EHR Certification under ARRA: Early Trends

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.