Some healthcare IT watchers are questioning the propriety of a confidential conference call between leaders of the Electronic Health Record Vendors Association and the Certification Commission for Healthcare Information Technology, which is charged under a federal contract with developing a methodology of certifying the capabilities of healthcare IT systems.
One source described the call as a brash end run around the fairness and transparency that have characterized CCHIT's work so far. The unconventional call to CCHIT Chairman Mark Leavitt centered on 39 recommendations regarding electronic health records made by the Electronic Health Record Vendors Association -- many of which would effectively defang stricter guidelines now being tested by CCHIT.
And as news of the April 3 call spread from the payers to the healthcare providers who are staked in the EHR process, several of them grumbled about the perceived conflict of interest between Leavitt, who was the chief medical officer at the Healthcare Information and Management Systems Society, and Stephen Lieber, HIMSS president and chief executive officer, who spearheaded the call.
Moreover, the recommendations made by the EHRVA in its conversation and a previous letter could throw a wrench into a process that has already been delayed. If a middle ground can't be reached, vendors could ultimately have to answer to federal regulations rather than industry-sponsored ones -- a prospect neither side is eager to see.
But, according to a source who spoke to Modern Healthcare on the condition of anonymity, it was the secretive nature of the call -- EHRVA (a part of HIMSS) deemed it "confidential" -- that could leave a hint of impropriety. At the very least, the source said, EHRVA should get reined-in for prompting the call. "If the process doesn't have credibility, then it will collapse," the source said. "You can't have secret conversations."
And it's a sentiment not lost on the groups involved in the EHR-development process.
Last fall, David Brailer, the national coordinator for health information technology at HHS, awarded three EHR-related contracts, including a $2.7 million one, to CCHIT. As a contract requirement, Brailer's office said transparency was important to the process.
John Hummel, a commission member and national director of Perot Systems Clinical Solutions Center, said he bristled at the tone of the EHRVA letter, adding that "a lot of people were concerned about the way it was brought up." His initial take: "All these vendors are trying to gut the process," although he later tempered his view.
Leavitt downplayed the EHRVA call, which aside from Lieber included at least three other CCHIT or HIMSS executives. Leavitt said the call was in response to previously -- and publicly -- posted comments by the vendors association and was taken to accommodate a shortened timeline.
Plus, Leavitt said he plans to post online a letter, dated March 31 and acquired by Modern Healthcare, which served as a precursor to the phone call. "Every step of the way we have been open and transparent and have no intention to change that at this point," he said.
Lieber also categorized the call as routine and said its sole purpose was to raise questions that the association had over the draft certifications. As for the confidentiality of the call, Lieber said it was done more as a courtesy to CCHIT.
The letter argues that the "pass-fail approach will deter vendors from participating in certification efforts." Instead, EHRVA members told Leavitt that an alternative method to the certification process -- one based on points or letter grades assigned to specific "must-have" specifications -- would be favored.
EHRVA etched out a series of proposals that would make certification far less rigorous than planned, critics charged. But Leavitt said CCHIT isn't automatically going to give in. Just because "the vendors say they want to water it down or make it less risky doesn't mean we are going to make changes," he said.
That a vendors association is pushing for a less rigorous process more suited to its members comes as little surprise, Leavitt said.
Still, there's little chance that the commission will budge on the pass or fail aspect to certification, according to Hummel. "In the end, I would rather buy a power cord that has an Underwriters Laboratories tag on it that says 'passed' rather than 'almost passed,' " he said.
Joseph Conn contributed to this article.
This story was originally published in Modern Healthcare magazine.
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