CCHIT Open Source Forum at HIMSS 09

Certification Commission for Healthcare Information Technology Open Source Forum A Dialog on Certification of Open Source EHRs Mark Leavitt, MD, PhD – Chair Alisa Ray – Executive Director Dennis Wilson – Information Technology Director Hyatt Regency McCormick Conference Center, Chicago, IL Room 10d Monday, April 6, 2:00 pm – 3:00 pm CDT Online participation: https://www1.gotomeeting.com/register/429901059 Dial in (877) 313-5342, ID # 91945091

Mission and Goals Goals: Mission: • Reduce the risks of Accelerate the adoption investing in health IT of robust, interoperable health IT by creating • Facilitate interoperability an efficient, credible of health IT certification process. • Unlock adoption incentives and regulatory relief • Protect the privacy of health information © 2009 | Slide 3 | April 6, 2009

History of CCHIT Sept 2004 Founded by AHIMA, HIMSS, and NAHIT June 2005 Eight more organizations contribute funding Oct 2005 Awarded 3-year $7.5M HHS/ONC contract May 2006 Ambulatory EHR certification launched Oct 2006 Federal recognition as Certifying Body Jan 2007 Becomes independent, nonprofit organization Aug 2007 Inpatient EHR certification launched 08 programs launched (2 updated programs, 4 new July 2008 programs) Oct 2008 HIE certification launched © 2009 | Slide 4 | April 6, 2009

A Mission-Focused, Nonprofit 501(c)3 Organization Board of Trustees Board of Commissioners Executive Director Alisa Ray Administrative Marketing & Communications Certification Development Certification Program Certification Technology Sue Reber, Director Kathy Shea, Director Kari Taylor Atkins, Director Bambi Rose, Director Dennis Wilson, Director John Morrissey Merril Prager Shweta Trivedi Amit Trivedi Vince Van de Coevering Rick Turoczy Jen Degler Soloman Appavu Ben Uphoff Diana Rios Michelle Knighton CO-CHAIRS STRATEGIC LEAD WORK GROUP WORK GROUP STRATEGIC LEAD CO-CHAIRS Ambulatory EHR Cardiovascular Steven Lane Kari Taylor Atkins Meredith Seidel Michael Mirro Eric Rose Michael Paquin Inpatient EHR Child Health Rick Reeves Kari Taylor Atkins Bonnie Cassidy Bobbie Byrne Kathy Scanlon Eugenia Marcus Emergency Dept EHR Interoperability Todd Rothenhaus Kari Taylor Atkins Amit Trivedi David Tao Steven Stewart Alan Zuckerman Network Privacy & Compliance A. John Blair Virginia Riehl Bonnie Cassidy Donald Bechtel Michael Kappel Cassi Brinbaum PHR Security Ted Eytan Jody Pettit Soloman Appavu Khalid Al-Maskari Lory Wood Rick Brady Behavioral Health Memo Keswick Kari Taylor Atkins Zebulon Taintor 22 staff facilitating the work of over 200 volunteers © 2009 | Slide 5 | April 6, 2009

Openness and Transparency • CCHIT Staff must disclose all conflicts of interest and may not have a financial relationship with any vendor • Volunteers must disclose all conflicts of interest • Stakeholder balance on CCHIT boards and volunteer work groups is required and actively monitored. Limits are enforced on percentage from the vendor community, as well as on the number of personnel from any one vendor • Work groups must have two co-chairs from different stakeholder groups • Minutes of all Commission and work group meetings are published on the web • ‘Town Hall’ and ‘Town Call’ community outreach meetings © 2009 | Slide 6 | April 6, 2009

Criteria are developed through a community collaborative model Inputs: * Scope Guidance from Commission Public Comment * Roadmap (from previous year) periods * Future Directions (from previous year) * Environmental Scan: - Use Cases from AHIC - Standards from HITSP, SDOs - Market research - More Refine Criteria Proposed Launch Develop Final Criteria and Develop Final Criteria “09” April Draft Criteria and Test Scripts Draft Test Scripts and Test Scripts Certification 2008 (July 2009) May July Sept Mar Dec 2009 2008 2008 2009 2008 Pilot Test Multi-stakeholder consensus-based process with multiple cycles of public input © 2009 | Slide 7 | April 6, 2009

Inspection Process • “Open book” model – all criteria and test scripts are published in advance for all applicants to use in preparation • Strict conflict of interest policy for staff and jurors: no financial relationship with any vendor is allowed • Cost-efficient – uses web-conferencing and other virtual presence tools to avoid travel expense • Robust retesting and appeal processes © 2009 | Slide 8 | April 6, 2009

Product Attributes and Inspection Methods Security and Functionality Interoperability Privacy Self-attestation (documentation review) Jury-observed demonstration Technical testing = Current methods = Driving direction © 2009 | Slide 9 | April 6, 2009

Juror-Observed Virtual Demonstration CCHIT Proctor Juror A (Practicing physician) Web conferencing Juror B and concurrent (Practicing audio conferencing Nurse Inpatient Products) Vendor personnel follow Test Script to demonstrate system Juror C at the vendor facility Jurors may not have a financial relationship with any vendor © 2009 | Slide 10 | April 6, 2009

Vendor Mix (08 Certification) Annual Revenue Practice Sizes Served of Ambulatory EHR Vendors by Vendors Applying > $100 million N/A 75% 7% 7% < $1 million 25% 50% $21-$100 million 9% 25% $11-$20 million 13% $1-$10 million 37% 1 2-5 6-15 16-50 >50 Number of Physicians in Practice © 2009 | Slide 12 | April 6, 2009 Revenue and Size data from application data of certified Ambulatory EHR 08 vendors as of March 2009; N=77; response rate 100%

Ensuring the Flow of Innovation • Continue to monitor vendor mix – Small vs large, new vs established, alternative deployment models, price points • Ensure EHR certification is accessible to all corners of the market – Commercial – Open-source – Self-developed – Modular © 2009 | Slide 13 | April 6, 2009

Discussion and Q&A For more information: www.cchit.org

CCHIT Open Source Forum at HIMSS 09

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