More Related Content Similar to CMIO Summit 2011 | Karen Bell (20) More from TriMed Media Group (20) CMIO Summit 2011 | Karen Bell2. Topics
Why Certification?
Current Certification Programs
EHR Alternative Certification for Healthcare Providers or
EACH™
The EACH Process
Tips for Providers
The Future
Q&A
© 2011 CCHIT | Slide 2 | June 2011
4. Why EHR Certification?
Purchaser (provider and patient) protection -- system has
desired features and functions as advertised
Security – at least to a minimum set of testable criteria
Interoperability – includes standards for
Nomenclature
Messaging
Implementation guidance
Transport
Meet specific objectives -- i.e., government defined measures
Stimulate innovation – identify floor on which to innovate
© 2011 CCHIT | Slide 4 | June 2011
5. EHR Certification:
Providers Find Value
Measurement
Specialty-Specific
Workflow Support beyond Federal MU
Functionalities
(e.g., ACO)
Functionalities Plug-and-Play Data
Usability Testing
beyond Basic Interchange
and Rating
Federal Capability
Efficient Integration Real-world usage
Stronger Security
of Functionalities verification
Basic Federal Vendor Stability Data Portability
Compliance for and Support (future-proofing)
Meaningful Use
© 2011 CCHIT | Slide 5 | June 2011
6. Current Certification Programs
Provider and patient accountable
Multiple settings and specialties, each with its separate program
Multi-stakeholder engagement, piloting, and updating
ONC-ATCB certified
Developer focused (vendor or provider)
Eligible provider (ambulatory) and Inpatient settings only
Essentially one size fits all
Codified in federal regulation
© 2011 CCHIT | Slide 6 | June 2011
7. Two Certification Programs
Nature of certification Voluntary, robust Mandatory for $$$, to minimum
government standards
Criteria and Testing Volunteer subject matter experts Federal government
Tool Development
Providers served Many types of providers seeking greater Medicare and Medicaid eligible
assurance when investing in new EHRs; providers and hospitals seeking
specialty options available incentive payments
Technology certified Comprehensive, integrated EHRs + use Broad, flexible array of EHR
verification, usability rating and vendor technologies: complete EHR and
characteristics EHR modules
Accountable to Providers Government
Goals Assurance of functionality, interoperability, Meaningful use (as defined by CMS)
security; meet provider needs for to improve outcomes of care,
transparency of product support health reform
© 2011 CCHIT | Slide 7 | June 2011
10. Three Steps to the Meaningful Use
Incentive Payment Process
Step 1: Step 2: Step 3:
Adopt certified Achieve Apply
EHR technology meaningful use for payment
EHR is certified by an Hospital or Eligible Hospital or Eligible
ONC-authorized Provider achieves Provider submits data
testing and certification Meaningful Use or reports in a manner
body against ONC- goals, objectives, and defined by CMS and
developed criteria and measures published collects payment
standards and NIST by CMS
test procedures
© 2011 CCHIT | Slide 10
11. Federal definitions of
certified EHR technology
Complete EHR: able to perform, at a minimum, all of the
applicable capabilities required by certification criteria adopted
by the Secretary, and thereby, as providing eligible
professionals or eligible hospitals with the technical
capabilities they need to support their achievement of
meaningful use of certified EHR technology
EHR Module: any service, component, or combination thereof
that can meet the requirements of at least one certification
criterion adopted by the Secretary
Qualified EHR: Either a complete EHR or a collection of
modules that are certified to meet every certification critierion
© 2011 CCHIT | Slide 11 | June 2011
12. ONC-ATCB 2011/2012 Hospital Criteria
A provider must
possess “certified
EHR technology”
meeting all criteria
to qualify
for incentives
From CCHIT’s Certification Facts™ product
listings
© 2011 CCHIT | Slide 12 | June 2011
13. Finding more information about ONC
criteria and test procedures
ONC’s website with a link to “Standards
and Certification Criteria for Electronic Health Records”
NIST’s website with a link to “Approved Test
Procedures”
