Certification Commission
for Healthcare
Information Technology
Town Call
An Exciting Year Ahead for Certification:
An Invitation to Join Us
Mark Leavitt, MD, PhD – Chair
Alisa Ray, Executive Director
Kari Taylor-Atkins, Certification Development Director
Sue Reber, Marketing and Outreach Director
Mar 17, 2009 (updated Mar 23, 2009)

Agenda
• Looking back: what you - our volunteers - have
accomplished
• A turning point in health IT: the American
Recovery and Reinvestment Act (ARRA)
• Looking ahead: our new environment
• An invitation to join us: how to volunteer
• Q & A: responses to Town Call questions @
ehrdecisions.com
© 2009 | Slide 2 | Mar 23, 2009

Looking Back:
What You –
Our Volunteers –
Have Accomplished

Together, we have...
• Started a brand-new certifying organization (2004)
• Won a 3 year, $7.5M Federal contract from HHS/ONC (2005)
• Met every contractual commitment and deliverable
– Developed and pilot tested certification criteria using an open,
voluntary, consensus-based process
– Developed robust, efficient inspection mechanisms
• Gained Federal recognition as a certifying body (2006)
• Become an independent, nonprofit 501(c)3 organization (2007)
• Launched and updated multiple certification programs
– Ambulatory EHR (2006), Inpatient EHR (2007), and HIE (2008)
– Expanded to additional specialties, settings, and populations
beyond HHS contract, in response to eager stakeholders
• Attracted more volunteers every year (>200 now)
© 2009 | Slide 4 | Mar 17, 2009

Remember This?
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 5 | Mar 17, 2009

A Turning Point in
Health IT:
The American Recovery
and Reinvestment Act
(ARRA)

Putting Health IT under ARRA
in Historical Context
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
1961 – 1969 (8 years) 2009 – 2014 (5 years)
Timeframe
Driver Scientific exploration + Enabler of health reform + Economic
National security recovery
Total government funding $22B (1969 dollars) $19B (2009 dollars, net after
anticipated cost savings)
NASA (gov‟t agency) HHS/ONC (gov‟t agency)
Management
Execution Multiple contractors (private sector) Multiple contractors (private sector)
[note: educated guess]
• Developing multiple, completely • Accelerating deployment of
Major challenges
new technologies technologies
• Safety of astronaut lives • Transforming care delivery to
improve quality and reduce costs
© 2009 | Slide 7 | Mar 17, 2009

Funding Flows
under ARRA
Source: “An Unprecedented Opportunity: Using
Federal Stimulus Funds to Advance Health IT in
Califormia,” California Health Care Foundation,
accessed at
www.chcf.org/documents/chronicdisease/AnUnprec © 2009 | Slide 8 | Mar 17, 2009
edentedOpportunity.pdf

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:
– “Meaningful use of certified EHR technology”
– “Information exchange”
– “Reporting on measures using EHR”
© 2009 | Slide 9 | Mar 17, 2009

CCHIT under ARRA
• We are confident CCHIT will be a Federally recognized
certification program under ARRA
– CCHIT has been Federally recognized since 2006
– Certification has high uptake in the vendor marketplace and high
recognition in the provider community
– A substantial number of EHR products are currently certified and
„adoption-ready‟
• We do not believe ONC would choose to reinvent certification
– ARRA‟s aggressive timeline -- adoption incentives start in 20 months –
requires purchases and implementations to begin immediately
– ONC has many other challenging new programs to develop
• But CCHIT must be flexible and responsive to its new environment
© 2009 | Slide 10 | Mar 17, 2009

Looking Ahead:
Our New Environment

Previous Environment
American Health Information Community
and AHIC Workgroups
Office of the National Coordinator
Strategic Direction +
Breakthrough Use Cases
Standards
Harmonization Harmonized
HITSP CCHIT:
Standards Accelerated
Certification adoption of robust,
Certification
Network of Health IT
NHIN Prototype interoperable,
of EHRs
Architecture
& Implementation products and and HIEs privacy-enhancing
Projects
services health IT
Privacy
Privacy & Security Policies
Policies, Laws,
Regulations
Volunteer Participation & Public Comment
from Multiple Stakeholders
Health IT
market insight
and research
© 2009 | Slide 12 | Mar 23, 2009

New Environment
Office of Health Reform
Secretary of HHS
Office of National Coordinator (established by ARRA; budget $2B
HIT Standards Committee
HIT Policy Committee
( established by ARRA;
( established by ARRA;
FACA-compliant)
FACA-compliant)
Recommended Approval/Recognition
Priorities Certification Criteria
*Accelerate adoption
Other Contracting
CCHIT
entities TBD *Reduce risk
Certification
*Ensure interoperability
of EHRs and HIEs
*Protect privacy
Other Contracting
+Qualify EHRs for
entities TBD
incentives totaling $34B
Volunteer Participation & Public Comment
from Multiple Stakeholders
Health IT
market insight
and research
© 2009 | Slide 13 | Mar 23, 2009

