070215 Plenary Ray


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  • 070215 Plenary Ray

    1. 1. CCHIT Progress: Toward EHR Adoption Alisa Ray, Executive Director, CCHIT Feb 15, 2007 American Health Quality Association New Orleans, LA
    2. 2. Topics <ul><li>Objectives of Session </li></ul><ul><li>Brief Update on CCHIT’s Work </li></ul><ul><li>Progress of Certification Development </li></ul><ul><li>Understanding the Certification Program </li></ul><ul><li>Accessing the Certification Program </li></ul><ul><li>Q & A </li></ul>
    3. 3. Objectives of Session <ul><li>Prepare you to: </li></ul><ul><li>Describe CCHIT’s strategic role and progress within the national health information technology initiatives </li></ul><ul><li>Participate in CCHIT’s current development for specialty and inpatient EHRs, and in future network certification development </li></ul><ul><li>Guide physician practices in how to access and use CCHIT’s current ambulatory certification program </li></ul>
    4. 4. Brief Update on CCHIT’s Work
    5. 5. Mission and Milestones <ul><li>Mission: accelerate the adoption of robust, interoperable health IT </li></ul><ul><li>Reduce the risks of investing in HIT </li></ul><ul><li>Facilitate interoperability of HIT products </li></ul><ul><li>Enhance availability of adoption incentives and regulatory relief </li></ul><ul><li>Ensure that the privacy of personal health information is protected </li></ul><ul><li>Milestones: </li></ul><ul><li>Sept 2004: AHIMA, HIMSS, and the Alliance partner to launch CCHIT </li></ul><ul><li>June 2005: AAFP, AAP, ACP and others add $325k funding support </li></ul><ul><li>Sept 2005: CCHIT awarded 3-year, $7.5M HHS development contract </li></ul><ul><li>May 2006: CCHIT Ambulatory EHR Criteria approved by AHIC and HHS </li></ul><ul><li>July 2006: First CCHIT Certified sm Ambulatory EHRs released </li></ul><ul><li>Oct 2006: HHS deems CCHIT a Recognized Certification Body </li></ul><ul><li>Dec 2006: CCHIT becomes independent nonprofit organization </li></ul>
    6. 6. Current Organization
    7. 7. CCHIT Role within HHS Health IT Strategy Standards Harmonization Contractor CCHIT: Compliance Certification Contractor Privacy/Security Solutions Contractor Office of the National Coordinator Project Officers American Health Information Community Chaired by HHS Secretary Mike Leavitt NHIN Prototype Contractors Harmonized Standards Network Architecture Privacy Policies Governance and Consensus Process Engaging Public and Private Sector Stakeholders Certification Criteria + Inspection Process for EHRs and Networks Strategic Direction + Breakthrough Use Cases Accelerated adoption of robust, interoperable, privacy-enhancing Health IT
    8. 8. Progress of Certification Development
    9. 9. Scope of Work Under HHS Contract <ul><li>Phase I (Oct 05 – Sep 06) </li></ul><ul><ul><li>Develop, pilot test, and assess certification of EHR products for ambulatory care settings – maintenance </li></ul></ul><ul><li>Phase II (Oct 06 – Sep 07) </li></ul><ul><ul><li>Develop, pilot test, and assess certification of EHR products for inpatient care settings </li></ul></ul><ul><li>Phase III (Oct 07 – Sep 08) </li></ul><ul><ul><li>Develop, pilot test, and assess certification of infrastructure or network components through which EHRs interoperate </li></ul></ul><ul><li>Scope Expansion (effective Oct 06) </li></ul><ul><ul><li>Address specialized EHR needs </li></ul></ul><ul><li>Concurrent effort (April 06 – Sep 08) </li></ul><ul><ul><li>Transition to become an independent, self-sustaining organization </li></ul></ul>
    10. 10. Development Timeline Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 2006 2005 2007 2008 Develop, publish proposed criteria Pilot test and publish report Develop, publish proposed inspection process Develop, publish proposed criteria Ambulatory EHR Domain (Update for 2006-07) Inpatient EHR Domain (New for 2006-07) Network Domain (Starts in 2007-08) Pilot test & publish report Final comments, begin certification Final comments, begin certification Update criteria, roadmap; publish Pilot test as needed; publish report Update inspection process; publish Final comments, apply updated criteria Preliminary data-gathering Develop, publish proposed ins. proc. We are here:  Final Ambulatory public comment (2/21)  New Inpatient schedule  Public comment on specialty roadmap  Initiating data-gathering on networks
