Intellectual Property News and Reports

An integrated electronic medical record (EMR) system can improve your practices processes through increased efficiency, better E&M coding and reduced mistakes and insurance rejections. Once your practice has decided to make the switch to an EMR system, it is important to research the products thoroughly to make sure you select the right package for your practice.

With so many EMR products on the market – where do you start? You may be frustrated and confused by the EMR industry claims. It is hard to judge product stability, quality, interoperability, data portability and security. Fortunately, the Certification Commission for Healthcare Information Technology (CCHIT) has taken some of the guesswork out by creating a certification program for EMR products that places a “gold seal” on packages that make the grade. Currently 37 products have received the CCHIT product certification.

CCHIT works in collaboration with the American Health Information Community, the Department of Commerce’s National Institute of Standard and Technology, and with several other organizations awarded HHS contracts to harmonize standards, develop prototypes for national health information network architecture, and assess privacy and security laws and practices. The work of CCHIT has been endorsed by a number of physician professional organizations, including: The American Academy of Family Physicians, The American Academy of Pediatrics, The American College of Physicians, and Physicians’ Foundation for Health Systems Excellence & Physicians’ Foundation for Health Systems Innovation.

CCHIT Certification Process

The CCHIT certification process tests and inspects products on a comprehensive set of criteria for:

• functionality (ability to create and manage electronic records for all patients, as well as automating workflow in a physician’s office),

• interoperability (a first step in the ability to receive and send electronic data to other entities such as laboratories), and

• security (ability to keep patients’ information safe).

Functionality

CCHIT certification for the functionality of an ambulatory EHR—its ability to carry out specific tasks—requires products to meet 263 criteria in 41 categories.

Security and Reliability

According to CCHIT, “An EMR must protect the privacy of patients’ health information while providing secure and reliable access for care providers.” To ensure data privacy and prevent data loss, CCHIT requires EMRs to meet 48 criteria in four security categories (access control, audit, authentication and technical services) and three reliability categories (backup/recovery, documentation and technical services).

Interoperability

The 27 CCHIT criteria governing certification requirements for interoperability - the ability to exchange data with other systems - require EHRs to be able to receive and transmit information in six categories:

• Laboratory and imaging

• Medications

• Immunizations

• Clinical documentation

• Secondary uses of clinical data

• Administrative and financial data

CCHIT’s certification compliance criteria and its design for a certification inspection process have been thoroughly researched, taking into account the state of the art of EMRs and available standards, and comparing certification processes in other industries and other countries. The inspection process is based on real-life medical scenarios designed to test products rigorously against the clinical needs of providers and the quality and safety needs of health care consumers and payers. One script, for example, recreates a scenario of an elderly man with poorly controlled diabetes, hypertension and other chronic conditions in order to test EMR functions such as potential adverse drug reactions, disease management and treatment plans.

The functions and capabilities required for certification by CCHIT for ambulatory EMRs were developed by a panel of volunteer experts meeting in multidisciplinary Work Groups, and approved by the Commissioners. Besides specifying the criteria required in 2006, the criteria documents include a “Roadmap” forecasting additional criteria to be required in 2007 and 2008. The “Roadmap” provides guidance to providers and the industry by offering a realistic timetable for incremental improvements in EHR systems, and each year the “Roadmap” will be extended to maintain visibility two years into the future.