Recognition of Criteria by
HHS/ONC
HHS/ONC Recognized
Certification Criteria
(late 2009?)
HHS/ONC has
alternatives:
– 09 criteria
– 08 criteria Existing
New criteria
criteria
– Subset (e.g., omit some that must
that may CCHIT 09 Criteria
be added
functionalities -- if HHS be omitted that are recognized
to the
from the
goal is to increase number recognized
recognized
of available products) set
set
– Superset (e.g., advanced
interoperability, quality
measurement – if HHS
goal is to accelerate
interoperability, quality
09 CCHIT Criteria
measurement)
(Published May 2009)
© 2009 | Slide 14 | Mar 23, 2009

Meeting Even Higher
Expectations
• Increased level of responsibility
– Guardian of a major public investment
– Size of funding brings increased risk of fraud and abuse – „fake EHRs‟
– Privacy concerns heightened by speed and breadth of EHR adoption
– Expectations of certification no longer end with product testing – responsibility
extends to usability, meaningful use, quality measurement, data exchange – and
ultimately health IT‟s role in health reform
• Increased scale
– Expand to new domains – EHRs must be available for all providers and facilities
eligible for incentives
– Volume of EHR suppliers will increase – expect new capital investments, new
entrants to the field
• Economic stimulus as a goal
– Ensure a vibrant, competitive marketplace; address questions regarding open
source EHRs, self-developed EHRs, modular EHR technologies
© 2009 | Slide 15 | Mar 17, 2009

Certification Commission
for Healthcare
Information Technology
An Invitation to Join Us:
How to Volunteer

Help Update Existing Programs
Base Domain Certification Options History/Status
(Add-on to Base Domain)
Ambulatory EHR Launched May 06
Updated May 07
Updated July 08
Ambulatory Child Health Launched July 08
Ambulatory Cardiovascular Medicine Launched July 08
Inpatient EHR Launched August 07
Updated August 08
Emergency Dept Launched August 08
Amb+Inpt+ED Enterprise Launched August 08
HIE Launched Oct 08
PHR To be launched July 09
Stand-alone ePrescribing To be launched July 09
© 2009 | Slide 17 | Mar 17, 2009

Expansion Roadmap
Updated - March 23, 2009
Base Domain Certification Options 09 10 11 12
(Add-on to Base Domain)
Ambulatory EHR
Behavioral Health (as add-on) D L
Behavioral Health (as stand-alone) D L
Clinical Research D L
Dermatology D L
Eye Care R D L
Oncology R D L
Advanced Interoperability D L
Advanced Quality D L
Advanced Security* D L
Advanced Clinical Decision Support* D L
Long Term Care Spectrum D L
Obstetrics/Gynecology R D L
*Note: Advanced Security and Advanced Clinical Decision Support
have been accelerated from previous version of Roadmap published in February
Legend: R = Research (staff level); D = Start Development; L = Launch (tentative)
© 2009 | Slide 18 | Mar 23, 2009

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
Additional (DER) (AQ)
(CH)
(BH)
(CV) (CR) (AIO)
Certifications
Advanced
Contribute Advanced Clinical
Inter-
Security Privacy Security Decision
Criteria for operability
Work Group Work Group (AS) Support
Specific Work Group
(Sec) (PRI) (ACDS)
Attributes (IO)
New Work Groups and
Panels being formed
Identify Stand-alone
Criteria for ePrescribing
Modular Work Group
Applications (eRx)
Long Term
Emerg Dept
Ambulatory Inpatient
Develop Base Care
PHR HIE
EHR
EHR EHR
Criteria for a Spectrum
Work Group Work Group
Work Group
Work Group Work Group
Domain Work Group
(PHR) (HIE)
(ED)
(Amb) (IP)
(LTC)
© 2009 | Slide 19 | Mar 23, 2009

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
– More detailed information on the application page on Mar 26
– Notifications in late May; public announcement in June
• 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 20 | Mar 23, 2009

What to Expect
• Term of service is July 1, 2009 to June 30, 2010
• Face-to-face kickoff meeting in July – date to be announced
• Regular meetings by teleconference
– May be weekly, biweekly, or less frequently, depending on
the group (new groups generally meet more frequently)
– Meetings usually last 60-90 minutes
• No alternates or substitutes may stand-in for the member
• Volunteers are responsible for their own expenses
• 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 21 | Mar 23, 2009

Summing Up
• Congratulations to our volunteers who have
brought us to this day – you have had a
phenomenal impact
• ARRA has transformed our world: more
responsibility, larger scale, new stakeholders
• We expect new challenges, but we also expect
to thrive in this new environment
• We invite you to join us, or continue your
contributions with us!
© 2009 | Slide 22 | Mar 17, 2009

Thank you!
For more information:
www.cchit.org
www.ehrdecisions.com