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One-on-One With CCHIT Chair Mark Leavitt, Part III

November 5, 2009
by root
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In this part of our interview, Leavitt says vendors must be part of the certification discussion.

As the long and winding river that is EHR certification rolls along, CCHIT recently opened up its latest iteration of testing to the public. The two new offerings are “CCHIT 2011 Comprehensive” Certification and, in line with what is known today about “meaningful use,” Preliminary ARRA 2011 Certification. To drill down on the distinction between these two programs, and to learn more about CCHIT’s progress overall, HCI Editor-in-Chief Anthony Guerra talked with CCHIT Chair Mark Leavitt.

(Part I, Part II)

GUERRA: Preliminary ARRA lowers the bar and leaves room for innovation in the marketplace, but doesn’t that mean there was a problem with the criteria being too proscriptive?


LEAVITT: No, because certification was voluntary before. When certification was voluntary, the issue was resolved by simply choosing to ignore us. The CIO of an advanced hospital was free to ignore us, and a vendor was free to ignore us. We were just there for those who said, “I think you could be helpful.”

ARRA changed that by making it – if not mandatory – at least pretty punitive not to adopt certified EHR technology. We didn’t ask for this, ARRA just happened to all of us, so we suddenly found ourselves on a bigger playing field with higher stakes. We had to figure out how to meet this higher responsibility, and since this is now not a purely voluntary matter, we were going to have to deal with that.

The option of site certification is needed as well. Because, for example, let’s say you have a sophisticated organization and they built their own EHR, or maybe they started with some products, but they modified them. Some of it maybe they built, some of it originated with the product. Under the site certification, it doesn’t matter where you got it. We’ll look at in place, and if it meets the standards, it gets certified. And we’ll find a way to do it at a lower cost for smaller organizations using the sliding scale, by simplifying the testing.


GUERRA: So Preliminary ARRA matches what you think HHS certification will be.


LEAVITT: Yes, and it has the standards in the meaningful use matrix. The standards came out of the Standards Committee; the meaningful use matrix came out of the Policy Committee. It uses those and nothing else. It does not go beyond what they’ve published. It is in their criteria. We’re just a testing organization for those.


GUERRA: And you feel comfortable reading the tea leaves that it’s pretty close to what’s actually going to come through.


LEAVITT: I feel pretty comfortable what will be final will not be more rigorous.


GUERRA: It’s been an interesting process, hasn’t it? People are working towards a goal as the goal is being defined – isn’t that difficult in theory?


LEAVITT: That happens in life and in business all the time.


GUERRA: It’s certainly not a best practice.


LEAVITT: Well, you know, I think that’s just life. I mean, we go to college before we know what we want to do when we’re finished. And we go to medical school before we decide if we’re going to specialize, and we start a business often not really realizing what the product is going to end up being. So I think that’s actually reality, and to assume everything would stand still is not.