Appearance is everything in CCHIT debate

It's crunch time in the health IT industry, which could learn today how HHS plans to define "meaningful use" of EHRs, as required by the stimulus legislation. It's an equally important time for the Certification Commission for Healthcare Information Technology, which soon could learn its own fate.

CCHIT has come under fire this year from critics, both legitimate and shadowy, who have questioned the commission's independence from health IT vendors and whether its certification programs help customers pick EHRs that truly will improve care quality and efficiency. The rhetoric is heating up again.

It should surprise no one that the HIMSS Electronic Health Record Association wants CCHIT to be the only recognized body for certifying meaningful use of health IT. After all, HIMSS co-founded CCHIT and, according to a rather unflattering story in the Washington Post, technically kept CCHIT Chairman Dr. Mark Leavitt on its payroll through last year. The EHRA stated its case in a letter to the HIT Policy Committee's certification/adoption workgroup this week, a federal panel that will make recommendations to the Office of the National Coordinator for Health Information Technology on how to spend federal stimulus money and develop the Nationwide Health Information Network.

However, the American Medical Informatics Association, which includes many physician informaticists from the academic world, told the committee that the current certification process is insufficient to assure truly meaningful use of health IT. "We believe that highly prescriptive and detailed, one-size-fits-all requirements will ultimately be counter productive," AMIA stated.

Montvale, NJ-based vendor SRSsoft likes to boast whenever a customer replaces a pricey, clunky CCHIT-certified EMR with the company's modular "hybrid" EMR, as happened again this week.

Another particularly unflattering story to CCHIT and HIMSS appeared in the Dallas Morning News on Tuesday. "[Dallas health IT attorney Richard] Kneipper and other critics argue that the commission has too many ties to industry groups to be the lone gatekeeper. The commission's leaders contend that they are independent from the industry. But after three years of certification, most systems still don't--and can't--communicate easily with one another, according to health care technology experts," the paper reports.

"I don't think the certification process has been particularly relevant so far," Kneipper is quoted as saying. "It's going to be very relevant for the purpose of having a toll gate for who gets into the stimulus money or not."

It's becoming clearer every day that even the appearance of a conflict of interest between CCHIT and the vendors it certifies could taint the entire effort. Perhaps it's time for the commission to face some competition, or morph into something less controversial. - Neil