A complete, certified EMR necessary for 'meaningful use'

Monday in FierceHealthIT, I discussed the new ONC Certified Health IT Products List. CHPL, or "The Chapel" in wonk-speak, is supposed to be the final word on EMRs certified as being capable of helping providers earn federal subsidies for "meaningful use."

After a few launch-related hiccups, CHPL now seems to be running smoothly, and the industry seems to be accepting it. "The CHPL is the authoritative source," Rik Drummond, CEO and chief scientist of the Drummond Group, one of three organizations authorized by ONC to certify EMRs, told me this week. An ONC official confirmed to me that each certification body must submit weekly reports that will be used to update the list (which also explains why there might be a short lag time before new certifications get posted).

The CHPL has the certification numbers that providers will have to include on their attestations of meaningful use they will submit to CMS in order to receive Medicare and Medicaid bonus payments.

Still, there are plenty of lingering questions and issues about certification. For one thing, I learned at last week's College of Healthcare Information Management Executives conference in Chandler, Ariz., that providers must have EMRs capable of meeting all of the metrics for Stage 1 meaningful use, even though some of the measures are optional until Stage 2 in 2013. "You're going to have to buy some of the things you're not necessarily planning on using," said Pamela McNutt, a CHIME board member who is vice president and CIO at Methodist Health System in Dallas.

"The only optional point is whether the EHR can report a breach," added Pat Becker, a health IT consultant and a Certification Commission for Health Information Technology commissioner.

If you want to know more about how some people are reacting upon learning of this provision, check out the Meaningful Use Answers group on LinkedIn. One post says it could be a "nightmare" for vendors of specialty systems.

It is for exactly this reason why CCHIT, which has been certifying EMRs on a voluntary basis since 2006, decided to keep its "CCHIT Certified" program in addition to its new, ONC-sanctioned certification track, specifically for "special populations, special settings and specialty medicine," CCHIT Executive Director Alisa Ray explained at the CHIME meeting.

"It's more assurance of integrated functionality, interoperability and security to healthcare providers," Ray said. She added that the modular testing of the CCHIT Certified program will help many providers "fill in gaps" in functionality by adding modules to an existing EMR installation.

From the sounds of things, the more assurance providers can get, the better. After working to make EMR usage "meaningful," the last thing a provider wants to do is miss out on stimulus funding because small parts of a modular EMR aren't up to federal standards. - Neil