CCHIT ending testing and certification of EHRs

The Certification Commission for Health Information Technology is getting out of the business of testing and certifying electronic health-record systems after nearly a decade as the first and still most-commonly used provider of those services in the U.S.

The organization also stopped taking applications for testing and certification services from vendors Tuesday and will finish work on about 70 of those systems it has in the pipeline and wind down that part of its operations by April or May, CCHIT Executive Director Alisa Ray said.

Today, roughly half of all health IT systems on the official Certified Health IT Product List kept by the Office of the National Coordinator for Health Information Technology at HHS have been tested and certified by CCHIT.

The once-rapid pace of EHR adoption has slowed, however, and the tempo of testing and certification of those systems has become erratic.

Besides CCHIT, there are five other Accredited Testing Laboratories recognized by the ONC and three other ONC-Authorized Certification Bodies doing the same work as CCHIT, which both tests and certifies EHRs and their component parts as qualified for use in the EHR incentive payment program under the American Recovery and Reinvestment Act of 2009.

CCHIT announced it also will halt its private-label certification programs for other health IT systems, including those used in cardiology, women's health, oncology, long-term and post-acute care and behavioral health. Expertise gained in developing those testing programs won't go to waste, however, Ray said, as the organization pivots to a more global scope.

The organization is reviving an affiliation with the Healthcare Information and Management Systems Society, the trade association for the health IT industry, which CCHIT said could open up global opportunities.

CCHIT will retain its own name and independent corporate status, but HIMSS has appointed four of its board members to CCHIT's seven member board, Ray said.

The certification commission was established in 2004 at the behest of Dr. David Brailer, then head of the ONC. Early in his campaign to boost the use of electronic health-record systems, Brailer called for the private sector to create an independent testing and certification authority for EHRs akin to the Underwriters Laboratory seal for consumer appliances. He reasoned the lack of arms-length information about EHRs was a barrier to clinician adoption.

HIMSS, the American Health Information Management Association and the now-defunct National Alliance for Health Information Technology kicked in time, talent and money to launch CCHIT, which subsequently received a federal contract to develop a testing and certification program for health IT systems.

Ray said business has been brisk in recent months as vendors rushed to have their systems tested and certified against the newly required 2014 Edition standards. But the CCHIT board found that being a testing and certification body under federal rules limited what the organization could do. Meanwhile, delays in the timing for adoption of Stage 2 and Stage 3 meaningful-use criteria and their attendant testing and certification criteria under the EHR incentive payment program, made it difficult to plan and run a business.

“It just doesn't fit with our mission anymore,” Ray said. “It's so complicated. All eyes are on what gets you incentives. We've found that's a very hard business in which to operate because it's so varied.

The business, she said, has been complicated by HHS' decisions to push back compliance with meaningful-use criteria. Compliance with the Stage 2 requirement had been pushed back one year, and recently the Stage 2 period was extended another year.

“When Stage 2 is delayed it makes sense from a policy perspective, but it pushes revenue out six months. We have to hire and add new people, and be skilled in operating a particular tool and that's taking us farther and farther away from our roots.”

Before the ARRA, CCHIT served as a convener of stakeholders to develop its own set of certification criteria, a role it would like to play in the future in promoting health IT outside of the tight ARRA framework, and perhaps, internationally.

“That type of intellectual leadership, we haven't been called on to do that,” Ray said. “It's been done through the FACAs (federal advisory committees established by the ARRA). We found that being in the ONC testing and certification role has limited us from being in other health IT conversations. We're not at the table because we're seen as the testers.”

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