and receive the biggest annual dollop of cash, which will be allocated during the subsidy program's first “payment year.” Like the criteria for certification, the criteria for meaningful use only recently were officially published and could still be amended.
Both certification and meaningful-use rules, released Dec. 30, 2009, are now in their public comment periods.
Trouble is, for now, though, CCHIT is not alone in its lack of federal recognition.
There are no ONC-recognized, stimulus law-compliant EHR testing certification organizations. Thus the government has created a bottleneck at the certification organization recognition phase of its own EHR subsidy program, a constriction that may not be relieved until as late as September, Leavitt said.
“Put your vendor hat on,” Leavitt said. “Come get certified with us right now—and we're fast—it can be done in 90 days, and get into marketplace.”
Providers, similarly, “can start now, when they need to, if they have any hope of getting to meaningful use by 2011 and 2012,” he said.
Granted, he said, providers will “run the risk” that ONC might never recognize CCHIT, but Leavitt said that risk “is incredibly small.”
“But if you wait for one of these new bodies, and that's likely going to take six or nine months, that's a larger risk that you're not going to be accredited in time,” he said.
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