Certification Commission

for Healthcare

Information Technology

Town CallAn Exciting Year Ahead for Certification:

An Invitation to Join Us

Mark Leavitt, MD, PhD – Chair

Alisa Ray, Executive Director

Kari Taylor-Atkins, Certification Development Director

Sue Reber, Marketing and Outreach Director

Mar 17, 2009 (updated Mar 23, 2009)

Agenda

•Looking back: what you - our volunteers - have

accomplished

•A turning point in health IT: the American

Recovery and Reinvestment Act (ARRA)

•Looking ahead: our new environment

•An invitation to join us: how to volunteer

•Q & A: responses to Town Call questions @

ehrdecisions.com

© 2009 | Slide 2 | Mar 23, 2009

Looking Back:

What You –

Our Volunteers –

Have Accomplished

© 2009 | Slide 4 | Mar 17, 2009

Together, we have...

• Started a brand-new certifying organization (2004)

• Won a 3 year, $7.5M Federal contract from HHS/ONC (2005)

• Met every contractual commitment and deliverable

– Developed and pilot tested certification criteria using an open,

voluntary, consensus-based process

– Developed robust, efficient inspection mechanisms

• Gained Federal recognition as a certifying body (2006)

• Become an independent, nonprofit 501(c)3 organization (2007)

• Launched and updated multiple certification programs

– Ambulatory EHR (2006), Inpatient EHR (2007), and HIE (2008)

– Expanded to additional specialties, settings, and populations

beyond HHS contract, in response to eager stakeholders

• Attracted more volunteers every year (>200 now)

© 2009 | Slide 5 | Mar 17, 2009

Remember This?

Payers/Purchasers

ProvidersIT Vendors

Beneficial effects and

interoperability assured,

unlocking incentives

Reduced risk and

availability of incentives

accelerates adoption

Growing market

attracts investment,

lowers costs

A Turning Point in

Health IT:

The American Recovery

and Reinvestment Act

(ARRA)

© 2009 | Slide 7 | Mar 17, 2009

Putting Health IT under ARRA

in Historical ContextApollo Program ARRA/Health IT

National goal Manned spaceflight to the moon Electronic health records for every

American

Level of leadership Presidential:

John F Kennedy

Presidential:

Barack Obama

Timeframe 1961 – 1969 (8 years) 2009 – 2014 (5 years)

Driver Scientific exploration +

National security

Enabler of health reform + Economic

recovery

Total government funding $22B (1969 dollars) $19B (2009 dollars, net after

anticipated cost savings)

Management NASA (gov‟t agency) HHS/ONC (gov‟t agency)

Execution Multiple contractors (private sector) Multiple contractors (private sector)

[note: educated guess]

Major challenges • Developing multiple, completely

new technologies

• Safety of astronaut lives

• Accelerating deployment of

technologies

• Transforming care delivery to

improve quality and reduce costs

© 2009 | Slide 8 | Mar 17, 2009

Funding Flows

under ARRA

Source: “An Unprecedented Opportunity: Using

Federal Stimulus Funds to Advance Health IT in

Califormia,” California Health Care Foundation,

accessed at

www.chcf.org/documents/chronicdisease/AnUnprec

edentedOpportunity.pdf

© 2009 | Slide 9 | Mar 17, 2009

ARRA Certification Language

• “The National Coordinator, in consultation with the Director

of the National Institute of Standards and Technology, shall

keep or recognize a program or programs for the voluntary

certification of health information technology as being in

compliance with applicable certification criteria adopted

under this subtitle.”

