On October 7, CCHIT launched its new 2011 certification programs. We announced results from the first few inspections last week and have more underway, but with everyone eager for predictions about “life under ARRA” we thought it might be helpful to share some details that point to early trends.
Since opening up the two 2011 programs a month ago, we’ve received a total of 25 applications already. About two-thirds are for the CCHIT Comprehensive program – which aims for maximal assurance to EHR buyers — and one-third for the Preliminary ARRA program which maximizes flexibility instead.
Within the Comprehensive program, the optional add-on programs are proving popular, with a total of 12 applications seeking to demonstrate these extra qualifications. Although most Comprehensive applications are for Ambulatory EHR, as expected, we have Inpatient, Emergency Department, and ePrescribing vendors in the mix as well.
Under the Preliminary ARRA program, two-thirds of the products are for Eligible Providers and one-third are targeted to Hospitals. We’re also seeing a nice spread between vendors focusing on just a few meaningful use objectives, those aiming for all of them, and some more in between.
It’s too early for statistical analysis, but some things are becoming apparent. First, it looks like our decision to move ahead rather than waiting for final rules next summer was valid. And we believe these numbers will accelerate once the upcoming ONC and CMS postings help to reduce the general uncertainty. Second, it looks like a sizable and diverse group of certified products will be available in the pipeline, and that’s good news for the whole ARRA initiative.
But let’s not minimize the challenges ahead. We’ve also been gathering data on how well providers and hospitals understand the ARRA incentives, the role of certification, and the fact that having certified EHR technology is only the first step on a complex road to meaningful use. The scores here are not good. At a focus group we held for non-EHR-using physicians, awareness of the meaningful use concept was essentially zero. In recent conversations with hospital representatives, we find their understanding is much better, but fear and doubt scores run high.
We’re going to do our best to make certification efficient to obtain, and easy to understand, but explaining and motivating meaningful use to hundreds and thousands of doctors, nurses, and managers will take a coordinated effort from everyone in health IT. To do our part, we plan to increase the number of Town Calls and educational programs we offer, and we look forward to partnering with others in the public and private sector to maximize effective outreach and communications. We would be pleased to hear your ideas about how to take on this challenge as well.
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Share stories of providers who have successfully implemented EMR’s.
Providers don’t really need to know the nuances of certification nor even “meaningful use” they just want to hear what is in it for them and their patients. Providers will rapidly adopt anything that improves patient safety, quality, and improves the providers income and quality of life but it is a hard sell if the goal is “health It”.
Providers aren’t averse to new technology (do you know any without a crack-berry or Iphone) nor are they averse to complex health IT (what small orthopedic office hasn’t considered their own MRI machine) but they are very sensitive to anything that impacts their time with patients or their income and I wouldn’t expect most of them to care about “meaningful use” of health IT.
As one simple example, I can promise you that if CMS or major insurance carriers compensated providers for answering email questions from patients its use would increase dramatically.
When we do EMR implementations at large hospital and healthcare systems (Group Health, Standford, etc) very few providers pay any attention until right before go live despite robust communication and engagement strategies. They also often don’t see the value of health IT unless they have worked with someone else or worked in another facility where it was already live and are very sensitive to how it impacts their workflow. The most powerful way that providers learn is watch one, do one teach one and sharing relevant stories of success is critical in what is essentially an organizational change process vs an IT implementation.
Much of the conversation up until now has revolved around the somewhat arcane “meaningful use” definition and certification and doc’s honestly don’t care. Very little attention has addressed the fundamental question of “measurable outcomes”- “what is in it for me or my patient?” When a provider buys a new piece of equipment they don’t need to know how the FDA approves it, simply that it works and that they can use it to provide more efficient, higher quality, patient centered care.
Frequently in government we look for ways to educate, inform and engage people in “programs” or attempt to use the power of policy to resolve social problems that don’t have a clear business case. In the private sector we look for ways to to “sell” a product or service at the expense of our competitors.
This is a unique opportunity to combine the best of both worlds and collaborate across systems but we need a national communication, education and engagement strategy for both providers and consumers. . Organizations like the American College of Physicians or the National eHealth Collaborative can work side by side with private sector companies who are about to reap billions in new business and government bodies like AHRQ, ONC, etc to help demonstrate to providers that this isn’t something being imposed on them but an amazing opportunity leverage the seed capital that CMS is providing to bring their practice into the 21st century.
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