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

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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

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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

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Context for Founding of CCHIT

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

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Founding of CCHIT

• Founded by three HIT organizations
• American Health Information Management Assoc
  (AHIMA)
• 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

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Mission of CCHIT
To accelerate the adoptionof robust,
interoperable HIT throughout the US healthcare
system,by creating an efficient, credible,
sustainable mechanism for the certification of
HIT products.
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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

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Ambulatory Care and HITA 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

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EHR Adoptionin 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
2004
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Standards and Certification Create Tipping
Points in Technology Adoption
The IBM-standard PC launched the personal
computing revolution
The Ethernet networking standardgave those PCs
connectivity
Wi-fi certification made connectivity available
almost anywhere
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How Product CertificationCan Accelerate HIT
Adoption

• 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
  purchasers/payers

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The EHR Adoption Deadlock
Wont offer incentives unless benefits and
interoperability of EHRs are assured
Payers/Purchasers
Providers
IT Vendors
Wont buy EHRs until costs and risks are lower
and/or incentives higher
Cant bring down costs until provider adoption
accelerates
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Getting the Wheels Turning
Beneficial effects andinteroperability
assured,unlocking incentives
Payers/Purchasers
Providers
IT Vendors
Reduced risk andavailability of incentives
accelerates adoption
Growing marketattracts investment, lowers costs
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CCHIT Organization
CCHIT Commissioners
Business Operations Committee
Program Management Team
Work Group Functionality
Work Group Inter-operability
Work GroupSecurity Reliability
Work GroupCertification Process

• Advisory Councils and Liaisons
• Vendor Associations
• Provider Organizations
• Payer/Purchaser Organizations
• Standards Development Organizations

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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.

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Commissioners

• 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)

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Key Stakeholder Relationships
Information on market needs
HIT Customers(Medical Practices)
Increase confidence in investment
Information on current and future state of
products
HIT Vendors
Accelerate market roadmap of future expectations
CertificationCommission
Commitment to incentivesfor certified products
Payers with Incentivesfor IT Adoption
orIT-Enabled Quality
Assurance that certified products, properly
deployed, can deliver results
Standards against whichcompliance can be tested
HIT Standards Organizations
Feedback on current standardsdrive development
of new standards
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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

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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
  system
• A voluntary process
• Initial requirements must be market reality-based
• A forward-looking requirements roadmap provides
  the best means to influence market direction

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Certification Roadmap Concept
AmbulatoryEHRProductAttributes
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
Functionality
Interoperability
Security Reliability
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Project Status

• Work Groups now completing Phase I Data
  Gathering
• 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

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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
  products/vendors
• Refine requirements and testing methodology
• Launch 2005 deliverables
• Begin accepting applications and granting
  certification
• Release forward-looking roadmap

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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

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Q and A

• For more information www.cchit.org
• Submit your questions and comments at the website