• To be eligible for the Medicare or Medicaid incentives, a

professional must be a “meaningful EHR user” and satisfy

each of the following requirements:

– “Meaningful use of certified EHR technology”

– “Information exchange”

– “Reporting on measures using EHR”

© 2009 | Slide 10 | Mar 17, 2009

CCHIT under ARRA

• We are confident CCHIT will be a Federally recognized

certification program under ARRA

– CCHIT has been Federally recognized since 2006

– Certification has high uptake in the vendor marketplace and high

recognition in the provider community

– A substantial number of EHR products are currently certified and

„adoption-ready‟

• We do not believe ONC would choose to reinvent certification

– ARRA‟s aggressive timeline -- adoption incentives start in 20 months –

requires purchases and implementations to begin immediately

– ONC has many other challenging new programs to develop

• But CCHIT must be flexible and responsive to its new environment

Looking Ahead:

Our New Environment

Previous Environment

Standards

Harmonization

HITSP CCHIT:

Certification

of Health IT

products and

services

Privacy & Security

Policies, Laws,

Regulations

Office of the National Coordinator

American Health Information Community

and AHIC Workgroups

NHIN Prototype

& Implementation

Projects

Harmonized

Standards

Network

Architecture

Privacy

Policies

Certification

of EHRs

and HIEs

Strategic Direction +

Breakthrough Use Cases

Accelerated

adoption of robust,

interoperable,

privacy-enhancing

health IT

© 2009 | Slide 12 | Mar 23, 2009

Health IT

market insight

and research

Volunteer Participation & Public Comment

from Multiple Stakeholders

New Environment

HIT Policy Committee

( established by ARRA;

FACA-compliant)

CCHIT

Other Contracting

entities TBD

Secretary of HHS

Other Contracting

entities TBDCertification

of EHRs and HIEs

Office of National Coordinator (established by ARRA; budget $2B

HIT Standards Committee

( established by ARRA;

FACA-compliant)

Volunteer Participation & Public Comment

from Multiple Stakeholders

Health IT

market insight

and research

Approval/RecognitionRecommendedCertification Criteria

Priorities

*Accelerate adoption

*Reduce risk

*Ensure interoperability

*Protect privacy

+Qualify EHRs for

incentives totaling $34B

Office of Health Reform

© 2009 | Slide 13 | Mar 23, 2009

Recognition of Criteria by

HHS/ONC

CCHIT 09 Criteria

that are recognized

Existing

criteria

that may

be omitted

from the

recognized

set

New criteria

that must

be added

to the

recognized

set

09 CCHIT Criteria

(Published May 2009)

HHS/ONC Recognized

Certification Criteria

(late 2009?)

HHS/ONC has

alternatives:– 09 criteria

– 08 criteria

– Subset (e.g., omit some

functionalities -- if HHS

goal is to increase number

of available products)

– Superset (e.g., advanced

interoperability, quality

measurement – if HHS

goal is to accelerate

interoperability, quality

measurement)

© 2009 | Slide 14 | Mar 23, 2009

© 2009 | Slide 15 | Mar 17, 2009

Meeting Even Higher

Expectations

• Increased level of responsibility

– Guardian of a major public investment

– Size of funding brings increased risk of fraud and abuse – „fake EHRs‟

– Privacy concerns heightened by speed and breadth of EHR adoption

– Expectations of certification no longer end with product testing – responsibility

extends to usability, meaningful use, quality measurement, data exchange – and

ultimately health IT‟s role in health reform

• Increased scale

– Expand to new domains – EHRs must be available for all providers and facilities

eligible for incentives

– Volume of EHR suppliers will increase – expect new capital investments, new

entrants to the field

• Economic stimulus as a goal

– Ensure a vibrant, competitive marketplace; address questions regarding open

source EHRs, self-developed EHRs, modular EHR technologies

Certification Commission

for Healthcare

Information Technology

An Invitation to Join Us:

How to Volunteer

© 2009 | Slide 17 | Mar 17, 2009

Help Update Existing Programs

Base Domain Certification Options(Add-on to Base Domain)

