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Certification Commission
                   for Healthcare
                   Information Technology




CCHIT Town Hall
M...
Agenda
• A Look Back
  – Assessing our progress
• A Look Ahead
  – The American Recovery and Reinvestment Act (ARRA)
  – T...
A Look Back




              © 2009 | Slide 3 | April 5, 2009
Mission and Goals

                           Goals:
Mission:
                           • Reduce the risks of
Accelerate ...
An Open, Transparent
                                Criteria Development Process

Inputs:
* Scope Guidance from Commissio...
An Efficient, Reliable
             Inspection Process
• Objective, rigorous, and reliable testing methods
• 100% complian...
A Mission-Focused,
                                     Nonprofit 501(c)3 Organization
                   Board of Trustee...
Other Key Accomplishments
• Executed 3 year, $7.5M HHS/ONC contract
• Federal recognition as a certifying body (2006)
• Tr...
Impact of Certification

                  Beneficial effects and
                interoperability assured,
              ...
Assessment of Impacts

                  Breakthrough needed:
                   Financial incentives


                 P...
Breakthrough Achieved:
                    Incentives for EHR Adoption
2006-2007                           44 new EHR ince...
A Look Ahead




               © 2009 | Slide 12 | April 5, 2009
The American Recovery
and Reinvestment Act
(ARRA)




                        © 2009 | Slide 13 | April 5, 2009
A Historical Comparison
                                     Apollo Program                   ARRA/Health IT
National goal...
ARRA Certification Language
• “The National Coordinator, in consultation with the Director of the
  National Institute of ...
We Are Already Seeing
                the Stimulus Effect of ARRA




    EHR
Certification
Applications
 Received
(per Mo...
A Record Number of
               New Applications, New Vendors
• 08 Ambulatory EHR applications
  – 64 total applications...
EHR Market Remains
                                    Diverse and Competitive
                 Annual Revenue            ...
Stepping Up to Meet Higher
               Expectations under ARRA
   Attribute           Before ARRA                      ...
Rating System Concept


              10
                        150




               © 2009 | Slide 20 | April 5, 2009
Ensuring the Flow of Innovation

• Continue to monitor vendor mix
   – Small vs large, new vs established, alternative dep...
Certification Life Cycle Concept

Green zone (new domains)
Certification focus: Define basic functionality,
security, inte...
Planning for the Recognition of
                          Certification Criteria by HHS/ONC
                              ...
Certification Commission
          for Healthcare
          Information Technology




Opportunities
Today
Schedule of
                 Participation Opportunities
• Public comment periods
   – Comments on Proposed Final 09 now o...
Help Update Existing Programs
  Base Domain                      Certification Options                    06    07        ...
Or Help Develop New Ones
     Base Domain                        Certification Options                       09    10     ...
Volunteer Workgroup Organization
                                 For Development of ’10 (launch 2010) Criteria
      Deve...
Volunteer Application Process
                 and Schedule
• Application process
   – Applications accepted March 26 to A...
What to Expect

• Term of service is July 1, 2009 to June 30, 2010
• Meetings may be weekly, biweekly, or less frequently,...
Technical Roundtables
                on Monday, April 6
• Session 1: Interoperability 09 and Beyond: a look
  at CCHIT’s ...
Discussion and
Q&A

For more information:
www.cchit.org
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CCHIT Town Hall HIMSS 09

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Transcript of "CCHIT Town Hall HIMSS 09"

