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The Certification Commission for Healthcare Information Technology (CCHIT) Overview and Update


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Title: The Certification Commission for Healthcare Information Technology (CCHIT) Overview and Update

The Certification Commission for Healthcare
Information Technology (CCHIT) Overview and Update
  • HIT Summit West
  • March 8, 2005
  • Mark Leavitt, MD, PhD
  • Chair, CCHIT
  • Medical Director, HIMSS

Introduction and Overview
  • Context and Origin of CCHIT
  • Mission and Concept
  • Organization
  • Stakeholder Relationships
  • Guiding Principles and Points to Clarify
  • Scope, Timeline and Deliverables
  • Q and A

Context for Founding of CCHIT
  • The Presidents goal Electronic health records
    (EHR) for every individual by 2014
  • ONCHIT Strategic Framework Private sector HIT
    product certification is one of eight key actions

Founding of CCHIT
  • Founded by three HIT organizations
  • American Health Information Management Assoc
  • Healthcare Information and Management Systems
    Society (HIMSS)
  • National Alliance for Health Information
    Technology (Alliance)
  • Formed panel to nominate first Commissioners
  • Provided seed funding for launch
  • First official meeting Sept 14, 2004

Mission of CCHIT
To accelerate the adoption of robust,
interoperable HIT throughout the US healthcare
system, by creating an efficient, credible,
sustainable mechanism for the certification of
HIT products.
Scope, Timeline, and Deliverables
  • Initial scope
  • Certify EHR products for physician offices
  • Timeline
  • Pilot process ready in Summer 2005
  • Deliverables
  • Operational capability for certification
  • Roadmap forecasting future certification plans
    2-3 years ahead

Ambulatory Care and HIT A Critical Need
  • Primary site for delivery of
  • Chronic disease management
  • Preventive care
  • System needs addressable with HIT
  • Quality improvement
  • Patient safety
  • Portability of patient records

EHR Adoption in Ambulatory Care
  • Clinical IT penetration level is low1
  • Small offices (i.e. most doctors) 7
  • Groups of 50 doctors or more 20
  • Barriers to EHR adoption
  • Cost of system
  • Risk of failure, incompatibility, obsolescence
  • Lack of positive incentives

1 Center for Studying Health System Change, Sept
Standards and Certification Create Tipping
Points in Technology Adoption
The IBM-standard PC launched the personal
computing revolution
The Ethernet networking standard gave those PCs
Wi-fi certification made connectivity available
almost anywhere
How Product Certification Can Accelerate HIT
  • Increase the confidence of providers to invest in
    and adopt HIT
  • Ensure interoperability of HIT products within
    the emerging health information infrastructure
  • Enhance the availability of HIT adoption
    incentives from public and private

The EHR Adoption Deadlock
Wont offer incentives unless benefits and
interoperability of EHRs are assured
IT Vendors
Wont buy EHRs until costs and risks are lower
and/or incentives higher
Cant bring down costs until provider adoption
Getting the Wheels Turning
Beneficial effects and interoperability
assured, unlocking incentives
IT Vendors
Reduced risk and availability of incentives
accelerates adoption
Growing market attracts investment, lowers costs
CCHIT Organization
CCHIT Commissioners
Business Operations Committee
Program Management Team
Work Group Functionality
Work Group Inter-operability
Work Group Security Reliability
Work Group Certification Process
  • Advisory Councils and Liaisons
  • Vendor Associations
  • Provider Organizations
  • Payer/Purchaser Organizations
  • Standards Development Organizations

Composition of the Commission
  • Three key constituencies (2 4 from each)
  • Providers
  • Vendors
  • Purchasers/payers/coalitions
  • Other at-large stakeholders (2 4 total)
  • Government HIT leaders (e.g. ONCHIT, CMS) note
    ex-officio, nonvoting role
  • Standards development organizations (e.g. HL7)
  • Others, e.g. healthcare consumer advocates, etc.

  • Mark Leavitt, MD, PhD (Chair) HIMSS
  • C. Martin Harris, MD Cleveland Clinic
  • Douglas Henley, MD AAFP
  • John Hummel Sutter Health
  • John Tooker, MD ACP
  • Graham O. King McKesson Corp
  • Jane B. Metzger First Consulting
  • Andrew G. Ury, MD PMSI
  • Suzanne Delbanco Leapfrog
  • Charles Kennedy, MD - Wellpoint
  • Reed Tuckson, MD United Health
  • Susan Postal HCA
  • Sam Karp CHCF
  • Wes Rishel HL7
  • Lori Evans ONCHIT (nonvoting)
  • Clay Ackerly CMS (nonvoting)

Key Stakeholder Relationships
Information on market needs
HIT Customers (Medical Practices)
Increase confidence in investment
Information on current and future state of
HIT Vendors
Accelerate market roadmap of future expectations
Certification Commission
Commitment to incentives for certified products
Payers with Incentives for IT Adoption
or IT-Enabled Quality
Assurance that certified products, properly
deployed, can deliver results
Standards against which compliance can be tested
HIT Standards Organizations
Feedback on current standards drive development
of new standards
Guiding Principles
  • Need for decisive private-sector action now
  • Must seek input and deliver a compelling value
    for all key stakeholders and the larger
    healthcare community
  • Most operate in credible, objective, and
    collaborative manner
  • Certification must be objective, laboratory
    verified to the greatest extent practical
  • Must be efficient, fast, and low in cost

Key Points to Clarify
  • Product Certification is different from
  • Organizational Accreditation
  • Professional Certification
  • Certification is binary, i.e. pass/fail
  • Not a subjective, comparative points rating
  • A voluntary process
  • Initial requirements must be market reality-based
  • A forward-looking requirements roadmap provides
    the best means to influence market direction

Certification Roadmap Concept
Ambulatory EHR Product Attributes
2 Years Ahead
1 Year Ahead
Current Year
Final 2005 Requirements Forecast 2006 Requirements Forecast 2007 Requirements
Final 2005 Requirements Forecast 2006 Requirements Forecast 2007 Requirements
Final 2005 Requirements Forecast 2006 Requirements Forecast 2007 Requirements
Security Reliability
Project Status
  • Work Groups now completing Phase I Data
  • Reference material on standards and other efforts
  • Stakeholder priorities
  • Availability in marketplace
  • Gain broad stakeholder input
  • Post for public comment (April)
  • Conference calls and online comment mechanisms
  • Outreach and communications program

Tasks Ahead
  • Phase II Draft Certification Requirements
  • Balance stakeholder desires, marketplace
    availability, testability, burden and cost
  • Second public comment cycle
  • Pilot/beta testing of certification
  • Confidential testing of initial set of
  • Refine requirements and testing methodology
  • Launch 2005 deliverables
  • Begin accepting applications and granting
  • Release forward-looking roadmap

Summing Up
  • CCHIT successfully launched and operating
  • Goal is to accelerate the adoption of robust,
    interoperable HIT -- while delivering value to
    providers, vendors, and purchasers/payers
  • Ambulatory EHR is initial focus, with first step
    certification in summer 2005
  • Commission to also deliver a forward-looking
    roadmap of certification plans to the industry

Q and A
  • For more information
  • Submit your questions and comments at the website