History/Status

Ambulatory EHR Launched May 06

Updated May 07

Updated July 08

Ambulatory Child Health Launched July 08

Ambulatory Cardiovascular Medicine Launched July 08

Inpatient EHR Launched August 07

Updated August 08

Emergency Dept Launched August 08

Amb+Inpt+ED Enterprise Launched August 08

HIE Launched Oct 08

PHR To be launched July 09

Stand-alone ePrescribing To be launched July 09

© 2009 | Slide 18 | Mar 23, 2009

Expansion RoadmapUpdated - March 23, 2009

Legend: R = Research (staff level); D = Start Development; L = Launch (tentative)

*Note: Advanced Security and Advanced Clinical Decision Support

have been accelerated from previous version of Roadmap published in February

Base Domain Certification Options

(Add-on to Base Domain)

09 10 11 12

Ambulatory EHR

Behavioral Health (as add-on) D L

Behavioral Health (as stand-alone) D L

Clinical Research D L

Dermatology D L

Eye Care R D L

Oncology R D L

Advanced Interoperability D L

Advanced Quality D L

Advanced Security* D L

Advanced Clinical Decision Support* D L

Long Term Care Spectrum D L

Obstetrics/Gynecology R D L

© 2009 | Slide 19 | Mar 23, 2009

Volunteer Workgroup Organization

Inpatient

EHR

Work Group

(IP)

Ambulatory

EHR

Work Group

(Amb)

Emerg Dept

EHR

Work Group

(ED)

Cardiovascular

Medicine

Work Group

(CV)

Stand-alone

ePrescribing

Work Group

(eRx)

Child Health

Work Group

(CH)

HIE

Work Group

(HIE)

Security

Work Group

(Sec)

Inter-

operability

Work Group

(IO)

Privacy

Work Group

(PRI)

PHR

Work Group

(PHR)

Long Term

Care

Spectrum

Work Group

(LTC)

Develop Base Criteria for a

Domain

Contribute Criteria for

Specific Attributes

Develop Criteria for

Optional Additional

Certifications

Behavioral

Health

Work Group

(BH)

For Development of ’10 (launch 2010) Criteria

Clinical

Research

Work Group

(CR)

Dermatology

Work Group

(DER)

Identify Criteria for

Modular Applications

Advanced

Quality

(AQ)

Advanced

Inter-

operability

(AIO)

New Work Groups and

Panels being formed

Advanced

Clinical

Decision

Support

(ACDS)

Advanced

Security

(AS)

© 2009 | Slide 20 | Mar 23, 2009

Volunteer Application

Process and Schedule• Application process

– Applications accepted March 26 to April 20, 2009

– Applications only accepted online: find link at www.cchit.org

– Indicate all positions you are interested in – member and/or

co-chair roles

– Existing volunteers must re-apply and supply updated

resume

– More detailed information on the application page on Mar 26

– Notifications in late May; public announcement in June

• Strengthened conflict of interest policy

– Applicants must disclose any financial relationship with a

vendor of certified or certifiable technology; if so, they are

assigned to Vendor stakeholder group

© 2009 | Slide 21 | Mar 23, 2009

What to Expect

• Term of service is July 1, 2009 to June 30, 2010

• Face-to-face kickoff meeting in July – date to be announced

• Regular meetings by teleconference

– May be weekly, biweekly, or less frequently, depending on

the group (new groups generally meet more frequently)

– Meetings usually last 60-90 minutes

• No alternates or substitutes may stand-in for the member

• Volunteers are responsible for their own expenses

• Volunteers may also be invited to serve on various panels

or task forces during the course of the year

• We are in a dynamic new environment – expect changes!

© 2009 | Slide 22 | Mar 17, 2009

Summing Up

• Congratulations to our volunteers who have

brought us to this day – you have had a

phenomenal impact

• ARRA has transformed our world: more

responsibility, larger scale, new stakeholders

• We expect new challenges, but we also expect

to thrive in this new environment

• We invite you to join us, or continue your

contributions with us!

Thank you!

For more information:

www.cchit.org

www.ehrdecisions.com