Members of the small but passionate community of healthcare open-source software developers and users are meeting with the leaders of the Certification Commission for Healthcare Information Technology at the 2009 Healthcare Information and Management Systems Society's conference in Chicago and will attempt to find rapprochement with the federally supported not-for-profit organization that could play an increasingly important role in the governments IT booster initiative.
Under the American Recovery and Reinvestment Act of 2009, providers can receive subsidies as part of the stimulus initiative to purchase and use an electronic health-record system, but there are strings attached. One of them is that providers must use a certified EHR system to qualify for the federal subsidy. So far, CCHIT is the only game in town for EHR certification.
There are a number of people in the open-source communitysome are folks that make software, some are just people involved in open source(who) have taken a position that the CCHIT process, how can I put this in a diplomatic way, presents some obstacles for open source that it doesnt for others, said Joseph Dal Molin, a vice president of WorldVistA, a not-for-profit organization promoting an open-source version of the Veterans Affairs Departments Veterans Health Information Systems and Technology Architecture EHR system.
WorldVistA, which helped develop a version of VistA for use in physician offices under contract with the CMS, has the only truly open-source software system to receive CCHIT certification.
While CCHIT received a three-year, $7.5 million contract from HHS to set up a testing and certification program for health IT systems, the Bush administration, which often sought private-sector organizations to carry out government functions, set a goal from the beginning to have CCHIT become self-sustaining. CCHIT is moving toward weaning itself off the federal subsidy by charging vendors fees to go through the certification process. That has created an affordability problem, Dal Molin said, which needs to be addressed if open-source developers are to have a fair shot at providing healthcare applications. The CCHIT certification fee for the WorldVistA EHR took a big bite out of WorldVistas bank account, money it had raised from attendance fees to its semiannual meetings and some left over funding from the HHS contract.
It was $30,000 and I think its gone up now, and thats our biggest concern as a not-for-profit, Dal Molin said. It was up to me to push the go button and take the risk of passing certification and risk losing all that money, and I can tell you that was one of the toughest decisions I had to make even though I was confident wed pass.