As the industry waits breathlessly for federal guidance on EMR certification, no organization is closer to the edge of its seat than CCHIT. As such, no individual will be more interested in reading that anticipated document than CCHIT Executive Director Alisa Ray. With the impending resignation of CCHIT Chair Mark Leavitt, and no word on his replacement, Ray will be responsible for leading the ultra-important organization through the choppy waters ahead. To learn more about how CCHIT is operating in today’s hazy climate, healthsystemCIO.com editor Anthony Guerra caught up with Ray.
I think hospitals are probably more risk averse … so maybe it won’t be until this fall that we should start trying to build the site inspection model and get ready for that.
The vendors know us and have some faith in the fairness of the test — that it’s not going to be easier or more difficult for them than their competition.
I don’t know if competition has value to them. If you’re a vendor, I don’t know how you would choose?
GUERRA: Have you heard many vendors saying, “I’m not doing anything on certification until we get clarity from the government”?
RAY: We heard that when we did some polling before we launched the programs in October. That sentiment was in the minority, but there are some that are definitely taking that position. If you were a vendor you’d want to send the message to your customers that, “I’m keeping in touch with what’s coming out of Washington, I’m taking steps, I’m demonstrating the best I can that the gaps are going to be minor,” that gives them a number of months advantage over waiting to when everything is finally locked down.. My best guess says that won’t be until this fall.
GUERRA: Let’s talk a little bit about site certification. How can you have enough capacity to certify the thousands of complex clinical environment that might need their entire architecture certified, rather than one simple application?
RAY: We started hearing from organizations about the issue you mention. The fact is that many folks have a mix of certified vendors, some homegrown or self-developed code for some particular functions within the facility, some other vendor applications that haven’t been certified yet, more modular, and every site is going to be different as to how those systems are configured.
We realized we had to develop a flexible model that uses things we’ve done already. I mentioned a little bit before about our inspection processes, and I think the criteria will be the same. It’s the criteria defined by the federal government, what we’re calling the IFR Stage 1 Certification Criteria. We can use a lot of the testing tools that we’ve used with the vendor applications.
So the idea of an observed demonstration that you do remotely is the right one. We don’t actually do onsite visits to inspect the vendor’s technology, and we think that same model can work with the institutions, with the hospitals as well. So you can keep cost down that way. Also some of the interoperability testing we use — like Project LAIKA — are all setup to be done virtually.
So the model that we’ve been using is really efficient. We don’t get out and travel the globe to visit all the sites, and we’ve demonstrated that it’s really scalable too because you need staff to proctor or oversee the exams. I suspect we would just expand our pool of qualified and trained jurors that we have on call to meet new demand. Those are our IT experts. A lot of them are physicians — either practicing or informatics experts or security experts — that we retain and have on call, depending on the volume of inspections we have. We have had some ramping up. But again, I think the way we’ve done this in the past is really scalable, so that’s probably the least of our worries.
GUERRA: So you don’t feel the same pinch that many are feeling, in terms of getting the HIT talent you need?
RAY: Well, here’s the key difference — most hospitals have their IT environments in place and are making adjustments to it. It’s not like we need to do a preliminary program of that, we can wait – and also, I think hospitals are probably more risk averse; the idea of preliminary work is not going to be something they would be as receptive to. I think all of that means we should wait until the rules are final for them. So maybe it won’t be until this fall that we should start trying to build the site inspection model and get ready for that. We have started to float the concept, to get a little more feedback on how the model could look. We do town calls and different sessions to test some of the assumptions.
We had a town call with University Health Consortium a couple of months ago, and we’ve been talking with others in the industry. We’d like to arrange more of those. This will be part of our presentation at HIMSS, so we’re going to start getting out there and, as we get more traction, you’ll see more Webinars and things to get the word out about this, but we’re testing the concepts right now.
GUERRA: You’re a not-for-profit, a 501c3. How do you view competition?
RAY: Well, I think you always go back to the mission, which is to accelerate the adoption of health information technology. Clearly, the biggest thing happening in health IT is what’s happening with the federal government, and that’s a game we have to be a part of, and we need to do those certifications. Like I said, we’re confident we’ll be accredited and we need to be a part of that, and we’ve got tons of experience doing it. We’ve gone beyond the basics with our comprehensive programs, and that’s really because there are some things doctors and hospitals need that go beyond what the federal government has contemplated. I do think the comprehensive programs differentiate us.
I think we have a brand that’s trusted amongst the provider community. The vendors know us and have some faith in the fairness of the test — that it’s not going to be easier or more difficult for them than their competition. That’s all part of what we do.
GUERRA: Do you think this is a good place for competition?
RAY: Well, competition is one of those words that always sounds good, but I’m not sure if it’s really our place to say if it’s good or not. If you’re a provider, you just really want to know that the system is certified to the same level regardless of who it’s certified by. So I don’t know if competition has value to them. If you’re a vendor, I don’t know how you would choose? I guess if one certifying body had a reputation of being easier or cheaper, you might go with them.