Behavioral health providers seeking a duly certified electronic health record (EHR) as the first step to earning federal incentives for using information technology need only check the available inventory accumulating on a new Web site established by the Department of Health and Human Services.
Of course, having definitive EHR certification information in one place may take some getting used to, given the noise from the other EHR certification labels and designations that have come and gone during more than a year of “preliminary” certification activity.
The American Recovery and Reinvestment Act of 2009 (ARRA), in a bid to stimulate adoption of “meaningful use” of EHRs among the nation's hospitals and certain healthcare professionals, authorized billions of dollars in financial incentives and laid out a three-step process to qualify for the dangled dollars: (1) acquire certified EHR technology; (2) employ the technology to hit certain marks for meaningful use over three stages of requirements through 2015; and (3) report the results to the Centers for Medicare and Medicaid Services (CMS).
As the healthcare industry waited throughout 2009 and into 2010 for the HHS Office of the Coordinator for Health Information Technology (ONC) to articulate the final form of the meaningful-use objectives and work with CMS to turn them into regulations, the Certification Commission for Health Information Technology (CCHIT)-the only certifying body at the time-sought to design interim certification testing around the preliminary criteria being discussed by the ONC. CCHIT then planned to make alterations as needed when the final criteria came out.
“Our aim is to ensure that hospitals and doctors have enough time to purchase and implement certified EHRs and achieve meaningful use in time to qualify for HHS financial incentives in 2011 and 2012,” CCHIT executive director Alisa Ray explained in announcing the second of two preliminary adjustments to its ARRA criteria in January 2010, when ONC published an interim final rule on certification criteria. “With eligibility for hospitals opening in October 2010, there is an urgent need for certification programs to be in place.”
But in March 2010, ONC announced it was creating a new and separate program for the purpose of certifying the ability of EHRs to support its Stage 1 meaningful use objectives-actually two consecutive programs. To meet the impending launch of the incentive program in October, the office said it would create a temporary process to get “certifying bodies” accredited and operating for them to test and certify EHR products in time. Meanwhile it would work on a permanent program, operating more formally under the auspices of outside accreditation organizations, which would take effect at an indeterminate future date.
Since July, when ONC published a final rule on the certification process and started taking applicants, a growing number of organizations have been designated an “authorized testing and certification body,” recognized by the acronym ONC-ATCB. As of January 2011, there are six such bodies:
CCHIT, the Chicago group formed in late 2004 by three health IT-related organizations at the behest of the first national coordinator, Dr. David Brailer, to specify minimum functions, security measures and data exchange abilities for EHRs in hospital and office settings.
Drummond Group, Inc. (Austin, Tex.)
ICSA Labs (Mechanicsburg, Pa.)
InfoGard Laboratories (San Luis Obispo, Calif.)
SLI Global Solutions (Denver, Colo.)
These five ATCBs have a scope of authorization that includes complete EHRs and EHR modules. The sixth ATCB, Surescripts LLC (Arlington, Va.), has a narrower authorized scope: EHR modules for E-prescribing, Privacy, and Security only.
For providers shopping new EHR systems or planning to upgrade an existing EHR to a version that qualifies for incentives under ARRA's Health Information Technology Economic and Clinical Health (HITECH) Act, “The only certification that counts right now are those criteria that are coming out of ONC and [EHRs that] are being certified as part of the temporary certification process,” said Rik Drummond, chief executive officer of Drummond Group. “Anything previous to that will not get you the meaningful use funds from HITECH … That's very straightforward, that's the only way this happens.”
And because ONC took the reins of certification and engineered both a common process and an oversight function for authorized testing/certification bodies, “We're all exactly the same; we all operate the same level of procedures to do the testing and certification,” said Drummond. “There's no difference in what we're doing there.”
ONC has established a “certified health IT product list” website at http://onc-chpl.force.com/ehrcert. As of yearend 2010, the site already lists more than 200 products (thankfully, in alphabetical order by product name) that have been tested under ONC-ATCB procedures and given a unique certification number. The site specifies whether an EHR is “complete” or “modular,” but thus far does not distinguish between EHRs for the hospital and office settings. An ONC spokesperson said the next version of the website, expected in early 2011, will have increased functionality including the ability to filter and sort by care setting.