© 2011 CCHIT | Slide 13 | June 2011
14. Lesson Learned: IT’S COMPLICATED!!
Provider developers and vendor developers have different missions,
business strategies, and objectives for their EHRs
Many hospitals (and some physicians) use combinations of the above
(best of breed approach) to meet their strategic objectives
ONC criteria (modules) may not match clinical workflows
A model of obtaining “certified EHR technology” from a vendor fails
when:
Health IT is partly or fully self-developed
A product has been significantly customized
A commercial product version is too old to be upgraded
A hospital is in a multi-year product upgrade or conversion
A vendor has chosen not to present an updated EHR for ONC-
ATCB 2011/2012 certification
© 2011 CCHIT | Slide 14 | June 2011
15. Where providers can find ONC-ATBC
certification results
ONC’s Certified HIT Products List (CHPL) Web Page
All certified Complete EHRs and EHR Modules that meet the
definition of Certified EHR Technology (from all ONC-ATCBs)
Providers electing to combine Modules use the CHPL to validate
whether the Modules they have selected satisfy all of the applicable
certification criteria
Generates ID number required for CMS application
CCHIT’s “Find Products” Web Page (inspected by us)
An aggregate, cross-indexed product listing with a faceted search
capability to help providers find products that meet their needs
An individual product page includes all of the ONC reporting
requirements
© 2011 CCHIT | Slide 15 | June 2011
17. EHR Certification Alternative for
Healthcare Providers (EACH™)
A certification alternative for hospitals and eligible
providers who are
Self-developing or significantly customizing EHR technology
Using older, uncertified EHR technology
Needing gap closure due to a mix of certified and uncertified
EHR technologies
Alternative certification is not needed if a hospital or
eligible provider has adopted an EHR with Complete
certification, or a combination of certified EHR Modules
supporting all Meaningful Use objectives
© 2011 CCHIT | Slide 17 | June 2011
18. How do we know if
we need EACH?
© 2011 CCHIT | Slide 18 | June 2011
19. First – check your eligibility
Review the CMS requirements for
eligibility at their EHR Incentive
Program web site. If you are an
eligible professional, you can use
their Eligibility Wizard.
Click here
© 2011 CCHIT | Slide 19 | June 2011
20. What’s the process?
Determine Certify your Register to
your products and participate in
certification retrieve CMS the EHR
needs Identifier from Incentive
ONC Program
© 2011 CCHIT | Slide 20 | June 2011
21. Examples of certification scenarios –
which are you?
A single, uncertified system
A mix of systems, some certified EACH
Many sites with many different systems
© 2011 CCHIT | Slide 21 | June 2011
22. A single, uncertified system
CMS
Self-developed Complete EHR EACH ID
All criteria are applied for with one system in
use at one location or multiple, identical
locations, a Complete EHR certification is
granted with one CMS ID
© 2011 CCHIT | Slide 22 | June 2011
23. A mix of systems, some certified
170.302(a)
170.302(b)
Vendor-certified CMS
product ID
170.302(c)
170.302(d) EACH
Self-developed
© 2011 CCHIT | Slide 23 | June 2011
24. Many sites with many different systems
170.302(a)
170.302(b)
170.302(c)
170.302(a) CMS ID
170.302(b) EACH CMS ID
170.302(c)
170.302(a) MyEHR
170.302(b) Uncertified Vendor Product
170.302(c) Self-Developed Product
Certified EHR
© 2011 CCHIT | Slide 24 | June 2011
26. Three phases in the EACH Program
Preparation Readiness Certification
Online program Online self-assessment Inspection scheduled
orientation tool with learning program when applicant is prepared
Introduction to the Site inventory and gap Virtual web-based testing
EACH online community analysis of criteria not using ONC criteria and
of hospitals covered by certified EHR NIST test procedures
technology
Team formed and ready Certification results
for self-assessment Certification learning reported and sent to ONC;
program with toolkit listed at cchit.org
including test scripts and
interoperability guide Retests available
© 2011 CCHIT | Slide 26 | June 2011
27. SR17
Phase 1: Preparation
Create an account at
each.cchit.org
Take a learning course and
understand what testing and
certification mean to you
© 2011 CCHIT | Slide 27 | June 2011
28. Slide 27
SR17 Insert screen shot of orienation learning program
Sue Reber, 11/29/2010
29. SR18
Phase 1: More Preparation
Explore Resources
Participate in our
- Community
- Weekly Webinar
© 2011 CCHIT | Slide 28 | June 2011
30. Slide 28
SR18 Insert screen shot of orienation learning program
Sue Reber, 11/29/2010
31. SR19
You may certify a
complete EHR to meet
Phase 2: Readiness all criteria
You may certify an EHR
module to meet just a few
criteria
© 2011 CCHIT | Slide 29 | June 2011
32. Slide 29
SR19 Insert shot of application
Sue Reber, 11/29/2010
33. SR20
Phase 2: More Readiness
Creating an inventory
to assess your gaps
Build a plan to fill in
your gaps
© 2011 CCHIT | Slide 30 | June 2011
34. Slide 30
SR20 Insert shot(s) of assessment tool
Sue Reber, 11/29/2010
35. Phase 2: More Readiness
Practice
demonstration
& customized
reports Readiness reports
can also be used
as Medicaid
attestation
documentation
© 2011 CCHIT | Slide 31 | June 2011
36. Phase 3: Certification
CCHIT
Tester
Healthcare
Web conferencing and providers follow
concurrent audio Test Script to
conferencing demonstrate EHR
technology at their
facility
© 2011 CCHIT | Slide 32 | June 2011
37. End Result of Certification
Reported to
ONC-CHPL
and
CMS EHR
Certification ID
rendered
© 2011 CCHIT | Slide 33 | June 2011
39. Which ambulatory certified product(s)
might work best for you?
