So far, six ambulatory electronic medical-record products have passed muster with the Certification Commission for Healthcare Information Technology's 2007 criteria for functionality, interoperability and security.
Those products are:
- Auburn, N.Y.-based Community Computer Service's Medent 17.
- Austin, Texas-based e-MDs' Solution Series 6.1.2.
- Carrollton, Ga.-based Greenway Medical Technologies' PrimeSuite 2007 R2.
- Alpharetta, Ga.-based McKesson Provider Technologies' Practice Partner 9.2.1.
- Horsham, Pa.-based NextGen Healthcare Information Systems' EMR 5.4.29.
- St. Louis-based Purkinje's CareSeries EHR 2.0.
Some 89 ambulatory EHR products were certified under the 2006 criteria. If vendors want to continue marketing those EHRs with the 2006 CCHIT seal of approval beyond a 12-month period, commission spokeswoman Sue Reber said they will need to pay a $4,800 "maintenance" fee. Vendors seeking to keep old products certified and eligible for the 2006 seal while submitting new versions of the product for testing under the new criteria will need to pay a $4,800 maintenance fee plus the $23,200 fee for the certification test.
LeAnn Levering, e-MDs spokeswoman, said her company is planning to submit its certified products for retesting every year.
"CCHIT certification is definitely something we put a lot of effort into," she said. "It's a necessary step to be an EHR industry leader."
Unlike in previous rounds of certification testing, CCHIT is releasing names as vendors successfully complete the process rather than waiting and then releasing several names at once.
Although so far only six products have been certified under the 2007 criteria, on July 31, CCHIT Chairman Mark Leavitt told the HHS IT advisory panel known as the American Health Information Community that several more inspections were already in progress.
In order to be certified, an EHR product needs to register a 100% score on the CCHIT test. With the 2006 test, there were 151 criteria inspected using 200 test steps, while the 2007 test includes 247 criteria inspected through 315 test steps.
New features in the 2007 test include requirements for electronic prescribing, receiving and displaying laboratory test results, stronger audit trails, management of patient advance directives and treatment decisions, electronic order-entry capabilities, improved drug-interaction and allergy-checking decision-support tools, disease-management tools and improved features for population reporting.
"The biggest change is that the interoperability (testing) is a lot more rigorous," said Andy Ury, vice president and general manager of McKesson Practice Partner.
Although it's the second time Practice Partner went through CCHIT certification, it's the first time it's done so under the McKesson umbrella as Ury's company was acquired by McKesson in February of this year. Ury, who is also a CCHIT commissioner, said last year's criteria were based on applications that were widely in use, while this year's criteria are prompting vendors to make changes to their software and add functions.
He added that the industry, as a whole, has supported certification and believes it is helping expand adoption, but the concern of the industry is to always make sure the certification criteria meet the needs of providers and not just become a formal academic or regulatory exercise.
Leavitt reported to AHIC that certification has had a positive impact, and that it is even being looked at as a qualifying mechanism for some payer and state financial incentives for IT adoption. He also told the panel that CCHIT is researching the justification for medical liability insurance premium discounts for practices that use certified EHRs.
Levering said certification is achieving its intended results.
"The product certification that CCHIT provides gives our customers a level of confidence in what they're buying," she said. "It's not perfect, but it's doing what it's supposed to be doing."
CCHIT is expanding certification to include inpatient products this year, and Ury said criteria will be narrowly focused on medication administration and computerized physician order entry in the first go round.
While interested, officials with Unibased Systems Architecture, a St. Louis-based IT vendor specializing in enterprise scheduling and operating room scheduling systems, said they will wait for inpatient certification to mature before they engage in the process.
"We certainly are interested, but we haven't been pursuing it," said Barry Rundquist, Unibased's chief executive officer and executive vice president of sales and marketing. "We understand the value."
In addition to waiting for the inpatient certification process to develop, Rundquist said his staff is too busy working on customer implementations and is not available to work on certification at this time.
As a "best of breed" niche vendor, Rundquist said his company is particularly interested in how the CCHIT interoperability standards develop.
"All we can control is what we accept, deposit and send out," he said. "We can't control the link on the other side."
Unibased Vice President of Product Management and Marketing Larry Grossman said he is looking for CCHIT to clearly define "what the data elements are and where they belong."
Grossman also said that there is a concern that, if the process is too ponderous, certification could work against one of Unibased's strengths: speeding new functions to the market.
So, as far as CCHIT certification goes, Rundquist said that "when it becomes evident that they're ready for us and we're ready for them, we'll be Johnny-on-the-Spot to be there."
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