Certification Group Finalizes Criteria for Inpatient EHRs

The Certification Commission for Healthcare IT on Thursday published on its Web site the final certification criteria for the first round of testing inpatient electronic health record systems, Health Data Management reports (Health Data Management, 6/28).

Vendor applications will be accepted from Aug. 1 to Aug. 14 for testing and certification of inpatient computerized physician order entry and electronic medication-administration systems. The test results are expected to be announced in late October, and certification lasts for three years.

The cost of certification testing and a first-year maintenance fee totals $34,000, and an annual maintenance fee of $5,800 will be charged for the remaining two years, Health IT Strategist reports (Conn, Health IT Strategist, 6/28).

Commissioners

In related news, CCHIT through July will accept applications for six positions on its 21-member board of commissioners. The positions will represent:

• Ambulatory care providers;
• Consumers;
• Health information exchanges;
• Informatics experts;
• Public health agencies; and
• Safety-net providers (Health Data Management, 6/28).

Article: http://www.ihealthbeat.org

Not everyone benefits from IRS ruling, analysts say

6/11/07 Richard Pizzi www.healthitnews.com

Not all electronic medical records vendors will benefit equally from the recent Internal Revenue Service ruling allowing not-for-profit hospitals to provide healthcare information technology to physicians, according to a recent report by analysts at Leerink Swann & Company.

George Hill and Bret Jones of Leerink Swann’s Health Care Equity Research team wrote the report for investors in the wake of the May 11 IRS memorandum. They believe that vendors that currently have a high profile position in the national EMR market are best positioned to capitalize on the “potential influx of spending from not-for-profit hospitals,” but that the ruling could actually harm smaller, regional vendors.

The recent IRS ruling was important because it declared that a not-for-profit hospital’s purchase of an EMR system for a physician would not be considered an “impermissible private benefit,” according to the terms of the exemption to the Stark Anti-trust laws provided by CMS, and would not put a hospital’s tax-exempt status at risk.

In their report, Hill and Jones anticipate that the number of hospitals planning to assist physicians with the purchase of an EMR system may be greater than previously thought.

The Leerink Swann analysts contend that some regions, particularly urban areas, could see a “heightening competitive environment” as hospitals offer financial assistance to physicians for EMR purchases in order to attract more referrals for surgeries and other hospital-based procedures.

While hospital spending on EMRs for physicians is likely to increase, Hill and Jones suggest that contract signings with vendors may not spike in the immediate future. Hospital systems are generally conservative, they say, and their longer cycle capital budgeting process probably means that contract awards are several quarters away.

The analysts point out that the relaxation of the Stark Law may have some negative effects on ambulatory EMR vendors. In the near term, physician practices might choose to delay the purchase of EMR systems, “in the hopes that some local hospital will pick up a large portion of the tab for the costs” of a new EMR.

Hill and Jones also claim that competition for the large hospital-physician contracts that the Stark relaxation allows could lead to increased price competition and discounting among EMR vendors. If so, this could result in “lower net pricing and potentially lower levels of profitability for EMR software vendors.”

While the analysts suggest that many companies that offer an ambulatory EMR package will benefit from the IRS ruling, not all vendors will realize financial rewards.

The Leerink Swann report predicts that hospitals may be willing to be interoperable with a few outpatient EMR systems, but by no means all. If this proves to be true, it could act as a barrier to entry for smaller vendors in the ambulatory market.

“A hospital could choose to work with its inpatient vendor, another 3-4 outpatient [EMR] systems vendors, and then all other smaller vendors could essentially be locked out of that regional market as RHIOs are developed,” Hill and Jones warn in the report.

This possibility unnerves many smaller EMR vendors, says Don Schoen, CEO of Des Moines, Iowa-based MediNotes.

“Hospitals need to allow physician practices – particularly smaller practices – to make choices about which product they want to use in the office,” Schoen said. “This ruling can be a good thing, but it’s very dangerous for a hospital to push for only one specific product in every physician office in a community.”

