The Certification Commission for Healthcare Information Technology is an independent, non-profit organization that examines and certifies Electronic Medical Records (EMR) software based on a standard set of criteria. Their goal is to “accelerate the adoption of robust, interoperable healthcare information technology…” The idea is to take the uncertainty out of selecting an EMR. They want physicians to think that any CCHIT-certified EMR will provide quality and functionality.

Is CCHIT really necessary? Back when I was in grad school, we had a saying: “The great thing about computer standards is there are so many of them.” The same thing could be said about EMRs. Interoperability is important, but CCHIT has a few problems. First, CCHIT is quite expensive. Second, very few products are actually certified. Third, physicians may not need all of the features mandated by CCHIT.

CCHIT is expensive. Certification and first-year maintenance costs about $34,000, and EMR vendors must pay a yearly maintenance fee of $5,800 for the remaining two years of their certification. CCHIT is also a moving target. The requirements change each year. In addition to application fees, EMR vendors have to spend a considerable amount of manpower to keep their certifications current. These costs are passed onto customers, resulting in a very expensive product. The first year certification fee costs more than some EMR systems.

Few products are CCHIT certified. An interesting article states that in 2006, 83 products were certified. In 2007, 51 products were certified, and in 2008, only 12 have been certified so far. That does not imply there are only 12 worthwhile products on the market. On the contrary, these numbers point to rapidly decreasing demand for certification. Vendors realize they can reinvest that money in their business and provide better products. It will be interesting to see how many EMRs are certified in 2009. If the trend continues, we can expect to see only five or six products certified.

Physicians may not need all of the functionality CCHIT requires. CCHIT certifications require an exhaustive list of features concerning functionality, interoperability, and security. While each of these things are important, physicians may only need the EMR equivalent of a Honda instead of a Rolls Royce. Both the Honda and Rolls Royce provide basically the same functionality; however, one is much more affordable for the average physician.

Custom software allows physicians to tailor their system, so they pay for only what they need. Interoperability is not a big problem, because most systems use Center for Medicare and Medicade Services (CMS) standards anyway. From a technical view, any system that can import and export XML or HL7 should be able to interoperate with other systems.

Rather than a mandatory benchmark, it seems that CCHIT is becoming irrelevant in the EMR marketplace. While its mission is a good one, it is too expensive and overcomplicates EMR software. Physicians do not need certified software to have a good system.

Ryan Ricks
Security Officer