Last week, the Office of the National Coordinator for Health IT unveiled one of the final missing puzzle pieces of the "meaningful use" incentive program by naming the Certification Commission for Health IT and the Drummond Group as the first ONC-Authorized Testing and Certification Bodies under the temporary electronic health record certification program.
The 2009 federal economic stimulus package included Medicare and Medicaid incentive payments for physicians and hospitals that demonstrate meaningful use of certified EHRs. Prior to the announcement, no certifying groups were in place to determine whether vendors' EHR products have the functions necessary for health care providers to meet the federal government's meaningful use Stage 1 criteria.
National Coordinator for Health IT David Blumenthal said the announcement "is a crucial step because it ensures that certified EHR 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."
EHR vendors can select which ONC-ATCB to use to get their products tested and certified. The ATCBs must use ONC-approved test procedures to test and certify EHR technology, but the ATCBs are responsible for individually and independently determining their pricing structure for EHR testing and certification.
CCHIT, Drummond Group Get Down to Work
Just a couple of days after announcing that CCHIT and the Drummond Group had been named ONC-ATCBs, ONC called the groups to Washington, D.C., for a training session.
The Drummond Group, which specializes in testing software for interoperability in a number of industries, will be able to certify complete EHRs and EHR modules for ambulatory and inpatient settings.
Rik Drummond, CEO of the Drummond Group, said, "We highly commend ONC and their accreditation process, which tested the details of our testing and certification process and our industry knowledge. Having started new tests with other industries, we found this approval process to be the most demanding and most thorough we have encountered."
The Drummond Group already is accepting applications for certification and has posted information, including pricing and testing processes, on its website.
CCHIT -- a not-for-profit group that previously had been the only organization authorized to certify EHRs -- plans to open up its certification program on Sept. 20.
CCHIT already offers several health IT certification programs. CCHIT Chair Karen Bell said, "We will be continuing to develop our branded CCHIT certification program, and then we have a very separate program for the HHS certification process." She said that vendors will be able to choose whether they want to be tested for certification under both programs or just one of the programs.
Some experts have questioned whether the newly named ONC-ATCBs will be prepared to handle the certification demand.
Bell said that "the demand is going to depend on how quickly a lot of the vendors will be able to incorporate some of the new criteria that came out in July." She added, "We actually don't know how many vendors are going to be ready to go forward, but ... we've been through this before. We have staff [who is] ready, waiting to jump in and move forward with this very quickly."
It still is unclear how closely the ONC-ATCBs will work together.
Bell said, "I don't know what ONC has in mind for this. I think that there's no question that we have done a huge amount of work in this area, and we're very dedicated to helping the delivery system and vendors move along the path of more effective use of [health] IT." However, she added, "We're a not-for-profit, and I know that Drummond is a for-profit. So I think we're in a position where we need to be very careful about how we share our resources and what we might consider information that we would need to keep in order to meet our own objectives."
An ONC spokesperson said, "The ONC-ATCBs will need to work together with respect to programmatic issues. Otherwise they are expected to act as independent entities."
Additional Certification Groups Possible
ONC said additional applications to become temporary certification and testing bodies are under review, but officials could not comment on what groups had applied, the number of applications under review or provide an estimate on the number of additional groups that could become ONC-ATCBs.
An ONC spokesperson said additional ONC-ATCBs will be announced as soon as they are authorized, which the spokesperson said is expected this fall.
On Sept. 1, Weno Healthcare announced that it submitted an application on Aug. 20 and that it expects to hear a decision by the end of September.
Tina Goodman, CEO of Weno Healthcare, said that if Weno Healthcare becomes an ONC-ATCB, it will offer a shorter certification process at a lower cost. The group already is accepting applications for quotes and no-obligation placements on its waiting list.
When asked whether she was concerned there might be too many authorized certification groups, Bell said she was not, adding, "There aren't a whole lot of certifying bodies, I suspect, or folks out there, that are going to want to get into this business for 15 months. Until there's a better concept of what the final process is going to look like and what it's going to entail, I think it's probably fair to say there will not be huge numbers of people in this game."
Looking Ahead to Permanent Certification Program
With last week's announcement about the ONC-ATCBs under the temporary certification program, many stakeholders already are looking ahead to ONC's permanent certification program that is set to begin in January 2012.
The permanent certification program separates the responsibility for performing testing and certification of EHR systems as recommended by the Health IT Policy Committee and the National Institute of Standards and Technology.
However, ONC officials said that organizations would be allowed to perform both testing and certification if they would like, but they would need to receive accreditation for both separately.
Bell said that CCHIT has not received any additional guidance from ONC on what the permanent certification program will entail, but restated the organization's intention to apply to become a permanent certification body.