  1. 1. Certification Commission for Healthcare Information Technology CCHIT Town Hall Mark Leavitt, MD, PhD – Chair Alisa Ray – Executive Director HIMSS 09 Annual Conference and Exposition Event 38, Room W192b Chicago, IL Sunday, April 5, 9:45 AM - 11:15 AM
  2. 2. Agenda • A Look Back – Assessing our progress • A Look Ahead – The American Recovery and Reinvestment Act (ARRA) – The evolving role of certification under ARRA • Opportunities Today – Certification programs for 2010 – Opportunities for participation © 2009 | Slide 2 | April 5, 2009
  3. 3. A Look Back © 2009 | Slide 3 | April 5, 2009
  4. 4. 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 4 | April 5, 2009
  5. 5. An Open, Transparent Criteria Development Process 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 Final Criteria Refine Criteria Proposed Launch Develop Test Scripts and Develop Final Criteria “09” April Draft Criteria and Roadmap Draft Test Scripts and Test Scripts Certification 2008 for the Future (July 2009) May July Sept Mar Dec 2009 2008 2008 2009 2008 Pilot Test A voluntary, consensus-based process with multiple cycles of public vetting © 2009 | Slide 5 | April 5, 2009
  6. 6. An Efficient, Reliable Inspection Process • Objective, rigorous, and reliable testing methods • 100% compliance required • “Open book” model – criteria and test scripts published in advance • Cost-efficient – web-conferencing and other virtual presence tools; no travel expense • Robust retesting and appeal processes © 2009 | Slide 6 | April 5, 2009
  7. 7. 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 Steven Lane Kari Taylor Atkins Meredith Seidel Michael Mirro Ambulatory EHR Cardiovascular Eric Rose Michael Paquin Rick Reeves Kari Taylor Atkins Bonnie Cassidy Bobbie Byrne Inpatient EHR Child Health Kathy Scanlon Eugenia Marcus Todd Rothenhaus Kari Taylor Atkins Amit Trivedi David Tao Emergency Dept EHR Interoperability Steven Stewart Alan Zuckerman A. John Blair Virginia Riehl Bonnie Cassidy Donald Bechtel Network Privacy & Compliance Michael Kappel Cassi Brinbaum Ted Eytan Jody Pettit Soloman Appavu Khalid Al-Maskari PHR Security Lory Wood Rick Brady Memo Keswick Kari Taylor Atkins Behavioral Health Zebulon Taintor 22 staff facilitating the work of over 200 volunteers © 2009 | Slide 7 | April 5, 2009
  8. 8. Other Key Accomplishments • Executed 3 year, $7.5M HHS/ONC contract • Federal recognition as a certifying body (2006) • Transitioned to independent, nonprofit 501(c)3 status (2007-2008) • Expanded to additional specialties, settings, and populations beyond HHS contract, in response to stakeholder interest • Strong stakeholder engagement, steady increase in volunteer commitment © 2009 | Slide 8 | April 5, 2009
  9. 9. Impact of Certification Beneficial effects and interoperability assured, unlocking incentives Payers/Purchasers Providers IT Vendors Reduced risk and Growing market availability of incentives attracts investment, accelerates adoption lowers costs © 2009 | Slide 9 | April 5, 2009
  10. 10. Assessment of Impacts Breakthrough needed: Financial incentives Payers/Purchasers Providers IT Vendors Rapid uptake; Support of professional >160 products certified societies; high awareness >75% of marketplace among providers © 2009 | Slide 10 | April 5, 2009
  11. 11. Breakthrough Achieved: Incentives for EHR Adoption 2006-2007 44 new EHR incentive programs First 2 years of certification Total new incentives: ~$700 Million 21 states with health IT programs 54 EHR rollouts (157 hospitals) using Stark safe harbor Health plans with P4P incentive for certified EHR 11.3% ►25.8% Liability insurance discounts 2008 MIPPA incentive for ePrescribing Additional incentives: ~$2 Billion 2009 - 2014 American Recovery and Reinvestment Act Total incentives: ~$34 Billion © 2009 | Slide 11 | April 5, 2009
  12. 12. A Look Ahead © 2009 | Slide 12 | April 5, 2009
  13. 13. The American Recovery and Reinvestment Act (ARRA) © 2009 | Slide 13 | April 5, 2009