Article: http://www.healthcareitnews.com/

 

HHS Promulgates New Regulations to Facilitate Adoption of Health Information Technology

On August 1, 2006, the U.S. Department of Health & Human Services (”HHS”) promulgated final rules (”Final Rules”) that will permit hospitals, physician practices and certain other organizations to donate electronic prescribing (”e-prescribing”) and electronic health records (”EHR”) technology and supporting services to physicians without violating either the federal physician self-referral (”Stark”) law or the federal health care program anti-kickback law (”AKL”). Both Final Rules are a result of the Congressional mandate in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (”MMA”) for the creation of a Stark law exception and an AKL safe harbor that would enable entities (such as hospitals) to encourage and assist physicians to embrace the use of e-prescribing technology. In promulgating the Final Rules,

HHS elected to go beyond e-prescribing, providing immunity for the donation of EHR technology and services under certain circumstances, as well.

I. The Final Rules

The Stark law exceptions and AKL safe harbors established by the Final Rules

are considerably more protective than was originally contemplated in the

October 11, 2005 proposed rules (the “Proposed Rules”). Among other things, the Final Rules allow for a broader range of qualifying donors and recipients; cover a more extensive range of technology; and replace a possible cap on the value of the donated e-prescribing or EHR technology with a recipient cost sharing provision for EHR.

A. E-prescribing

The e-prescribing exception and safe harbor are nearly identical, protecting donations by a hospital, physician group practice, Medicare Part D Prescription Drug Plan (”PDP”) sponsor, or Medicare Advantage (”MA”) organization of hardware, software, information technology (including internet connectivity), and training and support services that are necessary and used solely to receive and transmit electronic prescription information, provided that several conditions are met. For example: (1) the donor may not limit or restrict the use or compatibility of the donated technology or services with other e-prescribing or electronic health information systems; (2) the technology and services must be capable of being used for any patient regardless of payor status; (3) the donation of the items and services cannot be conditioned on an agreement by the recipient to do business with the donor; and (4) the decision to make the donation - including the amount and nature of the items and services - must not be determined in a manner that takes into account the volume or value of referrals or other business generated between the parties. Significantly, HHS did not impose a limit on the value of e-prescribing technology that may be donated to an eligible recipient.

 

B. EHR

The Final Rules also establish a new regulatory Stark law exception and AKL safe harbor for the donation of EHR technology and services. The most significant aspects of this exception and safe harbor are discussed below.

1. Donors

In comparison to the Proposed Rules, the Final Rules expand the types of entities that may donate EHR items and services. Under the Stark law exception, donations may be made by any entity that furnishes “designated health services.” Under the AKL safe harbor, the donor may be (1) any individual or entity that provides covered items and services and seeks reimbursement, either directly or through reassignment, from any federal health care program, or (2) any health plan. This generous definition encompasses hospitals, group practices, physicians, nursing and other facilities, pharmacies, laboratories, oncology centers, community health centers, and dialysis facilities, among others.

2. Recipients

The Stark law exception protects items and services donated to any physician. The AKL safe harbor protects donations to any individual or entity engaged in the delivery of health care, such as physicians, group practices, physician assistants, nurse practitioners, nurses, therapists, audiologists, pharmacists, nursing and other facilities, community health centers, and laboratories.

3. Protected Items and Services

The Final Rules protect “information technology” (e.g., internet connectivity and maintenance) in addition to the software and training services (e.g., help desk) covered under the Proposed Rules. Software must contain, or link to, an e-prescribing component. (Protection is not afforded to the donation of hardware, however.) Unlike the e-prescribing Final Rule, EHR items and services must be necessary and used predominantly (rather than solely) to create, maintain, transmit or receive the EHR of the donor’s or physician’s patients in order to be protected. Although it is not clear what regulators will consider to be “necessary and predominant,” Preamble commentary indicates that software packages may include, depending on the circumstances, functions related to the care and treatment of individual patients, such as patient administration, scheduling functions, billing, and clinical support. Expressly excluded, however, is any technology used primarily for personal business or business unrelated to the recipient’s clinical practice or operations.

