Certification Commissionfor HealthcareInformation Technology

Mark Leavitt, MD, PhD – ChairAlisa Ray – Executive DirectorDennis Wilson – Information Technology DirectorHyatt Regency McCormick Conference Center, Chicago, ILRoom 10dMonday, April 6, 2:00 pm – 3:00 pm CDTOnline participation: https://www1.gotomeeting.com/register/429901059

Dial in (877) 313-5342, ID # 91945091

Open Source ForumA Dialog on Certification ofOpen Source EHRs

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Agenda

•Facts about CCHIT•Discussion of issues and concerns foropen source developers

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Mission and Goals

Accelerate the adoptionof robust, interoperablehealth IT by creatingan efficient, crediblecertification process.

• Reduce the risks ofinvesting in health IT

• Facilitate interoperabilityof health IT

• Unlock adoption incentivesand regulatory relief

• Protect the privacy ofhealth information

Goals:Mission:

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History of CCHIT

HIE certification launchedOct 2008

Sept 2004 Founded by AHIMA, HIMSS, and NAHIT

June 2005 Eight more organizations contribute funding

Oct 2005 Awarded 3-year $7.5M HHS/ONC contract

May 2006 Ambulatory EHR certification launched

Oct 2006 Federal recognition as Certifying Body

Jan 2007 Becomes independent, nonprofit organization

Aug 2007 Inpatient EHR certification launched

July 2008 08 programs launched (2 updated programs, 4 newprograms)

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A Mission-Focused,Nonprofit 501(c)3 Organization

Board of Trustees Board of Commissioners

Executive DirectorAlisa Ray

Administrative

Kathy Shea, DirectorMerril PragerJen Degler

Marketing & CommunicationsSue Reber, Director

John MorrisseyRick Turoczy

Certification Development

Kari Taylor Atkins, DirectorShweta Trivedi

Certification Program

Bambi Rose, DirectorAmit Trivedi

Soloman AppavuDiana Rios

Michelle Knighton

Certification Technology

Dennis Wilson, DirectorVince Van de Coevering

Ben Uphoff

CO-CHAIRS STRATEGIC LEAD WORK GROUP

Steven LaneEric Rose

Kari Taylor Atkins Ambulatory EHR

Rick ReevesKathy Scanlon

Kari Taylor Atkins Inpatient EHR

Todd RothenhausSteven Stewart

Kari Taylor Atkins Emergency Dept EHR

A. John BlairMichael Kappel

Virginia Riehl Network

Ted EytanLory Wood

Jody Pettit PHR

Memo KeswickZebulon Taintor

Kari Taylor Atkins Behavioral Health

WORK GROUP STRATEGIC LEAD CO-CHAIRS

Cardiovascular Meredith Seidel Michael MirroMichael Paquin

Child Health Bonnie Cassidy Bobbie ByrneEugenia Marcus

Interoperability Amit Trivedi David TaoAlan Zuckerman

Privacy & Compliance Bonnie Cassidy Donald BechtelCassi Brinbaum

Security Soloman Appavu Khalid Al-MaskariRick Brady

22 staff facilitating the work of over 200 volunteers

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Openness and Transparency

• CCHIT Staff must disclose all conflicts of interest and maynot have a financial relationship with any vendor

• Volunteers must disclose all conflicts of interest• Stakeholder balance on CCHIT boards and volunteer work

groups is required and actively monitored. Limits areenforced on percentage from the vendor community, aswell as on the number of personnel from any one vendor

• Work groups must have two co-chairs from differentstakeholder groups

• Minutes of all Commission and work group meetings arepublished on the web

• ‘Town Hall’ and ‘Town Call’ community outreach meetings

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Inputs:* Scope Guidance from Commission* Roadmap (from previous year)* Future Directions (from previous year)* Environmental Scan: - Use Cases from AHIC - Standards from HITSP, SDOs - Market research - More

Criteria are developed through acommunity collaborative model

DevelopDraft Criteria

Refine Criteriaand DevelopDraft Test Scripts

ProposedFinal Criteriaand Test Scripts

Final Criteriaand Test Scripts

Public Commentperiods

Pilot Test

Launch“09”

Certification(July 2009)

Multi-stakeholder consensus-based processwith multiple cycles of public input

Sept2008

Dec2008

Mar2009

May2009

July2008

April2008

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Inspection Process

• “Open book” model – all criteria and test scripts arepublished in advance for all applicants to use inpreparation

• Strict conflict of interest policy for staff and jurors: nofinancial relationship with any vendor is allowed

• Cost-efficient – uses web-conferencing and other virtualpresence tools to avoid travel expense

• Robust retesting and appeal processes

© 2009 | Slide 9 | April 6, 2009= Driving direction

Product Attributes andInspection Methods

Functionality Security andPrivacy Interoperability

Self-attestation(documentation

review)

Jury-observeddemonstration

Technicaltesting

= Current methods

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Juror-ObservedVirtual Demonstration

Vendor personnelfollow Test Script todemonstrate systemat the vendor facility

Juror A(Practicingphysician)

Juror B(Practicing

NurseInpatient Products)

Juror C

Web conferencingand concurrent

audio conferencing

CCHIT Proctor

Jurors may not have a financial relationship with any vendor

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LAIKA Open SourceInteroperability Testing Tool

Manage Test Cases

View Test Data

View Results

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Vendor Mix (08 Certification)

$1-$10 million

37% 1 2-5 6-15 16-50 >50

Annual Revenue of Ambulatory EHR Vendors

Practice Sizes Servedby Vendors Applying

Number of Physicians in Practice

25%

50%

75%

Revenue and Size data from application data of certified AmbulatoryEHR 08 vendors as of March 2009; N=77; response rate 100%

< $1 million25%

$11-$20 million

13%

$21-$100 million

9%

> $100 million

7%N/A7%

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Ensuring the Flow of Innovation

•Continue to monitor vendor mix– Small vs large, new vs established, alternative deployment

models, price points

•Ensure EHR certification is accessible to allcorners of the market

– Commercial– Open-source– Self-developed– Modular

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Issues and Concerns ofOpen Source Developers

•Certification fees•Versioning requirements•Add here...

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Actions Discussed

•Add here...

Discussion and

Q & A

For more information:www.cchit.org