In response to Joseph Conns Will CCHIT have competition due to stimulus law?":
There has been considerable discussion in healthcare blogs recently concerning the Certification Commission for Healthcare Information Technology's conflict of interest as a private-public organization, creating criteria that attempt to get everyone to look like me, and holding up significant cost barriers for enrollment in the certification process. A government-only electronic health record accrediting body makes more sense, and removes some of the concerns of conflict of interest that have been raised.
Regardless, my concern is that whatever new body is charged with EHR certification going forward will simply inherit the CCHIT criteria set without re-examination. The result of the certification process to date has been certification of very expensive and cumbersome EHRs with poor usability.
I agree that cost is a major barrier to EHR adoption by medical practices, especially small practicesthis includes the hidden costs of hardware infrastructure, IT support, need for consultants, third-party software licenses, data backup costs and so forth, that go along with a local client/server installation. The next-most-important barrier to adoption is poor usabilitylong learning curves for physicians and other staff members to learn the program, poor interface design where the needed information is not easily available, and slowdown in the busy work pace experienced in clinical practice. Usability has specifically not been an aspect of CCHIT certification.
Here is a good background resource describing a systematic method for measuring usability (i.e., accuracy, efficiency and satisfaction around a set of common work tasks).
My hope is that there will be a new method for certification of EHRs: It should include usability (which subsumes the previous CCHIT domain of functionality), interoperability and affordability. It is true that affordability might not be a valid certification criteriaperhaps keeping the CCHIT domain of security would make sensebut affordability is certainly a consideration for those making EHR adoption decisions.
Robert Rowley, M.D.Chief medical officerPractice FusionSan Francisco To submit a letter to the Modern Physician Reader Blog, click here. Please include your name, title, company and hometown. Modern Physician reserves the right to edit all submissions.