 

4. Interoperability

Under the Final Rules, which abandon the pre- and post-interoperability distinction

contained in the Proposed Rules, donated EHR technology must be interoperable with other e-health systems at the time of its donation in order to be protected.

“Interoperable” is defined as software able to (1) communicate and exchange data accurately, effectively, securely, and consistently with different information technology systems, software applications, and networks, in various settings, and (2) exchange

data such that the clinical or operational purpose and meaning of the data are preserved without alteration. Software is “deemed” interoperable if a certifying body recognized by HHS has certified the software no more than 12 months prior to the date

of donation. In notices published in the August 4, 2006 edition of the Federal Register,

HHS (1) recognized certain ambulatory EHR criteria developed by the Certification

Commission for Healthcare Information Technology that may be used by certifying

bodies to deem technologies interoperable and (2) promulgated interim guidance for entities that want to become recognized EHR certifying bodies.

5. Cost Sharing

The Final Rules require the recipient physician to pre-pay a minimum of 15 percent of the donor’s costs. Neither the donor nor a related party may finance the physician’s payment.

6. Selection of Recipients

EHR donors may not directly take into account the volume or value of referrals or other business generated between the parties when determining whether, and the extent to which, a particular recipient is provided EHR. The Final Rules, however, list various selection criteria that donors may use without triggering the volume or value or other business generated standards. For example, donors may consider such practice specific criteria as the total number of prescriptions written, practice size, number of hours worked by the physician, and the physician’s overall use of automated technology.

II. Conclusion

The Final Rules reflect an unprecedented degree of coordination between CMS and OIG, resulting in consistent treatment of health information technology donations under the Stark law and AKL. This coordination reflects the government’s desire to remove impediments to the adoption of important, but expensive, software and related information technology that will enhance patient care and safety and reduce medical errors while simultaneously protecting federal health care programs from fraud, waste and abuse.

The Final Rules are scheduled to be published in the Federal Register on August 8, 2006, and will become effective 60 days thereafter. Although the exception and safe harbor for EHR donations will sunset on December 31, 2013, the e-prescribing provisions are indefinite.

Group practice leaders looking to spend: survey

Group practice leaders responding to the 17th annual Modern Healthcare/Modern Physician Survey of Executive Opinions on Key Information Technology Issues are looking to spend more on healthcare IT in the near term than they are currently spending, but how much more is widely variable.

Of the 344 executives who responded to this year’s survey, 96 indicated they were leaders of medical group practices. Their organizations ranged in size from a couple of solo practices to two large medical groups with more than 1,300 physicians. The average practice size was 88 physicians, but the median size was 16. Average revenue was $41.7 million while median revenue was $11.5 million. The survey was open from Oct. 30, 2006, through Jan. 12.

Most executives (81%) deemed their practices to be operating in highly competitive environments, while 19% of respondents indicated their practices were geographically removed from other competitors.

Budgeting for healthcare IT spending varied greatly. More than half of respondents (54%) indicated they currently are allocating just 2.5% or less of total operating expenses for IT, with the mean range of 2.1% to 2.5% also the most often selected (by 16% of respondents).

But one in five respondents selected operating budget ranges of 4.6% or higher.

More than half of the group leaders (55%) in the survey reported they currently are spending 10% or less of their capital budgets on IT, while 50% indicated they would be spending 10% or less over the next three years.

But a large majority of executives (69%) predicted their spending on IT will increase over the same period, compared with 11% who thought their IT operating expenditures would decrease and 19% who reported that it would be unchanged.