ONC ATCB 2011/2012 only
Experienced in health IT or have your own self developed system
Desirous of a “niche” product or other technology for which there is
not a CCHIT Certified® program at present
CCHIT Certified® only - providers for whom there are no
incentive payments
Dual Certification: CCHIT Certified® and ONC-ATCB cert
Just about everyone else in the ambulatory environment!
Specialists who want available specialty certification and incentive
payments
© 2011 CCHIT | Slide 35 | June 2011
40. Approaching Hospital EHR Certification
Check with your vendors as to their intent to certify… and to which criteria
If vendor has an ONC-ATCB certified complete EHR, go no further (must use
it)
If using an older version of a vendor product, ask for Privacy and Security
upgrade, and modular certification of whatever is compliant with ONC criteria
Conduct your own gap analysis on older (or self developed) products and
services (using the NIST test procedures for each ONC criteria) to determine
extent of upgrades and additional modules necessary to achieve compliance
(CCHIT’s readiness program can help)
Consider cost of investment, ROI and fit with timing of current business plan
Buy, build or update as needed
Proceed with an EACH certification
© 2011 CCHIT | Slide 36 | June 2011
42. More Lessons Learned
Need to pilot NIST developed test procedures before “go live”
Need to assure that all criteria can be objectively tested
Time intensive interoperability testing, but no testing of actual ability to
exchange data in the native environment
No guarantee that “receivers” can accept data
Note that not all CQM measures need to be tested and certified as part
of EP “calculate and report quality measures” criterion
Some criteria need greater specificity, some need less
Hospitals who use “best of breed” may need multiple, duplicative
modules
An evolutionary process, learn as we go
© 2011 CCHIT | Slide 38 | June 2011
43. Near Future
ONC Certification
Stage Two Meaningful Use, Standards, and Certification Criteria (2013?)
Transition from 6 ONC Authorized Testing and Certifying bodies to a
limited set of Testing labs overseen by NIST and ONC authorized
Certification bodies – can be the same entity – but certifications to remain
active until new criteria are released
Permanent Certification rule calls out certification for HIT other than EHRs:
PHRs, remote monitoring devices, HIE entities
Always tied to MU objectives and measures
CCHIT Certified®
Only ONC certification organization to go beyond federal minimum
Continues to match HIT innovation with new, complimentary certification
processes that focus on provider/patient protection and patient care
© 2011 CCHIT | Slide 39 | June 2011
44. In Summary
CCHIT is an ONC-ATCB for ONC-ATCB 2011/2012
certification for both vendors and providers
CCHIT also offers a number of CCHIT Certified®
vendor programs (since 2006)
We have immediate capacity for EHR testing in all
programs
We offer an EHR alternative certification for both
hospitals and eligible providers called “EACH” to help
providers qualify for ARRA funds
CCHIT has limited scholarships for CAHs
© 2011 CCHIT | Slide 40 | June 2011
45. Questions & Answers
Karen Bell kbell@cchit.org
More information available at
cchit.org and at EACH
© 2011 CCHIT | Slide 41 | June 2011