  14. 14. A Historical Comparison Apollo Program ARRA/Health IT National goal Manned spaceflight to the moon Electronic health records for every American Level of leadership Presidential: Presidential: John F Kennedy Barack Obama Timeframe 1961 – 1969 (8 years) 2009 – 2014 (5 years) Driver Scientific exploration + Enabler of health reform + National security Economic stimulus Total government funding $22B (1969 dollars) $34B (total incentives; $19B net expenditure after savings) Management NASA (gov’t agency) HHS/ONC (gov’t agency) Execution Multiple contractors (private Multiple contractors and grantees sector) (private sector) • Developing completely new • Accelerating deployment and Major challenges technologies advancing existing technologies • Safety of astronaut lives • Transforming care delivery to improve quality and reduce costs © 2009 | Slide 14 | April 5, 2009
  15. 15. ARRA Certification Language • “The National Coordinator, in consultation with the Director of the National Institute of Standards and Technology, shall keep or recognize a program or programs for the voluntary certification of health information technology as being in compliance with applicable certification criteria adopted under this subtitle.” • To be eligible for the Medicare or Medicaid incentives, a professional must be a “meaningful EHR user” and satisfy each of the following requirements: – “using certified EHR technology in a meaningful manner, which shall include the use of electronic prescribing” – “electronic exchange of health information to improve the quality of health care” – “reporting on measures using EHR” © 2009 | Slide 15 | April 5, 2009
  16. 16. We Are Already Seeing the Stimulus Effect of ARRA EHR Certification Applications Received (per Month) ARRA signed Feb 17, 2009 Month © 2009 | Slide 16 | April 5, 2009
  17. 17. A Record Number of New Applications, New Vendors • 08 Ambulatory EHR applications – 64 total applications – 39% are NEW vendors – 40% also applied for Child Health certification – 17% also applied for Cardiovascular certification • 08 Emergency Department EHR – New domain for 08; approximately 10 vendors in market – 7 applications received © 2009 | Slide 17 | April 5, 2009
  18. 18. EHR Market Remains Diverse and Competitive 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 18 | April 5, 2009 Revenue and Size data from application data of certified Ambulatory EHR 08 vendors as of March 2009; N=77; response rate 100%
  19. 19. Stepping Up to Meet Higher Expectations under ARRA Attribute Before ARRA After ARRA Earn public trust as Sufficient to earn trust of Transparency guardian of $34B health IT stakeholders taxpayer investment Certify health IT product; Broader responsibility for Accountability not company, training, all prerequisites to support, usability meaningful use Results of EHR Measure and compare Outcomes implementations not part EHRs by effects on of certification quality, safety, cost Expand to all domains Expand to new domains Scale with incentives; scale up as resources permit for increased volume Powerful incentives Pace of progress limited Speed provide leverage to drive by market acceptance faster progress © 2009 | Slide 19 | April 5, 2009
  20. 20. Rating System Concept 10 150 © 2009 | Slide 20 | April 5, 2009
  21. 21. 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 21 | April 5, 2009
  22. 22. Certification Life Cycle Concept Green zone (new domains) Certification focus: Define basic functionality, security, interoperability Blue zone (active development period) Certification focus: Drive rapid progress in interoperability Yellow zone (maturity) Certification focus: Maintain compliance as standards are updated Certification life cycle of a domain © 2009 | Slide 22 | April 5, 2009
  23. 23. Planning for the Recognition of Certification Criteria by HHS/ONC HHS/ONC Recognized Offering alternatives to the Certification Criteria Health IT Standards (late 2009?) Committee: – 08, 09, or 10 criteria set may be chosen – Advanced certifications in Existing New criteria interoperability, quality, criteria that must clinical decision support, that may CCHIT 09 Criteria be added be omitted that are recognized security may or may not to the from the recognized be required recognized set set – Committee may request omission of some criteria – Committee may request addition of criteria 09 CCHIT Criteria (Published May 2009) © 2009 | Slide 23 | April 5, 2009
  24. 24. Certification Commission for Healthcare Information Technology Opportunities Today