Similarly, 61% of respondents estimated their IT capital expenditures will go up over the next three years, while 13% projected capital spending cuts and 24% selected “no change.”

With all the emphasis by the government and business interests on clinical IT systems, they were not the top “hot button” priority this year, according to our readers. Asked to prioritize their IT needs and make their top three choices from a list of 16 alternatives, 41% of respondents picked practice-management solutions, well ahead of ambulatory clinical solutions and clinical communication infrastructure/communication systems that were each chosen by 31% of the survey respondents.

Other oft-selected IT priorities were Web-based technologies to enable patient access to certain data via the Internet at 27%. At 22% were picture-archiving-and-communication and other imaging systems, along with consolidating all IT systems using common applications.

Michael Nissenbaum, president and chief executive officer of iMedica, a Carrollton, Texas-based vendor of an electronic medical-record/practice-management software suite, says there are several compelling reasons practice leaders are looking at their practice-management systems. Before joining iMedica, Nissenbaum spent five years as the president and CEO of Millbrook Corp., a practice-management systems provider that GE Medical Systems Information Technologies moved to acquire in late 2002.

“At Millbrook, we found that most PM systems have a useful life of five to seven years,” Nissenbaum says. “You had degradation of technology. Vendors didn’t supply upgrades on an ongoing basis. Also, this is a data repository and like any repository, data starts getting corrupted.”

A more pressing concern is the upcoming requirement under the Health Insurance Portability and Accountability Act that by May 23 all electronic transactions include a national provider identifier, or NPI.

If an old practice management system can’t accommodate tagging claims with an NPI, “It’s going to kill you,” Nissenbaum says. Additionally, having a common database for office scheduling, billing and EMR systems will allow staff to flag patients in need of other services.

“You set up a health maintenance rule for a patient in the clinical side of the application, whether it’s an Hb1Ac (blood-sugar test) or PSA (prostate-specific antigen) test, and when that patient calls in, regardless of the complaint, if they’re due for their current hemoglobin or their annual PSA, it pops, and it’s attractive for the practice as well. You have an opportunity to enhance services and increase revenues for the practice.”

Physician-Medical informaticist William Bria, agrees.

“That PM would still be king is not surprising,” says Bria, chief medical information officer at Shriners Hospitals for Children, a system based in Tampa, Fla., and chairman of the Association of Medical Directors of Information Systems. “What these folks may be saying is that they’re still focused on the bottom line and either: 1. A new generation of PM products is of interest; 2. Due to changing reimbursement rules and increasing complexity new systems are needed; or 3. New (Web-based) technologies are more attractive for many reasons and are now finally coming available.

“They just could also be purchasing new systems that include more of the clinical components of an ambulatory EMR,” Bria says.

This story initially appeared in this week’s edition of Modern Physician.

Article: www.modernhealthcare.com

CCHIT approves 2007 ambulatory EHR testing criteria

By Diana Manos, Senior Editor Healthcare IT News 03/16/07

CHICAGO – The Certification Commission for Healthcare Information Technology (CCHIT) announced Wednesday that it unanimously approved its new 2007 criteria for ambulatory electronic health records to be published March 19.

The criteria will take effect May 1 when CCHIT will begin taking applications for certification, according to a statement released by CCHIT. The Commissioners also approved test scripts for inpatient hospital-based EHRs and are seeking public comment online through April 13, according to CCHIT.

Among a number of new requirements this year in the ambulatory EHR certification is that systems must be able to send prescriptions and refills to pharmacies electronically and demonstrate their product’s ability to electronically receive standards-based lab result messages, CCHIT representatives said.

CCHIT has scheduled a town call teleconference April 5, at 11 a.m. EDT to discuss the 2007 ambulatory criteria, test scripts and certification process.

According to Mark Leavitt, CCHIT chair, “These latest materials show not only the concrete progress made during the past year, but also the path forward toward more complete interoperability of EHRs and health information networks in the years ahead.”