    11. 11. Update: Inpatient EHR Certification Development <ul><li>Inpatient systems much more complex than ambulatory </li></ul><ul><li>Modular approach </li></ul><ul><li>First modules to be certified: CPOE and eMAR </li></ul><ul><li>Core HIS/CIS probably next </li></ul><ul><li>Interoperability requirement: functional integration to pharmacy and Core HIS/CIS must be demonstrated </li></ul><ul><ul><li>Pharmacy and Core HIS/CIS can be same vendor’s application, other vendor’s application, or simulation </li></ul></ul><ul><ul><li>Demonstration can be at vendor’s facility or at customer site -- vendor’s choice </li></ul></ul><ul><li>Schedule delayed ~3 months – probable launch July/Aug </li></ul>
    12. 12. Update: Specialized EHR Certification Development <ul><li>Concept: </li></ul><ul><ul><li>Core Criteria with Additional Criteria serving particular specialties, settings, or populations </li></ul></ul><ul><ul><li>All EHRs certify to core criteria; vendors choose which additional sets to certify against </li></ul></ul><ul><ul><li>Full transparency on CCHIT website </li></ul></ul><ul><li>Status </li></ul><ul><ul><li>Environmental scan done </li></ul></ul><ul><ul><li>Commission published draft roadmap </li></ul></ul><ul><ul><li>Public comment Feb 2007 </li></ul></ul><ul><ul><li>Begin development for 2-3 specialties during 2007 </li></ul></ul>Core Criteria Specialty A Additional Criteria Setting M Additional Criteria Population X Additional Criteria
    13. 13. Understanding the Certification Program
    14. 14. Certification Program <ul><li>All requirements published well in advance: </li></ul><ul><ul><li>Functionality Criteria </li></ul></ul><ul><ul><li>Interoperability Criteria </li></ul></ul><ul><ul><li>Security Criteria </li></ul></ul><ul><ul><li>Test Scripts </li></ul></ul><ul><ul><li>Interoperability Practice Test Files </li></ul></ul><ul><li>Vendors apply, complete documentation requirements, and receive an inspection date </li></ul><ul><li>Multiple fail-safe mechanisms </li></ul><ul><li>Appeals process is available </li></ul>
    15. 15. Certification Flowchart Flowchart from CCHIT Certification Handbook (available at www.cchit.org)
    16. 16. Functionality Inspection: Jury-Observed Demonstration Vendor personnel follow Test Script to demonstrate system at the vendor facility Juror A (Practicing physician) Juror B Juror C Web conferencing (gotomeeting.com) and concurrent audio conferencing CCHIT Proctor
    17. 17. Security Inspection: Demonstration + Self-Attestation Vendor personnel follow Test Script to demonstrate system at the vendor facility Juror D (IT/Security Expert) Web conferencing (gotomeeting.com) and concurrent audio conferencing CCHIT Proctor Juror D (IT/Security Expert) also reviews self-attestation material offline, calls or emails vendor as needed for additional documentation
    18. 18. Interoperability Inspection: Demonstration + Self-Attestation Vendor imports Test Files during live demonstration Jurors confirm that result data appears correctly in the record CCHIT Proctor Vendor self-attests to ePrescribing standards compliance (certification by RxHub or SureScripts fulfills requirement) CCHIT staff reviews documentation and verifies valid certification by RxHub or SureScripts Vendor receives official Lab Result Test Files as test begins
    19. 19. Current Status of Certification Program 22 Certifications Announced May 3-12, 2006 1st 2006 Ambulatory EHRs July 2007 May 1-14, 2007 1st 2007 Ambulatory EHRs Apr 2007 Feb 1-14, 2007 4th 25% of est. market size Nov 1-14, 2006 29 Applications 3rd 11 Certifications Announced Aug 1-14, 2006 2nd Announcement Application Window Certification Quarter Certification Year
    20. 20. Evidence of Certification Impact on HIT Adoption <ul><li>Official recognition/deeming of CCHIT by HHS/AHIC </li></ul><ul><li>Stark and Anti-Kickback safe harbors require certification of donated EHRs </li></ul><ul><li>Physician community: certification endorsed by AAFP, AAP, ACP, MGMA, AEP, and Physicians Foundations </li></ul><ul><li>Evidence that communications efforts reaching physicians in their practices and influencing buying decisions </li></ul><ul><li>High interest from specialties in expanding EHR certification to their areas </li></ul>
    21. 21. Accessing the Certification Program
    22. 22. Which Products are Certified? Look for the official certification seal on the product, documentation, or marketing literature Find latest list at www.cchit.org website Or...