  25. 25. Schedule of Participation Opportunities • Public comment periods – Comments on Proposed Final 09 now open through April 28 – Next cycle (10): Sept 2009, Dec 2009, April 2010, May 2010 • Volunteer work group members and co-chairs – Applications now open through April 20 – Term: 1 year, July 1, 2009 – June 30, 2010 – More details on slides to follow • Board of Commissioners – Applications will open in July – Term: 2 years, Sept 2009 – Sept 2011 • Board of Trustees – Applications will open in October – Term: 3 years, Jan 2010 – Jan 2013 © 2009 | Slide 25 | April 5, 2009
  26. 26. Help Update Existing Programs Base Domain Certification Options 06 07 08 09 (Add-on to Base Domain) L Ambulatory EHR* Ambulatory L Child Health Ambulatory L Cardiovascular Medicine L Inpatient EHR* L Emergency Dept Amb+Inpt+ED L Enterprise L HIE* L PHR L Stand-alone ePrescribing Legend: L = Launch *Original HHS Contract (all other programs represent voluntary expansion) © 2009 | Slide 26 | April 5, 2009
  27. 27. Or Help Develop New Ones Base Domain Certification Options 09 10 11 12 (Add-on to Base Domain) Ambulatory EHR D L Behavioral Health (as add-on) D L Behavioral Health (as stand-alone) D L Clinical Research D L Dermatology R D L Eye Care R D L Oncology D L Advanced Interoperability D L Advanced Quality D L Advanced Security D L Advanced Clinical Decision Support D L Long Term Care Spectrum R D L Obstetrics/Gynecology Note: scheduling of all areas will remain flexible so the Commission can respond to the emerging requirements of the American Recovery and Reinvestment Act. Legend: R = Research (staff level); D = Start Development; L = Launch (tentative) © 2009 | Slide 27 | April 5, 2009
  28. 28. Volunteer Workgroup Organization For Development of ’10 (launch 2010) Criteria Develop Behavioral Cardiovascular Clinical Advanced Criteria for Dermatology Advanced Child Health Health Medicine Research Inter- Optional Work Group Quality Work Group Work Group Work Group Work Group operability (DER) (AQ) Additional (CH) (BH) (CV) (CR) (AIO) Certifications Advanced Advanced Clinical Contribute Inter- Security Privacy Security Decision Criteria for operability Work Group Work Group (AS) Support Work Group Specific (Sec) (PRI) (ACDS) (IO) Attributes New Work Groups and Panels being formed Stand-alone Identify ePrescribing Criteria for Work Group Modular (eRx) Applications Long Term Emerg Dept Ambulatory Inpatient Care Develop Base PHR HIE EHR EHR EHR Spectrum Work Group Work Group Criteria for a Work Group Work Group Work Group Work Group (PHR) (HIE) Domain (ED) (Amb) (IP) (LTC) © 2009 | Slide 28 | April 5, 2009
  29. 29. Volunteer Application Process and Schedule • Application process – Applications accepted March 26 to April 20, 2009 – Applications only accepted online: find link at www.cchit.org – Indicate all positions you are interested in – member and/or co- chair roles – Existing volunteers must re-apply and supply updated resume – Notifications in late May • Strengthened conflict of interest policy – Applicants must disclose any financial relationship with a vendor of certified or certifiable technology; if so, they are assigned to Vendor stakeholder group © 2009 | Slide 29 | April 5, 2009
  30. 30. What to Expect • Term of service is July 1, 2009 to June 30, 2010 • Meetings may be weekly, biweekly, or less frequently, depending on the group -- more information at the time of application • Face-to-face kickoff July 15-16 in Chicago – airport area hotel location to be announced • Volunteers may also be invited to serve on various Panels or Task Forces during the course of the year • We are in a dynamic new environment – expect changes! © 2009 | Slide 30 | April 5, 2009
  31. 31. Technical Roundtables on Monday, April 6 • Session 1: Interoperability 09 and Beyond: a look at CCHIT’s roadmap for the future – 1:00 – 2:00 PM CDT • Session #2: Open Source Forum: a dialogue on certification for open source EHRs – 2:00 – 3:00 PM CDT • To attend in person: – Room 10d, Hyatt Hotel at McCormick Conference Center – Registration not required to attend • To participate from offsite: – Register at: https://www1.gotomeeting.com/register/429901059 – Dial in to (877) 313-5342, ID # 91945091 © 2009 | Slide 31 | April 5, 2009
  32. 32. Discussion and Q&A For more information: www.cchit.org
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