Fewer certified EHR programs could mean higher prices
Certified EHRs are supposed to be the best, and the kind the feds want you to buy, but the number of programs attaining this status has tailed off big-time.
EHR certification is part of the federal push for a nationwide health information network. The US Department of Health and Human Services contracts with a private group called the Certification Commission for Healthcare Information Technology to certify EHR programs that can perform basic tasks such as creating and displaying problem lists, checking for drug interactions, and issuing reminders about overdue tests. The feds won’t let a hospital subsidize an EHR for you unless it has this stamp of approval.
Ninety programs were certified under the initial set of standards that CCHIT issued in 2006. However, CCHIT introduces new and tougher standards each year. That may explain why only 24 programs have been certified so far based on 2007 CCHIT criteria. The organization is still processing 27 applications that came in by the March 31 deadline for certification based on last year’s standards. However, even if all of them are approved, the total number of programs certified as meeting the 2007 criteria would only come to 51.
One key reason for the fall-off is the CCHIT requirement introduced in 2007 for electronic prescribing, says Mark Anderson, CEO of AC Group, a healthcare IT consulting firm in Montgomery, TX. “A lot of vendors don’t have this,” says Anderson, who notes that true e-prescribing is not merely faxing an Rx to a pharmacy, but transmitting it on a computer-to-computer basis. Anderson predicts that vendors will have an even harder time meeting the proposed criteria for 2008, which require EHRs, among other things, to be able to swap patient medical summaries with each other.
Adding such features to an EHR can translate into hundreds of thousands of dollars in programming costs for a vendor. In light of this expense, only the biggest and most well-heeled companies will be able to keep up with ever changing CCHIT criteria. “I think only 27 vendors will be able to pass this next set,” says Anderson.
EHR vendors lacking certified products probably won’t survive in the marketplace, says Anderson, who expects the number of EHR vendors to decline from roughly 390 today to less than 50 in 2012. While a smaller field of vendors simplifies shopping for an EHR, it also will raise prices, he notes.
Many doctors consider EHRs already too pricey. The average cost for nine programs certified under the 2007 CCHIT criteria was close to $30,000 per doctor over three years, according to a recent study by AC Group.
CCHIT spokesperson Sue Reber says another reason for the decline in certified programs is that since certification is good for three years, some vendors in the CCHIT class of 2006 may wait until 2009 before they reapply. Nevertheless, CCHIT is pleased with the number of vendors that have sought certification under the 2007 criteria, says Reber. “Vendors see certification as a competitive necessity.”
[Via Medical Economics’ InfoTech Bulletin]
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Fewer certified EHR programs on the market……
This is a hot topic for a couple reasons, EMRs already have the tag of being expensive for the physician…
CCHIT certification is all the buzz in the EMR world and physicians are being told that they may NEED to have a CCHIT certified product in order to be eligible for certain tax credits related to purchasing an EMR. But the fees associated with applying for CCHIT certification is cost prohibitive for many smaller EMR vendors. As a result, this creates an elite group of vendors who have the financial capabilities to pay for the cost of certification, and leaves those smaller vendors out in the cold. Also, many EMR vendors are not seeking certification because they are waiting to see just what CCHIT will become, as it seems to be losing some ground in it’s momentum lately as evidenced by the dwindling numbers of CCHIT certified EMR vendors. Also noteworthy is the fact that CCHIT is a not-for-profit organization and is not any kind government entity.
Many EMR vendors shy away from seeking certification not only due to the cost, but also due to the fact that many specialty-specific EMRs are being required to spend tens of thousands of dollars in programming costs so that their product can include needless items like, for example, growth charts for ophthalmology, just so their product can pass CCHIT certification requirements.
In addition to the thousands of dollars spent on programming, the approximate cost to seek and maintain CCHIT certification is a staggering $28K, which includes a nearly $5000 annual maintenance fee. In addition to that, once a vendor’s 5.0 version, for example, becomes CCHIT certified, and they release subsequent versions, those versions must also go through the entire CCHIT certification process again and once again, the software vendor must pay anywhere from 50%-100% of that cost once again depending on what type of changes were made in the new version. Also, CCHIT certification is only in effect for 3 years and vendors must pay nearly $5K annually to maintain CCHIT certification or their name is removed from the CCHIT’s list of certified vendors. Once the certification has expired, the vendor must reapply to begin the certification process all over again.
In my opinion, the CCHIT certification process is akin to a form of extortion. Someone is making a lot of money off the EMR vendors and the software vendors are then forced to pass along these costs to physicians in the form of higher software costs. Ultimately, somebody at a not-for-profit organization is making a lot of dollars and there doesn’t seem to be anyone standing up and saying, “enough is enough”. If a product has already passed the required standards for certification, why would an “enhanced” version of that product be subject such rigorous scrutiny and costly fees once again?
EMR vendors are being held hostage. What will it take to get someone to stand up and put a limit on the fees that EMR vendors should have to pay to seek and maintain CCHIT certification.
Jamie M. Zayach
Salt Lake City, UT