Confusion was the big headline in Williston, VT-based CapSite Consulting’s U.S. ambulatory EHR certification study. Despite an overwhelming majority of respondents (nearly 90 percent) citing the importance of EHR certification when evaluating EHR solutions, 40 percent of providers were unsure if certification was required to receive stimulus funds for ambulatory EHR purchases. Of the more than 850 healthcare provider organizations polled, misunderstanding about CCHIT (Certification Commission for Health Information Technology) Certification prevailed across small, medium, and large physician practices.
One reason for this mass confusion is the nature of the release of information about meaningful use requirements for electronic health records through the Health Information Technology for Economic and Clinical Health (HITECH) Act. “Generally, because the guidelines come in these different stages in terms of being interim rule, interim final rule, [and final rule], there’s just a lot of steps that went along in the process,” says Brendan FitzGerald , CapSite Consulting’s research director. “It was hard for providers to keep track.”
Another cause for confusion cited by the Williston, Vt.-based CapSite was that the certification requirements weren’t spelled out clearly enough for providers. The interim final rule was a staggering 556 pages long, while the interim EHR certification requirements was 136 pages. CapSite Consulting’s vice president and general manager Gino Johnson marveled at how any doctor could wade through all that information while also carrying busy caseloads.
Johnson believes EMR vendors also breed confusion within the market. “Over the last year or so, a number of vendors released press releases talking about [how] their product’s certified— certified by this body,” he says. “So, it just adds to this environment that is confusing for providers.”
Providers also didn’t seem to have consensus over who were the certifiers in the market. Sixty-nine percent of respondents didn’t realize there would be federally accredited alternatives to the Chicago-based CCHIT for EHR certification. Even though there wasn’t much variance across physician organization size, Johnson believes that smaller organizations are at a disadvantage as they might not have the relationships with advisory firms “to help them sift through” the flurry of press releases and new information on federally accredited certifying bodies.
Small physician practices were also found to be less concerned with who certifies their EHR as long as they are able to obtain stimulus funding. FitzGerald believes that since smaller physician practices have a larger burden in terms of cost and implementation, their primary goal is to meet requirements to get funding, rather than focusing on the certifier.
Bryan Fiekers, CapSite’s director of business development sees interoperability as the big challenge ahead for CIOs, as the certifying bodies determine the vendors that will be certified. “As these small physician practices look to integrate with these larger IDNs [integrated delivery network] in order to complete the health information exchange, there’s going to be a larger burden placed on the CIO in order to make sure these records are interoperable and that the use of records can be shared seamlessly,” he says.
Johnson does see a silver lining now that the final meaningful use rule has been released. And light will be shed on EHR certification by organizations like the Chicago-based Healthcare Information and Management Systems Society (HIMSS) to educate the market through webinars and white papers.