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Time Capsule: CCHIT’s First Certification List is Unsatisfying

September 9, 2011 Time Capsule 1 Comment

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 July 2006.

CCHIT’s First Certification List is Unsatisfying
By Mr. HIStalk


The Certification Commission for Healthcare Information Technology’s long-awaited announcement of the initial class of 20 certified ambulatory electronic medical records products this week was oddly unsatisfying. Rather than being an exclusive club, most big-name vendors made the list.

As I’ve said previously, certification has little value if most products earn it. Prospects considering the usual vendors won’t find their job any easier: everybody scored 100%. No one likes a game that ends in a tie.

CCHIT may ramp up the standards for future years. Maybe this initial pass was made intentionally easy (or, maybe vendors put a lot of resources into enhancements – we don’t know). That’s how certification usually works. You make it easy enough to be attractive initially and then toughen it up once it catches on.

The biggest companies dominate the list. Not coincidentally, they market the most expensive products to the largest physician practices. For them, the cost was inconsequential. On the other hand, they were already facing each other in system selections. Their prospects didn’t need much encouragement to consider EMRs. For those reasons, certification doesn’t really change anything for anybody in this category.

The winners were those newly certified products whose sweet spot is smaller practices. They have tons of competitors and CCHIT’s endorsement may help them rise above the crowd. They just have to figure out how to effectively market their new credential.

Now that we have certified products, we’ll find out if the marketplace values that status. If so, cautious vendors who sat out the first round will jump in line quickly. If not, even those who earned certification this week may opt out of future rounds. Vendor flaunting of the credential is the only way word will get out to the masses, although it wouldn’t be surprising if CCHIT forged relationships with physician and practice management groups to co-brand their certification efforts in some way.

What about customers? I’ve talked to several CEOs of ambulatory EMR companies and they don’t agree on the benefit of certification to physician practices. It may increase EMR adoption, but that’s a guess. It may reduce buyer risk, but only in the limited areas it measures. It may shake out vendors perceived as weak, but it may also provide a misleading stamp of approval to immature products with unproven support and longevity. It may improve reimbursement, but no one’s quite sure how. Customers still need to consider many factors in deciding when or what to buy.

I think the federal government will encourage the use of certified EMR products by sweetening reimbursement or making it a requirement for government-related purchases. We know the government is encouraging adoption of electronic records, so why wouldn’t it show a preference for certified ones? You might see the same nudging from insurers or regulators. It all depends on how well certification catches on.

Impatient people like me may have expected too much of an immediate product differentiator in this first round of certification. Still, CCHIT has done a good job defining the process, sticking to its timetable, and communicating its progress. Perhaps its most important work is yet to come.

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Currently there is "1 comment" on this Article:

  1. “CCHIT may ramp up the standards for future years.”

    Well, we see that this never happened as CCHIT continued to ignore usability and safety of the devices it was certifying.

    I remain disappointed as much now as I was then, when you first wrote this, that CCHIT was allowed to do this work for HIMSS and EHRA as if it was an independent certifying body.

    HIT would be much better now, and safer, if there was not such insider horse trading.

    Just my humble opinion.

    BTW, I hope the FDA gives them a comeuppance at its mobile medical apps workshop on Monday and Tuesday.

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