Certification commission for EHRs

[DrWinn]

Here is the scoop on proposed EHR certification. It will cover functionality, interoperability and security standards. The 'certification' commission is comprised of purchasers (physician/physician representatives), vendors, government HIT 'stake-holders', standards groups (HL-7) and private/public coalitions interested in spurring EHR adoption. Hopefully it won't bog down in 'committee'. :D I will be attending a HIMSS meeting in Chicago Nov 3rd-4th and will report back on the progress.
See this link for more details.
http://www.cchit.org/files/CCHIT_MeetingMinutes_2004-09-14.pdf

[ozzie]

I hope it stays in committee forever as there are just way to many fingers in this pot ..

We will end up with super bloat/cost ware and by the time GE and the likes have bought their way into the players . You and all the small vendors will be hosed..
Who gives who the right to certify in the first place ???


Oz

[mel]

David, any updates from the meeting?

[Surgeon]

Now Ozzie, I am optimistically certain that this effort will result in a product every bit as helpful as the HIPPAA regulation that have added so much to patient care...

[JADIP]

Now Ozzie, I am optimistically certain that this effort will result in a product every bit as helpful as the HIPPAA regulation that have added so much to patient care...

yeah and the 2000 extra law grads this year that feed off it :o

[DrWinn]

David, any updates from the meeting?

The certification commission is seeking public participation to help formulate certification requirements at http://www.cchit.org/ . There is a deadline.. yikes, just went to the site - it is Nov 17th. I have listed this URL elsewhere/before, so don't wail on me.

Certification commission will address functionality, interoperability and security. I applied for functionality (wish me luck... and if I get selected hit me with your ideas/requests). Also, see press release http://www.himss.org/ASP/ContentRedirector.asp?ContentID=59250

[ozzie]

So what does this mean The same tired old bunch of hacks that got us to the mess we are in now.. See I would not get in because I dont have a sugar daddy to pay the expenese fo flying around the country hotels etc..

In essence it will be all the big guys and they will close out all the little guys by commitee..
We need more protocols and meetings about as much as a Rabbi needs a pet pig..

snip
http://www.cchit.org/Call_prartcpt.htm
In evaluating work group applicants, the commission is looking for participants with at least 10 years of healthcare industry experience, practical experience in implementing healthcare IT and/or EHRs and previous participation in a large industry work group, committee or standards projects. Members will be required to attend all work group meetings, which will occur for one to two hours every one to two weeks. They also will be expected to contribute up to four hours a week on technical work for the work group. Their sponsoring organizations must be prepared to bear the cost of occasional travel when face-to-face meetings are required.

The commission will give guidance to each work group on their roles and expected accomplishments. They will be encouraged to seek broad input through public forums as part of their work. In addition to completing the necessary tasks to begin the pilot program, each work group will be expected to develop a three-year roadmap so vendors and others will know how product certification requirements can be expected to evolve over the next few years.

[DrWinn]

You aren't kidding about the expense. e-MDs, Soapware and MediNotes were the three small companies that helped found the EHRVA. All the other players are names like WebMD, GE and EPIC. There is another meeting scheduled for Dec 7th for 2 hours only in Washington DC. at night (so you have to stay over basically). This traveling is going to start to get expensive fast. Also, it appears the big companies will dominate the workgroups. We are trying to even the odds by applying to several workgroups. If we really do get 2-3 spots, the time commitment, travel and hotel costs will probably be >$25,000 per year. This is a drop in the bucket to the big companies, but it adds up fast to the little guys (one reason I suspect Randall Oates/Soapware hasn't made meetings).

[ozzie]

maybe the commitee should get funding to support the "other" interests..
Its pretty scary when a pinhead like me can see thru this charade so easily ..

sigh

Oz

[DrWinn]

The first meeting of the functionality committee on Dec 23rd concerned establishing standards for EHR certification. Interestingly, the HL7 recommendations are the basis by which the group is voting on functionality requirements. The "essential now" specs are pretty scarey - I don't see how some vendors will ever be able to be certified - and the timeline is aggressive. The HL7 group is composed primarily of consultants, academicians and non-EHR vendors. The problem with this is they don't understand development queues and allocation of resources within a software company. I estimate the cost to comply with some of these specs (if they get voted on and passed), will be in the hundreds of thousands to millions of dollars. That cost gets passed on to the purchaser. If functionality requirements are too rigid and costs escalate, then a mechanism should be in place to subsidize these costs for physicians. Even though the government stands to save 300 billion dollars per year in healthcare costs once there is widespread adoption of EHRs, I don't see them stepping up to the plate and paying for them. They have made their VA system 'free' - although, having seen it in action, I can honestly say "you get what you pay for". There goes the 'cheap' EHR. Sorry Al.

The next functionality meeting is slated for Jan 11th. I will have a better idea of which way the vote is going then. Ozzie is right on about how each of these different interest groups have their own ideas. Some of these folks are physicians and some are obviously very good at what they do... but will the committee process ultimately spec out a bloated "certified" EHR that doctors will refuse to use.

[Tim2]

How does Dr. David Brailer fit into all of this?

[pprescot]

Even though the government stands to save 300 billion dollars per year in healthcare costs once there is widespread adoption of EHRs....

I'll belive that estimate when I see it. Government estimates are generally pie-in-the-sky nonsense.


...but will the committee process ultimately spec out a bloated "certified" EHR that doctors will refuse to use.

Probably. Committees of non-users usually make a mess of things, especially if they have a vested interest in the outcome.

[DrWinn]

How does Dr. David Brailer fit into all of this?

Brailer is the reason everyone is taking this so seriously. Half a dozen different organizations are vying to 'control' the specs. The EHRVA/HIMSS is attempting to bring everyone together to minimize duplication of effort (and there is a lot of that going on). MRI/TEPR is essentially out of the loop. Look to the PEHRC (http://www.centerforhit.org/x199.xml), CCR (AAFP), CCHIT (http://www.cchit.org/) and EHRVA/HIMSS (http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=86) and (http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=35) for cogent discussions on interoperability, functionality, ecetera.

[ozzie]

if maybe a 1000 doctors emptied their kidneys into a pot rather than on each other maybe some sense could be made of all this .
But as the doctors are not really represented and small EMR corps will get trampled its just anotrher boondoggle in the making ..
I hear the slurping of GE licking their chops right now.

Sadly the small folks both EMR users and makers will get mangled in this process and the HMO's will be sitting in the wings just waiting for the small docs to fall and invite them into their fray . It may end up being a terrible lever as how is a small town doc going to pay for this (which will end up) very expensive (non) solution....
I think the HMO's, once they realise the fresh meat out they will take over the system their way.. Like Jackels HMO's will not make the kill but feast on the scraps of others..

[Tim2]

Who could fault GE? At least they didn't create an unnecessary mid-level managment system and insert themself into the medical GDP while blaming the problems on docs. I hope GE is given a Carte Blanc Monopoly to run Medicare/Medicaid/State-run-Insurance and turn Hartford CT and every other insurance Mecca into a ghost town.

[ozzie]

I expect GE to do this . thast what they do best ..
http://www.gefn.com/insurance/ but
But GE will not be bringing much to life when the ma and pa doc shops get shut down..
And yes your right GE did not create the mid level management but soon may BE the mid level management..