In order to become CCHIT-certified, electronic-medical-records vendors must have their EMR "certified" by the Certification Commission for Healthcare Information Technology. Originally, CCHIT considered creating a sliding certification application fee schedule, based on a vendor's sales/revenue/installed sites. Unfortunately, CCHIT ultimately decided that all EMR vendors, no matter how small, would be charged a certification application fee of $28,000.
I believe this fee will be an insurmountable barrier for many small EMR companies. As a result of not becoming certified, these small EMR companies will have less market visibility, and the number of EMRs available to physicians will dwindle. Further, the solo and small-group-practice physicians -- who do not have the resources to purchase from the larger EMR companies -- will now be forced to make their purchase decision based on anecdotal information, rather than based on CCHIT's rigorous and objective assessment of the EMR.
In response to a question about implementing a sliding-scale certification application fee, Chairman Mark Leavitt stated that CCHIT decided on a fixed fee because the EMR companies were unwilling to provide CCHIT with documentation regarding their size -- number of installations, revenue -- on the grounds that this was confidential information that the EMR companies did not want to release to CCHIT. However, as part of the CCHIT application process, the EMR companies are required to provide CCHIT with other types of confidential information, and CCHIT has promised to keep the confidential information private. Thus, there is an inherent inconsistency in the CCHIT certification process regarding what type of confidential information CCHIT mandates it receives.
During a teleconference about the CCHIT certification process, Leavitt also stated that if it becomes apparent that few small EMR companies are applying for certification, CCHIT would reconsider the fixed schedule in favor of a sliding-scale fee. Unfortunately, by the time CCHIT is able to determine its process is hurting the small EMR companies, many will likely cease to exist, as these companies do not have the capital to survive the "adverse market forces" that will result from their failure to obtain certification.
Unfortunately, we at ComChart Medical Software have decided that the application fee of $28,000 is currently beyond our means. In an attempt to demonstrate to the market that ComChart EMR is a robust product, we will be posting the CCHIT certification guidelines on our Web site and indicate those areas in which we believe we are in compliance.
Hayward Zwerling, M.D.
ComChart Medical Software
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