Time Capsule: CCHIT Should Provide More Information to Purchasers

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in January 2006.

CCHIT Should Provide More Information to Purchasers
By Mr. HIStalk

I admit that I paid little attention when, more than a year ago, the Certification Commission for Healthcare Information Technology (CCHIT) was born, sprung from the loins of HIMSS, AHIMA, and the group formerly known as NAHIT (now oddly and sinisterly calling itself just “ Alliance” for reasons surely less justifiable than renaming CCHIT itself, whose phonetic sounding-out always gets yuks from the watercooler crowd).

CCHIT came to life in the early, heady days of David Brailer’s rise to national prominence and, with him, an agenda that included certifying EHR products to reduce buyer risk and therefore increase adoption, particularly by that toughest nut to crack — physician offices.

I wasn’t expecting much — maybe a harmless, stuffy new bureaucracy whose core competency was hiring well-connected job seekers. Darned if CCHIT’s work groups didn’t go off and actually get some real work done that will have a significant impact on the industry.

You might mistake its 300-point evaluation tool and test scripts for a well-prepared RFP that addresses three categories: functionality, interoperability, and security and reliability. CCHIT is piloting the certification process now and will be in full certification mode by spring.

Maybe you didn’t know this: CCHIT will certify inpatient EMRs next, cranking up later this year. We aren’t talking about testing just ambulatory EMRs and interoperability. Hospital applications like those from Cerner, Epic, Eclipsys, McKesson, MEDITECH, and other full-blown inpatient EMR vendors are next.

Some vendors are complaining about the cost of certification and interference with their business. I understand their concerns, but I’ll stand by certification. Y2K Darwinism washed out weak physician system vendors, often spare bedroom programmer operations with minimal financial strength or clinical knowledge. I don’t hear much about them being fondly missed today. Vendors who don’t like CCHIT’s work would definitely be unhappy with full-blown FDA oversight similar to that of the drug and medical device industries.

CCHIT could be our industry’s Consumer Reports, just as KLAS and other companies provide our Gallup Poll. The former is an objective measure of how well products work, while the latter is a subjective assessment from customers. Put them together and you’re well on your way to a good product evaluation.

Here’s what I’d like to see CCHIT do, beyond what it has promised:

• Release the individual scoring sheets of the products it evaluates. CCHIT plans to only report whether a product has been certified. It stands to reason that some products will do better on the tests than others. Wouldn’t you like to see how well each product did? Why make new EMR adopters re-invent the wheel?
• Add a category for patient safety. We’ve seen plenty of examples in which new clinical systems harmed patients, either through product deficiencies or poor implementations. We need measurable product standards (and arguably measurable implementation standards, but that’s probably outside of CCHIT’s domain).
• Add criteria for usability. Part of the maturity of any technology is to make it intuitively and correctly usable by a wide variety of users. We expect doctors and nurses to use complex software that has confusing screens, a 500-page manual, and a two-day mandatory training session without making a mistake. Standards exist, but are rarely used by vendors or customers.

We can argue about specific criteria, but I’m looking forward to CCHIT’s results. The discussions they generate should be interesting.