| Does that mean it's time to buy an EHR? Maybe not. | | | | But what about CCHIT certification? |
| If you've been thinking about moving to an electronic | | | | Many EHRs currently carry a certification from the |
| health records (EHR) system, in hope of the federal | | | | Certification Commission for Health Information |
| government subsidizing the cost, you might be led to | | | | Technology (CCHIT), a non-profit organization that has |
| believe the time to act is now. After all, the promise of | | | | done much to develop standards for EHR software. |
| $44,000 per physician from Medicare (or up to $63,750 | | | | The CCHIT certification carried by an EHR is |
| under Medicaid) is pretty alluring. Getting that money, | | | | associated with a specific year to convey which set |
| however, is not automatic, and not every EHR may | | | | of standards (each year the criteria changes) that the |
| qualify. In fact, as of right now, no EHR qualifies for the | | | | EHR software meets. While useful, that certification is |
| reimbursement. Not even one. | | | | not the "official" certification your EHR needs. Most |
| Shocked? It's the little secret that vendors aren't | | | | likely, CCHIT will become a certifying body, and more |
| touting. | | | | organizations are expected. But for now, a CCHIT |
| To be fair, it's not the vendors' fault. And with all the | | | | certification doesn't get you the $44,000 per physician |
| news this week about "meaningful use," you might think | | | | in your practice. |
| that everything is settled. Well, it isn't, and I'll try to | | | | The bottom line is: If your EHR isn't certified-and none |
| explain why. | | | | are at this time-then you cannot qualify for the federal |
| In July, the Centers for Medicare & Medicaid Services | | | | dollars. |
| (CMS) posted its final rule on "meaningful use" | | | | What should you do? If you don't have an EHR in |
| requirements that physicians must meet with their EHR | | | | place, wait. At least until all the certification hullabaloo is |
| to participate in the Medicare or Medicaid incentive | | | | resolved. That may take a few months, because after |
| plans. So far, there are no big surprises, though | | | | the certification criteria is completely defined, the EHR |
| everyone is still digesting the massive 864-page | | | | vendors will most likely need to tweak and enhance |
| document. | | | | their products with the necessary features, and then |
| Essentially, the document spells out the minimum | | | | debug the software. To commit to an EHR before it is |
| amount of activities you must perform with your EHR | | | | certified is to place an enormous amount of faith-and |
| to be considered as having used it in a, well, meaningful | | | | the success of your practice, not to mention the |
| way. It includes such things as e-prescribing 40 percent | | | | $44,000 per physician-in the company that makes it. |
| of the time, maintaining vitals, recording smoking status, | | | | Sure, each company intends to have its EHR product |
| providing patients who ask for it with electronic copies | | | | certified, but how long will that take? In the world of |
| of their health information, and much, much more. | | | | software, that's like asking how long is a piece of |
| While "meaningful use" might seem enough to qualify | | | | string. And you really don't want to use any software |
| for the federal money, the EHR software itself must | | | | that was updated under the pressure of short |
| also be "certified." The problem is that the certifying | | | | deadlines until it has been adequately tested and |
| bodies-the organizations that will eventually certify the | | | | debugged. Otherwise, your practice becomes a test |
| EHR software-have not even been named yet. Even | | | | lab for uncovering those bugs. |
| worse, the process for certification was issued by | | | | If you can't wait, at least get a written guarantee-with |
| DHHS only on June 18, 2010. The industry is still waiting | | | | cash penalties-from the vendor that it will take |
| for the Department of Health and Human Services | | | | whatever steps are necessary to get its EHR product |
| (DHHS) to issue the specific criteria that EHRs must | | | | certified in time for you to qualify for the full $44,000 |
| meet to become certified. | | | | per physician Medicare incentive. However, if |
| Meanwhile, each potential certification body must | | | | certification doesn't occur until, say, late in 2012, you |
| become an official "Authorized Testing And | | | | won't be eligible for the full incentive amount. |
| Certification Body" (ATCB) as deemed by the Office | | | | If you already have an EHR in place, you should also |
| of the National Coordinator (ONC) for Health and | | | | wait, and make no further commitments to upgrades |
| Information Technology, or an ONC-ATCB. Only an | | | | until the new version of your EHR has been certified. |
| ONC-ATCB can deem an EHR software certified for | | | | You might also want to seek a written guarantee from |
| the CMS incentive programs. | | | | the vendor. Just be aware that at some point, you |
| In other words, no one currently has the authority to | | | | could face the dilemma of either choosing another |
| certify EHS software and the testing criteria for | | | | EHR or keeping what you have and forgoing the |
| certification does not exist yet. | | | | $44,000 per physician. |