CCHIT, an independent, nonprofit organization, has certified 57 ambulatory health record products within the last 10 months. It has also received a number of endorsements from trade associations and the federal government, including the Department of Health and Human Services, American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, Medical Group Management Association and the Physician’s Foundations for Health Systems Excellence, Leavitt said.

Read full article here: www.healthcareitnews.com

CCHIT to provide certification across settings, populations and specialties

By Diana Manos, Senior Editor Healthcare IT NEws 03/09/07

WASHINGTON – The Certification Commission for Healthcare Information Technology is developing a concept that will allow certification across settings, populations and specialties over and above basic EHR certification. CCHIT Chair Mark Leavitt, MD, made the announcement at a session of the Healthcare Information and Management Systems Society annual conference in New Orleans last week.

Leavitt said the reason the Commission is considering such a plan is that most physicians provide care across more than one setting and to more than one population. “Most documents work across many settings. It’s like soup,” Leavitt said. “That’s why CCHIT began to ask whether one set of certification criteria can cover everything–and the answer was, no, not for long.”

Populations, such as varying ages of patients, are a big concern, Leavitt noted. Documents need to cover certain things such as growth charts for children, but not for adults.

CCHIT plans to introduce its proposed dimensions of certification within two years, beginning with products that can serve behavioral healthcare, long-term care, home care, emergency care, and cardiology. The Commission is discussing adding allergy, dermatology, neurology and ophthalmology in years to follow and welcomes input from various other specialties interested in access to products certified for their use. Based on a recent survey conducted by CCHIT, cardiologists were chosen first because they were the most prevalent in their responses, Leavitt said.

CCHIT is also currently working on developing inpatient EHR test criteria and is accepting comments on its second draft criteria until March 16 with a certification launch date of August. “In-patient EHR certification is ten times more complex than ambulatory,” Leavitt said.

In 2008, CCHIT plans to develop, pilot test and launch certification of health information networks, according to Leavitt.

“The future is interoperability,” Leavitt said. “I see health information exchange networks as a first demo with potential for sharing, but what we’ll need is to test interoperability. We will need a test network to simulate a network. We all need this, but there are no contracts to build it so far.”

According to Alisa Ray, executive director of CCHIT, within the last 10 months, the Commission has certified 57 ambulatory health record products. On March 19, CCHIT will publish the final criteria for the 2007 ambulatory EHR certification and will begin accepting applications for certification on May 1, Ray said.

CCHIT, an independent, nonprofit organization, has received a number of endorsements from trade associations and the federal government, including the Department of Health and Human Services, American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, Medical Group Management Association and the Physician’s Foundations for Health Systems Excellence, Leavitt said.

 Access article here: www.healthcareitnews.com

ANSI-Approved Health IT Standard Announced

By M.L. Baker 2/21/2007 10:18:00 AM

A health IT standards group released a new, more-comprehensive standard for electronic health records on Feb. 21. The standard, released by Health Level Seven, is the first that specifies functional requirements for electronic health-records systems to win approval from the American National Standards Institute, a key standard-setting body. Electronic health records are advocated by the federal government and many health advocacy groups as a way to make sure that doctors have more complete information when caring for patients. Besides cost, one large barrier to EHR use is that different EHR systems cannot work together to exchange information, a problem that could be greatly alleviated by industry-wide standards. But health IT is plagued by competing standards, often developed by different sets of experts for different purposes. The problem is widely recognized. Earlier this month, HL7 and ASTM International, another standards organization, announced a merged standard for describing patients’ medical histories and demographics when discharged from a health institution. The move was heralded as an important advance in creating a nationwide health-information network.

The HL7 standard released Feb. 21 describes 1,000 conformance criteria across 130 functions, including medication history, problem lists, orders, clinical decision support, plus supports for privacy and security. “This new standard is a ’superset’ of functions that enables a standardized description and common understanding of functions, which is necessary when you’re working across care settings,” said Linda Fischetti, EHR Technical Committee co-chair.

