EMR certification now in hands of 2 firms approved by HHS

The companies will test and authorize products from vendors to ensure they meet "meaningful use" standards.

By Chris Silva — Posted Sept. 13, 2010

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The Dept. of Health and Human Services has tapped two software-testing companies to serve as the first authorized reviewers of electronic medical record systems that would make physicians and hospitals who adopted them eligible for federal financial incentives.

The Certification Commission for Health Information Technology, based in Chicago, and the Drummond Group, based in Austin, Texas, now can test and certify products from EMR vendors to ensure that they meet the "meaningful use" criteria, which are a core set of standards that physicians and hospitals must meet to qualify for incentive payments.

The Office of the National Coordinator for Health Information Technology announced the companies Aug. 30.

"This is a crucial step, because it ensures that certified [electronic health record] products will be available to support the achievement of the required meaningful use objectives, that these products will be aligned with one another on key standards, and that doctors and hospitals can invest with confidence in these certified systems," said David Blumenthal, MD, the national health information technology coordinator.

Dr. Blumenthal said they are reviewing applications for additional certifiers.

This latest announcement comes after the Centers for Medicare & Medicaid Services on July 13 unveiled the final meaningful use rule for EMR adoption and issued a final rule outlining the standards and criteria vendors must follow for their products to be certified.

Incentive payments coming

EMR certification is part of a broad initiative the Obama administration undertook as part of the Health Information Technology for Economic and Clinical Health Act, a part of the 2009 economic stimulus package.

The government may spend as much as $27 billion in incentive payments in the next six years, according to CMS. Eligible physicians who meet all required objectives could receive as much as $44,000 over five years from Medicare, or nearly $64,000 over six years from Medicaid. Doctors cannot receive both Medicare and Medicaid bonuses. To qualify for the payments, physicians and hospitals must adopt and demonstrate meaningful use of certified EMR systems.

CCHIT said it plans to launch its authorized certification program Sept. 20 and announce the first group of certified modules within weeks. The government previously recognized CCHIT as a certifier of certain software products. However, HHS officials said this year that no EMR systems that previously received the government's stamp of approval would automatically be grandfathered in under the new program.

Consequently, CCHIT went through the application process to be a certifier of meaningful use EMRs just like any other organization.

"We've been preparing for this for quite some time, and we're happy to be moving forward, because the provider community needs to have these systems," said Karen M. Bell, MD, chair of CCHIT.

"CCHIT has tested and certified hundreds of EHRs," Dr. Bell said. "Our experience has enabled us to promptly adapt our processes to accommodate the certification standards adopted by HHS to support the meaningful use of EHRs by health care providers."

Drummond Group CEO Rik Drummond released this statement: "After executing several pilots on existing EHR products and working with industry consultants, our organization is more than prepared to test and certify health care products. We look forward to beginning testing with the many EHR software companies that have contacted us." The organization did not, however, state when it would begin approving vendors.

Final rule details

The final CMS rule announced July 13 divides the initial 25 meaningful use objectives into two categories: a core group of 15 objectives that physicians and hospitals must meet, and a "menu set" of 10 procedures from which any five can be deferred in 2011-12, the first round of the incentive program.

Although the total number of measures physicians and hospital must meet was reduced to 20, down from 25 in CMS' initial proposed rule, the American Medical Association took issue with some of the final rule's provisions.

The AMA said in a July 21 statement that physicians face several challenges if they hope to be compliant before the Jan. 1, 2011, start of the incentive program.

Physicians who already have invested in EMRs must upgrade their systems to meet certification criteria. In addition, some thresholds for meeting the objectives remain high, the AMA said. For example, one measure requires physicians to maintain an up-to-date problem list of current and active diagnoses for more than 80% of patients. In addition, there is no mechanism for physicians to appeal any decision made during the incentive program.

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Road to certification

CMS has been developing "meaningful use" guidelines since the economic stimulus package was approved in early 2009. The law provides billions in potential Medicare and Medicaid incentive payments to physicians and hospitals who adopt certified electronic medical record systems and demonstrate meaningful use.

Here are some key actions since the law took effect:

June 16, 2009: David Blumenthal, MD, the national health information technology coordinator, asks a working group to revise a draft of its first definition of meaningful use.

Jan. 13, 2010: The Centers for Medicare & Medicaid Services issues two sets of proposed regulations designed to lay the groundwork for physicians and hospitals to receive incentive payments.

July 13, 2010: CMS announces the final "meaningful use" rule for EMR adoption, and outlines the standards and criteria EMR vendors must follow to become certified.

Aug. 17, 2010: CMS publishes details for state Medicaid directors on what they should expect from the federal government as they administer the Medicaid portion of the electronic medical records incentive program starting in 2011.

Source: Centers for Medicare & Medicaid Services

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