    23. 23. How Certification Helps <ul><li>An EHR is a major, long-term investment for a practice. </li></ul><ul><li>Take advantage of the work CCHIT has done in evaluating Ambulatory EHR products – then combine it with due diligence. </li></ul><ul><li>Look for the seal – be sure it’s CCHIT Certified sm </li></ul>
    24. 24. Download the Guide to Certification from www.cchit.org
    25. 25. Frequently asked questions <ul><li>For certified products, can practices skip all the pre-purchase evaluation steps previously performed? </li></ul><ul><ul><li>No, but they can probably spend evaluation time more efficiently. </li></ul></ul><ul><ul><li>They can use CCHIT certification to narrow the initial field of vendors. </li></ul></ul><ul><ul><li>They can also use CCHIT certification to assure basic functionality, letting them focus their evaluation more on any special or unusual needs of their practice </li></ul></ul>
    26. 26. Frequently asked questions <ul><li>Are the certification criteria universally applicable to all practices? </li></ul><ul><ul><li>CCHIT developed criteria that provide a broad foundation of required capabilities in typical ambulatory care settings. </li></ul></ul><ul><ul><li>However, some specialties may not need all of the functionality required by CCHIT, while others may need additional specialized capabilities. Take this into account when evaluating products and their certification status. </li></ul></ul><ul><ul><li>CCHIT has begun to evaluate program expansions to specialty practice, special settings and special populations. </li></ul></ul>
    27. 27. Frequently asked questions <ul><li>Does CCHIT evaluate the vendor’s support capabilities? </li></ul><ul><ul><li>No, CCHIT tests only the product and does not evaluate service aspects of the company. Practices should perform this due diligence themselves. </li></ul></ul><ul><li>Can CCHIT eliminate concerns about vendor financial viability? </li></ul><ul><ul><li>No, CCHIT only evaluates products, not vendor financial status. Practices must continue to perform this due diligence. </li></ul></ul>
    28. 28. Frequently asked questions <ul><li>Can certification guarantee compatibility with other IT systems? </li></ul><ul><ul><li>In health IT, interoperability is at an early stage. CCHIT criteria are just beginning to establish requirements for interoperability. Choosing a certified product does increase the likelihood that a system can interoperate with others now and in the future, but the problem will take years to completely solve. </li></ul></ul>
    29. 29. Frequently asked questions <ul><li>Is CCHIT controlled by a particular set of interests? </li></ul><ul><ul><li>CCHIT’s decisions involve many stakeholders – physicians, health IT vendors, payers, and others. CCHIT strives to find fair and balanced solutions that deliver value for all stakeholders. CCHIT leadership and volunteers must disclose all conflicts of interest, and multiple protections are in place to reduce the possibility of undue influence by any one group. </li></ul></ul><ul><li>Is CCHIT a government agency? </li></ul><ul><ul><li>No, CCHIT is a private sector organization, currently transitioning to nonprofit, self-sustaining status. In 2005, CCHIT was awarded a 3-year, $7.5M government contract to develop certification criteria and an inspection process </li></ul></ul>
    30. 30. Frequently asked questions <ul><li>Vendor sometimes claim to be “CCHIT-compliant”. Is this the same as being certified? </li></ul><ul><ul><li>No, look for the CCHIT seal on the product or marketing literature. It tells you not only that the vendor is certified, but which year’s criteria it was tested against. Criteria are updated every year in May. </li></ul></ul><ul><ul><li>To be certain, visit the CCHIT website ( www.cchit.org ) for the list of currently certified products. </li></ul></ul><ul><ul><li>Report any deceptive misrepresentations to [email_address] </li></ul></ul>
    31. 31. Summing Up
    32. 32. Summary <ul><li>An independent, nonprofit initiative to accelerate the adoption of robust, interoperable HIT </li></ul><ul><li>Building a reputation for transparency, credibility, integrity </li></ul><ul><li>Successful launch of Ambulatory EHR certification </li></ul><ul><li>Officially recognized by HHS; certification required for EHR donations under Stark/AKA safe harbor </li></ul><ul><li>Next challenges: </li></ul><ul><ul><li>Deliver on our commitment to launch inpatient EHR certification in 2007 </li></ul></ul><ul><ul><li>Expand certification to specialties / special settings </li></ul></ul><ul><ul><li>Establish relationships with emerging networks, learn their challenges, and determine how CCHIT can deliver value </li></ul></ul>
    33. 33. Thank You! Q & A For more information: www.cchit.org