A recent poll from IT consultancy CapSite reveals some deep levels of confusion around EHR certification, the cornerstone of qualifying for meaningful use incentive money. Some 800 group practices answered questions about their understanding and perception of what certification is, and if this poll is any indication, the feds have a big job of education on their hands. While 90 percent of respondents understand the value of certification, just over half believed—falsely—that CCHIT certification is required to qualify for any stimulus money. And nearly 70 percent did not know there would be alternatives to CCHIT certification.

As it stands today, there is no official certification body, but Chicago-based CCHIT (Certification Commission for Health Information Technology) has applied to become one. And here’s where the story gets a bit convoluted. In fact, CCHIT has applied to be one of the government’s “temporary” certifying organizations, an interim step before a permanent certification program takes effect in 2012.  In addition, some 30-plus other organizations have made similar applications, responding to the government’s call for proposals spelled out in its dubiously named “final rule for temporary certification.”

This temporary status would expire in a year, after which, CCHIT, or any other group, would need to re-apply to become a permanent certifying group. Meanwhile, several of the Regional Extension Centers—organizations initially funded by the government to help group practices adopt EHRs and qualify for the stimulus money—have named “solution partners,” namely recommended EHR vendors for physicians to consider. Help!

The need to put a giddy-up on the accreditation process—or the temporary one at least--has not been lost on Michigan Congressman John Dingell, a sponsor of the enabling legislation. Earlier this week, Dingell grilled HHS officials, including David Blumenthal, the national coordinator for health IT, about their plans, urging them to move as quickly as possible. According to Inside Health Reform, Dingell also suggested that if eligible physicians and other providers "don't know what systems will pass the test, they will be slow to go out and buy it."

No kidding. Not only do practices not know which systems will pass, they’re not even sure about whose grades to believe. It doesn’t help when the regional extension centers jump the gun either.

Now don’t get me wrong, I think Blumenthal and his office have done yeoman’s duty in trying to pull off this massive—and quick—investment in EHR technology. He’s merely carrying out the marching orders from Congress. At the same time, with so many uncertainties afloat, many of the paper-based group practices the incentive program is trying to help might opt out from wading into an EHR adoption which is all but guaranteed to be disruptive.
As one physician reminded Congress earlier this week, these are tough economic times for many group practices. Roland Goertz, president-elect of the American Academy of Family Physicians, testified about the EHR incentive program before the House Energy and Commerce Subcommittee on Health. Not only are small practices strapped financially, they lack the resources to undertake an EHR deployment by themselves, he said, urging Congress to closely monitor the management of the incentive program. “Practices are at their maximum capacities for change,” he said. 



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