Will New Certification Criteria Fuel Open Source E-Health Records?Will New Certification Criteria Fuel Open Source E-Health Records?

Till now, certification requirements for electronic medical records were pretty hefty, addressing hundreds of stringent criteria that comprehensive inpatient and ambulatory systems must meet in order to get a seal of approval from the Certification Commission for Health Information Technology, or CCHIT, a non-profit federally supported group.But moving forward, new certification "paths" recently announced by CCHIT will be a boost for modular software packages, especially those from smaller software vendors and open source developers, as well as their potential customers, including doctor practices that don't need fancier software tools, as well as health care organizations that have a hybrid mix of health IT systems featuring legacy and best-of-breed applications.

A couple of weeks ago, CCHIT announced it was replacing the single certification approach its had since 2006 with three new certification "paths."

CCHIT said the changes are meant to help support more widespread adoption and "meaningful use" of certified health IT systems by doctors and hospitals so that they're eligible to receive federal stimulus incentives that kick-in starting in 2011.

In a nutshell, CCHIT says its three CCHIT certification paths include:

• A rigorous certification for comprehensive EHR systems that significantly exceed minimum Federal standards requirements. This "EHR-C" certification would be targeted to the needs of providers who want maximal assurance of EHR capabilities and compliance.

This path includes many of the criteria that have been demanded till now for products to receive CCHIT certification.

What's new from CCHIT includes these additional paths:

• A new, modular certification program for electronic prescribing, personal health records, registries, and other technologies. Focusing on basic compliance with Federal standards and security, the EHR-M program would be offered at lower cost, and could accommodate a wide variety of specialties, settings, and technologies. It would appeal to providers who prefer to combine technologies from multiple certified sources.

• A simplified, low cost site-level certification. This program would enable providers who self-develop or assemble EHRs from noncertified sources to also qualify for the federal incentives.

The new paths are welcome news to developers in the open source community, including Medsphere, a maker of open source EHR OpenVista, which is a commercialized version of VistA, the U.S. Department of Veterans Affairs' e-medical record.

Open source developers typically can't afford the "costly and comprehensive" requirements and testing that were previously needed for CCHIT certification, says Dr. Edmund Billings, Medsphere chief medical officer in an interview with information.

The nitty-gritty specifics of CCHIT's new criteria haven't been disclosed yet, nor has the federal government yet published its "meaningful use" definition, so "the devil is still in the details" says Billings about the exact new "rigors of CCHIT certification."

Yet, he's hopeful the new paths will make it easier and quicker for open-source providers and smaller software vendors to have their products tested and approved, so that healthcare providers can feel confident their health IT investments will be eligible for the $20 billion federal stimulus rewards that begin from 2011 and last till 2015.

So far, the high level "meaningful use" criteria covers e-prescribing, sharing medical records electronically, and submitting reports on quality of care electronically, he says.

Under the new CCHIT certification proposals, it's possible for healthcare providers to take a "more flexible, modular" approach in their adoption of health IT, such as adopting e-prescribing modules now, and more complex e-medical record applications a little later.

That would help healthcare providers avoid being overwhelmed with cost, complex functionality and workflow changes all at once, which is often the case when implementing more comprehensive EMR packages, Billings says.

A lot of these EMR package are so complex that "they have everything to run an office," he says. But not all doctor practices want every "bell and whistle," he says. "Less is more," he says. "When things are too complex, the mainstream won't adopt it," he says.

What do you think?