For years now, CCHIT has been the only certification game in town.
Pre-HITECH, the organization both created certification criteria and tested
vendors against that criteria. Post-HITECH, everything has changed.
Recommendations from the federal HIT Policy Committee indicate that CCHIT will
not be able to perform its dual roles, leaving it to only handle the testing
function. The committee also encouraged others to get into the testing game,
injecting market dynamics and competition into this new niche of healthcare IT.
After a few months of silence, CCHIT’s first competitor has emerged – the
Austin, Texas-based Drummond Group.
Recently, HCI Editor-in-Chief Anthony Guerra had a chance to chat with CEO Rik
Drummond about his decision to enter this evolving market.
(Part
I)
GUERRA: Do
you see an issue with the fact that CCHIT has a substantial degree of vendor
involvement? Is that something you will try to avoid?
DRUMMOND: We
always try to have a really good mix of vendors and end users because they have
different points of view, and you need to satisfy them both. You need to
satisfy the vendors so they can make money on developing product. You also need
to satisfy the users so they can buy a reasonably priced product.
Often, because each side has a different
perspective, unless you have both of
those perspectives in place, you will not end up with a well-priced quality
product, which is also reasonably easy to produce. So you must have both of
those involved, and if you don’t have them both as part of your stakeholder
group, it doesn’t work. Of course, if your stakeholder group is only vendors, quite
often you get too focused on what the vendors want versus what the end users
want. If your stakeholder group is all end users without involvement from the
vendors, you get what the end users want, and they often want things which the
vendors can’t do in a cost competitive manner. So it’s a very sensitive balance
to have those two involved, and we always work very hard to bring both to the
table.
GUERRA: You
said it would be important to collaborate with CCHIT in some ways. In what ways
will you collaborate versus compete?
DRUMMOND: We
might compete, for example, on things like the length of the test, whether it’s
a thorough test, whether the output of the test actually produces conformant
products. It can’t just say they’re conformant, but it’s about whether the
output of the test actually produces interoperable products.
When I say interoperable, I should be able to buy
it off the shelf and install it, and it should be able to talk to another
product of the same type really, really easily. I shouldn’t have to debug it. It
should just start working, and we have a depth of experience in commercial off
the shelf products in this area.
So we will
compete on the quality of output of the tests, and the pricing of the tests.
But again, the feeder for the whole test is the vendor/user stakeholder groups
determining the functionality that’s required.
At that point, testing agencies can take those
things, break them down to more detailed tests, and go through and verify that
the software actually does what it’s supposed to do. If you don’t do it that
way, what you have is a group over here testing ambulatory care with a slightly
different ilk than a group over there. When those two products have to
communicate, they may not work because you’ve chosen different functional
things, because you didn’t all choose exactly the same piece of detailed
functionality to test on.
GUERRA: So
the real value of a “Drummond Group” stamp might not be known until the user,
not the vendor, has to exchange information with another EHR in a real-world
situation?
DRUMMOND: Right.
What you want to have them do is buy the product, the other guy buy another
product (which both say they’ve been tested and they’re interoperable and conformant),
they both install them, they say, “Let’s communicate,” and the user says, “Oh,
this is working really smoothly. I’ve just got to read the manual and click the
right configuration buttons. I don’t have to debug it.”
And that’s the key to this whole thing and, of
course, that takes massive amounts of planning. And the way you have to attack
this whole problem is to work backwards. You go out and ask yourself the
question: What does the end-user market want when they install this product? And
you start working backwards to get to that.
The next question really is, once these things are
in place, how do I maintain that these products stay true to this standard as
they go through versions over the years
– and we call that life cycle
issues – which you have to think about upfront or you start having major
problems. So you start working backwards.
So you start thinking about getting products out the door, and we often talk about the words, ‘facilitating
adoption.’ This is about facilitating adoption of these kind of products in the
marketplace, and that’s what you’re after in the end –getting people to buy
these products and install them because they work well.
GUERRA: CCHIT
offers different levels of certification. Will you do something similar?
DRUMMOND: We
do that in some areas now. We have some standards where we offer basic
certification and then additional levels of certification because the user
community is demanding different ones. In some areas, users are not going to
pay for an enhanced certification.
GUERRA: CCHIT
offers site testing. Do you have any thoughts yet on actually going out to
hospitals and practices and certifying some sort of homegrown system?
DRUMMOND: We
do both of those in a lot of our tests. We do both homegrown and also
commercial off the shelf. We manage this with our patented software to automate
those sorts of tests.
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