The Certification Commission for Healthcare Information Technology (CCHIT) Overview and Update HIT Summit West March 8, 2005 Mark Leavitt, MD, PhD Chair,

The Certification Commission for Healthcare Information

Technology (CCHIT)Overview and Update

HIT Summit WestMarch 8, 2005

Mark Leavitt, MD, PhD Chair, CCHIT

Medical Director, HIMSS

Slide 2

Introduction and Overview

• Context and Origin of CCHIT

• Mission and Concept

• Organization

• Stakeholder Relationships

• Guiding Principles and Points to Clarify

• Scope, Timeline and Deliverables

• Q and A

Slide 3

Context for Founding of CCHIT

• The President’s goal:Electronic health records (EHR) for every individual by 2014

• ONCHIT Strategic Framework: Private sector HIT product certification is one of eight key actions

Slide 4

Founding of CCHIT

• Founded by three HIT organizations:• American Health Information Management Assoc (AHIMA)• Healthcare Information and Management Systems Society

(HIMSS)• National Alliance for Health Information Technology

(Alliance)

• Formed panel to nominate first Commissioners

• Provided seed funding for launch• First official meeting Sept 14, 2004

Slide 5

Mission of CCHIT

To accelerate the adoptionof robust, interoperable HIT

throughout the US healthcare system,

by creating an efficient, credible, sustainable mechanism

for the certification of HIT products.

Slide 6

Scope, Timeline, and Deliverables

• Initial scope• Certify EHR products for physician

offices• Timeline

• Pilot process ready in Summer 2005• Deliverables:

• Operational capability for certification • Roadmap forecasting future certification

plans 2-3 years ahead

Slide 7

Ambulatory Care and HIT:A Critical Need

• Primary site for delivery of:• Chronic disease management• Preventive care

• System needs addressable with HIT:• Quality improvement• Patient safety• Portability of patient records

Slide 8

EHR Adoptionin Ambulatory Care

• Clinical IT penetration level is low:1 • Small offices (i.e. most doctors): 7%• Groups of 50 doctors or more: 20%

• Barriers to EHR adoption:• Cost of system• Risk of failure, incompatibility,

obsolescence• Lack of positive incentives

1 Center for Studying Health System Change, Sept 2004

Slide 9

Standards and Certification Create “Tipping Points” in Technology

Adoption

The IBM-standard PC launched the personal computing revolution

The Ethernet networking standardgave those PC’s connectivity

Wi-fi certification made connectivity available almost anywhere

Slide 10

How Product CertificationCan Accelerate HIT

Adoption

• Increase the confidence of providers to invest in and adopt HIT

• Ensure interoperability of HIT products within the emerging health information infrastructure

• Enhance the availability of HIT adoption incentives from public and private purchasers/payers

Slide 11

The EHR Adoption Deadlock

Payers/Purchasers

ProvidersIT VendorsWon’t buy EHRs until

costs and risks are lower and/or incentives higher

Can’t bring down costs until provider

adoption accelerates

Won’t offer incentives unless benefits and

interoperability of EHRs are assured

Slide 12

Getting the Wheels Turning

Payers/Purchasers

ProvidersIT Vendors

Beneficial effects andinteroperability assured,

unlocking incentives

Reduced risk andavailability of incentives

accelerates adoption

Growing marketattracts investment,

lowers costs

Slide 13

CCHIT Organization

CCHITCommissioners

Business Operations Committee

Program Management

Team

Work Group:

Functionality

Work Group: Inter-

operability

Work Group:Security & Reliability

Work Group:Certification

Process

Advisory Councils and Liaisons:- Vendor Associations- Provider Organizations- Payer/Purchaser Organizations- Standards Development Organizations

Slide 14

Composition of the Commission

• Three key constituencies (2 – 4 from each):

• Providers• Vendors• Purchasers/payers/coalitions

• Other at-large stakeholders (2 – 4 total):• Government HIT leaders (e.g. ONCHIT, CMS) – note:

ex-officio, nonvoting role• Standards development organizations (e.g. HL7)• Others, e.g. healthcare consumer advocates, etc.

Slide 15

Commissioners

• C. Martin Harris, MD – Cleveland Clinic• Douglas Henley, MD – AAFP• John Hummel – Sutter Health• John Tooker, MD – ACP• Graham O. King – McKesson Corp• Jane B. Metzger – First Consulting • Andrew G. Ury, MD – PMSI

• Suzanne Delbanco – Leapfrog• Charles Kennedy, MD - Wellpoint• Reed Tuckson, MD – United Health• Susan Postal – HCA• Sam Karp – CHCF• Wes Rishel – HL7

• Mark Leavitt, MD, PhD (Chair) – HIMSS

• Lori Evans – ONCHIT (nonvoting)• Clay Ackerly – CMS (nonvoting)

Slide 16

Key Stakeholder Relationships

Payers with Incentivesfor IT Adoption orIT-Enabled Quality

CertificationCommission

HIT Vendors

HIT Customers(Medical Practices)

HIT Standards Organizations

Information on market & needs

Increase confidence in investment

Information on current and future state of products

Accelerate market; roadmap of future expectations

Commitment to incentivesfor certified products

Assurance that certified products, properly deployed, can deliver results

Standards against whichcompliance can be tested

Feedback on current standards;drive development of new standards

Slide 17

Guiding Principles

• Need for decisive private-sector action now• Must seek input and deliver a compelling

value for all key stakeholders and the larger healthcare community

• Most operate in credible, objective, and collaborative manner

• Certification must be objective, laboratory verified to the greatest extent practical

• Must be efficient, fast, and low in cost

Slide 18

Key Points to Clarify

• Product Certification is different from:• Organizational Accreditation• Professional Certification

• Certification is binary, i.e. “pass/fail”• Not a subjective, comparative “points” rating

system• A voluntary process

• Initial requirements must be market reality-based• A forward-looking requirements roadmap provides

the best means to influence market direction

Slide 19

Certification Roadmap Concept

Final 2005 Requirements

Forecast 2006 Requirements

Forecast 2007 Requirements

Final 2005 Requirements

Forecast 2006 Requirements

Forecast 2007 Requirements

Final 2005 Requirements

Forecast 2006 Requirements

Forecast 2007 Requirements

AmbulatoryEHR

ProductAttributes

Functionality

Security& Reliability

Interoperability

Current Year 1 Year Ahead 2 Years Ahead

Slide 20

Project Status

• Work Groups now completing Phase I – Data Gathering

• Reference material on standards and other efforts

• Stakeholder priorities• Availability in marketplace

• Gain broad stakeholder input• Post for public comment (~April)• Conference calls and online comment

mechanisms• Outreach and communications program

Slide 21

Tasks Ahead

• Phase II – Draft Certification Requirements• Balance stakeholder desires, marketplace availability,

testability, burden and cost• Second public comment cycle

• Pilot/beta testing of certification• Confidential testing of initial set of products/vendors• Refine requirements and testing methodology

• Launch 2005 deliverables• Begin accepting applications and granting certification• Release forward-looking roadmap

Slide 22

Summing Up

• CCHIT successfully launched and operating• Goal is to accelerate the adoption of robust,

interoperable HIT -- while delivering value to providers, vendors, and purchasers/payers

• Ambulatory EHR is initial focus, with first step certification in summer 2005

• Commission to also deliver a forward-looking roadmap of certification plans to the industry

Q and A

For more information: www.cchit.org

Submit your questions and comments at the website