Certification Commission for Healthcare Information Technology Certification Commission for Healthcare Information Technology (CCHIT): Report on Activities and Progress Mark Leavitt, MD, PhD Chair, CCHIT Alisa Ray Executive Director, CCHIT Presentation to the National Academy of Science Committee on the Review of the Adoption and Implementation of Health IT Standards by the DHHS Office of the National Coordinator for Health Information Technology Washington, DC Sept 16, 2007
Outline Background Role of Certification in the Health IT Strategy Development Process Inspection and Certification Results of Certification and Evidence of Impact Looking Ahead Q & A 2007 Slide 2 Sept 16, 2007
Mission Accelerate the adoption of robust, interoperable health IT by creating an efficient, credible certification process. 2007 Slide 3 Sept 16, 2007
Milestones Sept 2004 June 2005 Oct 2005 May 2006 Oct 2006 Jan 2007 May 2007 July 2007 Founded by AHIMA, HIMSS, and the Alliance (NAHIT) Eight more organizations contribute funding Awarded 3-year $7.5M HHS/ONC contract Certification of Ambulatory EHRs launched Recognized as Certifying Body by HHS; regulatory relief for donation of certified EHRs by covered entities Becomes fully independent, nonprofit organization Updated criteria for Ambulatory EHRs -- includes standardsbased eprescribing, lab result receiving Certification of Inpatient EHRs launched. Development work started for certifying health information networks, emergency department systems, child health, cardiology 2007 Slide 4 Sept 16, 2007
Role of Certification in the Health IT Strategy American Health Information Community and AHIC Workgroups Office of the National Coordinator Standards Harmonization HITSP NHIN Prototype & Implementation Projects Privacy & Security Policies, Laws, Regulations Harmonized Standards Network Architecture Privacy Policies Strategic Direction + Breakthrough Use Cases CCHIT: Certifying Standards Compliance of Health IT Certification of EHRs and Networks Governance and Consensus Process Engaging Public and Private Sector Stakeholders Accelerated adoption of robust, interoperable, privacy-enhancing health IT Certification is a voluntary, market-based mechanism to accelerate the adoption of standards and interoperability 2007 Slide 5 Sept 16, 2007
Four Goals of Certification Reduce the risks of investing in health IT Facilitate interoperability of EHRs and health information exchange networks Enhance availability of adoption incentives and regulatory relief Ensure that the privacy of personal health information is protected 2007 Slide 6 Sept 16, 2007
Scope of Work 2006: Develop, pilot test, and launch certification of ambulatory (office-based) EHRs 2007: Develop, pilot test, and launch certification of inpatient (hospital) EHRs 2008: Develop, pilot test, and launch certification of networks through which EHRs interoperate Update certification criteria for each domain annually Expand certification to address additional specialties, care settings, and populations Transition to become an independent, self-sustaining organization by the end of the contract period 2007 Slide 7 Sept 16, 2007
Foundations of Credibility Governance Transparency Consensus-based decision making Multiple public input opportunities Stakeholder outreach and engagement Broad and diverse volunteer participation CCHIT s most important asset is the trust of its stakeholders 2007 Slide 8 Sept 16, 2007
Development Process May June July Aug WG Selection Complete 2007 2008 Sept Oct Nov Dec Jan Feb March April May June July Face-to-face kickoff mtg receive Commission guidance; begin restructuring of existing criteria Publish Env Scan 30 day comment Publish Draft Criteria 30 day comment Face-to-face mtg review comments; refine criteria; resolve overlaps, gaps, conflicts α Publish Second Draft Criteria and Draft Test Scripts 30 day comment Alpha Test (new domains) Pilot Test Publish Pilot Result, Proposed Final Criteria and Test Scripts Publish Final Materials 2007 Slide 9 Sept 16, 2007
Inspection and Certification Functionality, Interoperability, Security 100% compliance required; multiple fail-safe mechanisms and appeals process Efficient web-based process combines jury-observed demonstration, expert examination, and technical tools 2007 Slide 10 Sept 16, 2007
Certification Commission for Healthcare Information Technology Results of Certification and Evidence of Impact
Acceptance among Providers Endorsement by physician professional societies: American Academy of Family Physicians American Academy of Pediatrics American College of Physicians American College of Emergency Physicians American Medical Association Medical Group Management Association Physicians Foundations for Health Systems Excellence Hospital IT executives 66% are familiar with certification 1 55% will require certification in purchase decisions 1 1 Survey conducted by HIMSS Analytics, March 2007 2007 Slide 12 Sept 16, 2007
Ambulatory EHR: Acceptance among Vendors About 200 vendors in marketplace (estimate) 83 vendors / 92 products certified to date More than 40% of vendors in the market became certified within a year of launch (May 2006) Adjusting for installed market share, about 75% of EHRs in use are from certified vendors Inpatient EHR: About 25 vendors in marketplace (estimate) 6 vendors (~24% of market) applied immediately when certification was launched (August 2007) 2007 Slide 13 Sept 16, 2007
Competitive Marketplace Intact Annual Revenue of Certified Vendors Practice Sizes Served by Certified Vendors $1 million to $10 million 56% 75% 50% 25% < $1 million 17% > $10 million 27% 1 2-5 6-15 16-50 >50 Number of Physicians in Practice Certification has created a level playing field for a wide diversity of EHR companies to compete Revenue and Size data from anonymous survey of certified ambulatory EHR vendors as of February 2007; N=30; response rate 55%. 2007 Slide 14 Sept 16, 2007
Additional Positive Impacts Financial incentives for adoption of certified EHRs Regulatory relief available for donation of certified EHRs to physicians by hospitals, others Malpractice premium discounts for certified EHRs Support by emerging health information networks Security/privacy standard of practice raised Interoperability standard of practice raised 2007 Slide 15 Sept 16, 2007
Looking Ahead: Expansion Roadmap Expansion Area 2007 10/07-4/08 2008 2009 2010 Populations Child Health Begin development =========> Launch - July 2008 Behavioral Healthcare Preparatory Studies Begin development Launch TBD Care Settings Emergency Department Begin development =========> Launch July 2008 Long Term Care Preparatory Studies Begin development Launch TBD Launch TBD Home and Other Care Models Further discussions Professional Specialties Cardiovascular Medicine Begin development ==========> Launch July 2008 Other Specialties Discussions, Update Roadmap Begin selected development Launches TBD Launches TBD 2007 Slide 16 Sept 16, 2007
Specialty Endorsement Criteria Population Care Criteria Domain Criteria Modular Certification Structure to Support Future Expansion Cardiovascular Medicine: Additional Criteria and/or Specialized Case Scenario Ambulatory EHR Criteria Future Specialty Additions Child Health Criteria Inpatient EHR Criteria ED EHR Criteria Future Population Additions, e.g. Behavioral Health Future EHR Domains, e.g. Long Term Care Foundation Criteria EHR Foundation Criteria Network Criteria 2007 Slide 17 Sept 16, 2007
Summing Up An independent, nonprofit organization on track to becoming financially self-sustaining A public mission to accelerate adoption of robust, interoperable health IT Consensus-based process has attracted strong volunteer commitment and earned industry credibility Positive results emerging High market acceptance by providers and vendors Unlocking financial incentives and regulatory relief Raising the bar in interoperability and security 2007 Slide 18 Sept 16, 2007
Thank you! Q & A For more information: www.cchit.org