A federally supported industry collaborative that certifies electronic health-records systems praised HL7, saying the two organizations provided a good example of collaboration in the health IT field. “The HL7 standard for EHR systems has been extremely valuable to us, providing the starting framework for CCHIT’s development of certification criteria,” said Mark Leavitt, head of CCHIT (Certification Commission for Health Information Technology). The standard should also serve as the basis for additional functions of electronic health-records systems, such as the ability to serve as a legal record for business purposes. The standard is also designed to accommodate EHR systems aimed for special purposes, such as disaster preparedness, long-term care, behavioral health, children and clinical research.

Find article here: www.channelinsider.com

Warnings Over Privacy of U.S. Health Network

By ROBERT PEAR New York Times February 18, 2007

WASHINGTON, Feb. 17 — The Bush administration has no clear strategy to protect the privacy of patients as it promotes the use of electronic medical records throughout the nation’s health care system, federal investigators say in a new report.

In the report, the Government Accountability Office, an investigative arm of Congress, said the administration had a jumble of studies and vague policy statements but no overall strategy to ensure that privacy protections would be built into computer networks linking insurers, doctors, hospitals and other health care providers.

President Bush has repeatedly called for the creation of such networks, through which health care providers could share information on patients. In 2004, Mr. Bush declared that every American should have a “personal electronic medical record” within 10 years — by 2014. With computerized records, he said, “we can avoid dangerous medical mistakes, reduce costs and improve care.”

In response to the president’s plea, federal officials have developed elaborate plans for what they describe as “a nationwide health information network.” Mr. Bush has said: “One of the things I’ve insisted upon is that it’s got to be secure and private. There’s nothing more private than your own health records.”

But in the report, issued this month, the G.A.O. said the administration had taken only rudimentary steps to safeguard sensitive personal data that would be exchanged over the network.

Senator Daniel K. Akaka, Democrat of Hawaii, who requested the investigation, said it showed that “the Bush administration is not doing enough to protect the privacy of confidential health information.” As a result, Mr. Akaka said, “more and more companies, health care providers and carriers are moving forward with health information technology without the necessary protections.”

In written comments on the report, Jim Nicholson, the secretary of veterans affairs, who supervises one of the nation’s largest health care systems, said, “I concur with the G.A.O. findings.”

But Dr. Robert M. Kolodner, who coordinates work on information technology at the Department of Health and Human Services, disputed the findings. Dr. Kolodner said his department was “very committed to privacy and security as it works toward the president’s goal” of switching medical records from paper to electronic files.

Read full article here:  www.nytimes.com

The EHR debate continues …

Article published Feb 16, 2007 Modern Healthcare Online

I’ve read Andis Robeznieks’ article “Using EHRs to extract data on adverse drug events.” It is all true. But why isn’t it a common practice? Why don’t we have an EHR that all healthcare providers use? Why don’t we use standards that make all this possible?

For almost eight years I was chairman of CEN/tc251/wg1. CEN is the European standardization organization. While I was chairman, CEN/tc251 worked on three European standards—one is becoming an Australian standard; two are on their way to becoming International Organization for Standardization standards.

One standard defines the concepts and terms clinicians need to cooperate. The second standard makes possible plug-and-play exchange of documented information gathered while providing care to the patient and while collaborating with colleagues. Plug-and-play is defined as systems capable of recieving, storing, retrieving, presenting and exchanging information without any programming. This is based on a new exciting paradigm—a paradigm that is used for messaging. It is called the archetype paradigm or two-model-level paradigm. The third one makes it possible that EHR systems are capable of cooperation.

This set of three standards makes it possible for EHR systems to provide the things discussed in the article, and it can provide much more.

