EMR: The Buyer's Dilemma

Catch-22. Cart-before-the-horse. Chickens-before-they-hatch.

Pick an idiom. It seems from your email messages that any of the above encapsulates the conundrum of buying an EMR system before it has been certified. And we at IO Practiceware feel your pain. But we'd also like to put you at ease. But not in a sleazy way, involving low lighting or Barry Manilow music. Because, c'mon, Barry Manilow makes you uncomfortable, and you know it.

You may have many reasons to delay your EMR decision until next year or beyond, but concerns about CCHIT certification should not be one of them. IO Practiceware -- and all other EMR vendors -- have no choice but to follow the ARRA rules. It's true that certain consultants and other industry figures say that practices must wait until vendors get certified -- but this presumes that there's a high level of uncertainty and/or ambiguity surrounding the process and guidelines for certification. But there simply is not. Companies can either choose to take the necessary steps or choose not to.

For everyone's sake, we choose: certification.

And, it's like, um, obvious. Not only are we being compliant for our customers' sake, but getting certified is an unconditional must if we -- or any company -- hope to remain on the market as a viable EMR vendor.

IO Practiceware will be certified as an EMR-C ("Comprehensive"), as opposed to -M ("Module"), by CCHIT for the 2011-2012 period -- which is the soonest possible period for all vendors. (There is no freestanding 2009-2010 certification. In fact, all currently CCHIT certified vendors must be re-certified for the new period.) Testing will begin in September 2009, and we are gearing up for this process by developing all the necessary enhancements for our software. (Here is an article that breaks down the timeline in greater detail.)

So, believe it or not, you can start to breathe easy. In a world of relative uncertainty and inexplicability -- where haircuts like this achieve national celebrity -- CCHIT certification should be a comfort, not a source of angst. Given the recent revisions to its criteria, CCHIT has become a means by which EMR can achieve high functionality, uniformity, and interconnectivity. Vendors like IO Practiceware, committed to the success of customers and the EMR industry, will do what it takes, get certified, and work to improve American health care.

--FR

For the Record: AAO on CCHIT

For those interested, here is the American Academy of Ophthalmology's official stance on CCHIT with respect to eye care:

The 2007 Ambulatory EHR Criteria represent basic requirements that the Commission and its workgroups believe are appropriate for many common ambulatory care settings. CCHIT acknowledges that these criteria may not be suitable for settings such as behavioral health, emergency departments, or specialty practices and our current certification makes no representation for these. Purchasers should not interpret a lack of CCHIT Certification as being of significance for specialties and domains not yet addressed by CCHIT Criteria.

Currently, there is no eye care specialty CCHIT certification. The current process for testing is not designed for eye care only EHR vendors, and they cannot participate in the process. A lack of current CCHIT certification does not have significance for eye care specialty needs. Current CCHIT certification means that the system satisfies basic ambulatory care needs. Practices need to look at different systems and how they best meet your needs in delivering eye care services.

From Flora Lum, M.D.
Quality of Care and Knowledge Base Development, AAO

Squeaky wheels seek CCHIT oil

CCHIT's timeline for EMR certification excludes ophthalmology-specific EMRs like IO Practiceware until the year 2011. While we in the Eye Care community have an overwhelming urge to go Chuck Norris on CCHIT, we're going to first try peaceful resistance.

If you believe in the value of specialty-specific EMRs, make your voice heard! Post comments below.

To start the dialogue, here is a letter from Gregory Leopold, CEO of IO Practiceware:

Some of the most innovative EMRs are specialty-specific. This is certainly true in ophthalmology. While it may be self-serving to say so, it is true that non-specialty specific EMR have generally failed to supply ophthalmology practices with the tools they need to record their exams properly and cost effectively. The American Academy of Ophthalmology has been working with a group of ophthalmology-specific EMR companies to develop scripts for CCHIT certification for ophthalmology-specific EMR vendors. The work on these scripts has been completed and they could be used immediately to certify ophthalmology specific EMR companies.

While we appreciate CCHIT’s willingness to work with us in this area, the timeline for completion of the CCHIT certification process for eye care – which is currently set for 2011 – is unacceptable. Other EMR vendors in the AAO sponsored group share my concern and disquietude.

It is crucial that the timeline be moved to 2009 – or that some sort of arrangements are made for ophthalmology-specific EMR companies to receive some sort of “in progress” certification that allows us to participate in a marketplace that increasingly shuts out non-CCHIT certified products.

Either let us in now or tell the world that it’s OK for us to be “in the process”. It would be a great disservice to the cause of EMR if CCHIT were to drive some of the most innovative EMR companies out of business because it could not certify them promptly.

If our respectful protestations don't get CCHIT's attention, we may have to resort to Article B: a diatribe of semi-vulgar, though pun-obscured expletives entitled, "Cut the *BULLCCHIT*" (stay tuned).