The question is, “Why are we not using these standards?” My answer is:

• The “not invented here” syndrome.
• The belief by many that Health Level 7 and its message paradigm will solve the problems, while it never can because all messages take a lot of resources to produce them and even more to implement them in all systems in a patient-safe way.
• The fact that information technology vendors and consultants make a lot of money out of the mess the message paradigm is associated with.
• HL7—the industry and consultants do a good job promoting the message paradigm as the only solution.

For more information I refer to openehr.org, an open-source community that provides a lot of background technical information and implementable specifications, plus some software.

Gerard Freriks, MD
member of EuroRec
European Institute for Health Records
the Netherlands

Article Here: www.modernhealthcare.com

CCHIT receives record number of EHR applicants

The Certification Commission for Healthcare Information Technology has received a record 35 applications from electronic health-records system vendors for the fourth round of government-supported certification testing, according to CCHIT officials.

The deadline for applications was Wednesday, said Mark Leavitt, chairman of CCHIT, which has thus far certified 57 EHR systems for use in the ambulatory-care environment since testing began last year under a three-year contract totaling $7.5 million with HHS.

Leavitt had said earlier he thought there would be a drop off in the number off applicants, but had expressed surprise at the steady stream of applicants.

“It was, again, more than we expected,” Leavitt said.

This is the final batch of applicants seeking certification by CCHIT using the initial set of testing criteria. Results of the current round of testing should be announced in April, Leavitt said.

In addition, CCHIT is working on development of additional criteria for use in the second round of testing due to start later this year. The public comment period for the expanded 2007 criteria for outpatient EHRs opened Wednesday and will run through Feb. 28.

“Applications will open again May 1 for testing under the 2007 criteria,” said CCHIT spokeswoman Sue Reber, who expects a number of applicants under the new testing regime will be vendors applying for re-certification even though vendors whose systems passed under the 2006 criteria can advertise as being CCHIT compliant for up to three years.

“We’ve had a fair amount of comment from a number of the certified vendors that they are going to recertify for 2007,” Reber said. “Part of what is driving this is we will begin the first significant interoperability testing in 2007.”

The two major interoperability areas to be tested are whether the system enables a physician to send an electronic prescription to a pharmacy and to electronically receive laboratory results, Reber said.

CCHIT has asked for and received deeming authority from HHS to certify an EHR system’s interoperability, which is a prerequisite to quality for Stark and anti-kickback relief provisions created by HHS last August. The Stark exceptions and anti-kickback safe harbors allow hospitals to pay for up to 85% of the software and training costs for installing an EHR system in physician offices.

CCHIT does not disclose the names of vendors seeking certification. It only discloses those whose systems pass, but some of the vendors swelling the ranks of this recent batch of certification candidates are those developers that had submitted applications for their systems previously and either withdrew them before testing or failed one or more portions of the test, Leavitt said. To be certified, systems must meet all criteria. According to Leavitt, none of the EHR systems that have received CCHIT certification thus far is open-source.

“Each quarter, not everyone that applies makes it through certification,” he said. “Some, even before we inspect, they say they’re not ready. We don’t have an issue with that, if they change their mind.

At least one of the EHR systems seeking certification in the latest round is known, however. It is the work product of a three-year effort by the CMS and the Veterans Affairs Department to adapt the VA’s Veterans Health Information Systems and Technology Architecture, or VistA, software for physician use outside the VA in the small office market.

Joseph Dal Molin, interim president and vice president of business development for WorldVista, confirmed that WorldVistA Office EHR is one of the systems being tested this round.

WorldVistA is not-for-profit organization that took over much of the development work for the VistA project under a contract initiated in 2004 by the CMS with the Iowa Foundation for Medical Care, the Medicare quality improvement organization for Iowa. The CMS spent slightly more than $6 million on the VistA Office development efforts to make a low-cost, quality EHR available for the small physician office market where most market surveys show the high cost of EHR systems is the No. 1 barrier to adoption.

Article here: www.modernhealthcare.com