I’ve had a number of EMR companies ask me where they can get help to become a certified EHR. There’s certainly plenty of resources online, but I find that most EMR companies want some real hands on experience and help to be able to navigate the EHR certification process. Whenever I’m asked this question, I always tell those people to go and talk with Jim Tate.

I still remember when I first met Jim Tate at HIMSS last year. I was hanging around the HIMSS exhibit floor because I was early to a meeting with a vendor. I’m sure I was in a partially lost state since I was trying to figure out what to do with the few minutes I had available before my meeting when I heard someone say my name.

I looked up from my lost state to see who was saying my name and saw an all too familiar face for which I couldn’t place. The person then said, “You’re techguy right?” (I’m @techguy on Twitter, and @ehrandhit as well). Then, everything clicked and I said, “You’re Jim Tate right?” See the funny thing was that Jim and I had never met in person, but obviously both of us had seen each others healthcare IT tweets many times before (I think he enjoyed reading my rips on CCHIT pre-HITECH). It’s always interesting (and usually fun) to meet someone in person that you feel like you already know online.

Personal stories aside, I’ve still gotten to know Jim Tate more online than I did in person. I hope that will change at HIMSS this year. Even if it’s just running across Jim on the HIMSS exhibit floor or one of the various parties. Jim has an incredible amount of knowledge and experience in EMR certification. I’m not sure what it says about me that I find the idea of sitting around with Jim listening to old EMR certification “war stories” to be really interesting.

Of course, what prompted my storytelling about Jim Tate? A tweet Jim recently sent that said he’d worked with 90+ HIT vendors. He has a great EMR certification page on his website which has over 75 Ambulatory and Inpatient EMR vendors that he’s worked with. That’s A LOT of EMR companies. You can see the image of EMR companies he’s helped at the bottom of this post.

One ONC-ATCB recently told me that many of the EHR companies that come to them are incredibly well informed, others are just missing some of the details and others are just completely lost. I’m quite sure Jim Tate’s EMR companies fall into the first category.

Now Jim Tate is starting to share his expertise even more broadly as he partners with HITECH Answer and their Virtual Extension Center. Seems like meaningful use consulting will be Jim Tate and EMR Advocate’s next step and probably a very good one. Or as Jim said it:

Time 2 put my shoulder 2 the #Meaningfuluse wheel: http://twurl.nl/it22nb free for EPs, EHs , medical soc, RECs #HITsm #ONC #EHR #healthit

February 10, 2011 1:24 pm via TweetDeckReplyRetweetFavorite

@jimtate

Jim Tate

Jim also gets my funniest tweet of the year award too. In response to @motorcycle_guy’s tweet about who should replace Dr. Blumenthal as ONC head? Jim replied:

Mubarak needs a job. RT @motorcycle_guy: [MG] Who should replace Dr. Blumenthal as #ONC Head? http://goo.gl/fb/l8fPB

February 4, 2011 9:36 am via TweetDeckReplyRetweetFavorite

@jimtate

Jim Tate

Last month, Beth Israel Deaconess Medical Center (BIDMC) became the first hospital to to have its EHR certified as “complete” by the CCHIT.

BIDMC was part of a pilot program testing out CCHIT’s EHR Alternative Certification for Hospitals (EACH), a special program for installed hospital EHR technology.

How did the testing process go?  Well, according to Beth Israel CIO John Halamka, the CCHIT staff was very helpful, but the NIST scripts could use some work before CCHIT rolls out EACH to the world.

BIDMC, which runs all-Intersystems Cache-based hospital systems and Microsoft SQL Server-based business intelligence systems,  had to follow 500 pages of  NIST scripts over 8 hours to satisfy the examiners.

While many of those scripts made sense to Halamka, some seemed just plain odd.   For example, he notes, NIST scripts require hospitals to place a CPOE order for Darvocet for pain control, even though Darvocet has been removed from the market by the FDA.    In another case, a script required Beth Israel to send data to a public health entity about an infection the patient did not have, he says.

All told, if your hospital is planning to try for EACH certification, you’d better be well prepared, Halamka suggests.  ”I recommend that hospitals devote at least 2 weeks and 5 FTEs to reviewing the scripts, analyzing the best way to show the necessary functionality, and practicing the demonstration,”  Halamka warns readers of his Life as a Healthcare CIO blog.

Today, HHS announced two more organizations that have been approved as ONC-ATCB for EHR certification:
SLI Global Solutions – Denver CO
Date of authorization: December 10, 2010.
Scope of authorization: Complete EHR and EHR Modules.

ICSA Labs – Mechanicsburg PA
Date of authorization: December 10, 2010.
Scope of authorization: Complete EHR and EHR Modules.

I’ve actually met with both of these organization. I met with SLI Global Solutions in Denver when I was attending AAFP. I wrote this blog post about SLI Global Solutions as an ONC-ATCB EHR Certification body after my visit with them. I’ll be getting more information from them which I’ll post on this or EMR and HIPAA as I get it.

ICSA Labs is an Independent Division of Verizon Business. I met with the CMO of Verizon at last year’s HIMSS where he told me that ICSA labs would become a certifying body (sorry I can’t find the post right now).

Both are very legitimate organizations with some definite interest and expertise in the healthcare space. For example, Verizon is making a big play with their Verizon HIE product offering.

I’ll see about getting more details on each of these new EHR certifying bodies so that we can see how they compare against the other ONC-ATCB. 5 EHR Certifying bodies. That’s probably enough to keep it competitive.

This is the third post in the series of posts(see the previous ONC-ATCB Certified EHR Breakdown and ONC-ATCB Certified EHR Breakdown by Certifying Body) looking at the EHR certification numbers put together by HITECH Answers. The following is a list of Certified EHR products by vendor:

Top 3 Vendors by number of Products Certified
- Cerner Corporation – 13 products
- Siemens Medical Solutions USA Inc – 9 products
- Epic Systems Corporation – 4 products

I guess these are the EHR software you want to avoid. Ok, that’s partially facetious. Just, can you imagine trying to battle the other 12 certified EHR to get support. Granted, most of them are likely hospital EHR and so there are usually support contracts in place to deal with this kind of thing. Don’t worry though, Allscripts should be on this list soon. I think they have something like 7 EHR software for just ambulatory right now. I guess that’s the nature of acquisitions.

It will be interesting to continue to see this evolve.

This is the second post in the series of posts (see the previous ONC-ATCB Certified EHR Breakdown) looking at the EHR certification numbers put together by HITECH Answers. The following is the breakdown of EHR Certification by Certifying body:

2 Certified by Infogard
- 1 Modular Ambulatory system
- 1 Modular Inpatient system
40 Certified by Drummond
- 15 Complete Ambulatory systems
- 5 Complete Inpatient systems
- 15 Modular Ambulatory systems
- 5 Modular Inpatient systems
88 Certified by CCHIT
- 50 Complete Ambulatory systems
- 15 Complete Inpatient systems
- 11 Modular Ambulatory systems
- 12 Modular Inpatient systems

Infogard is just getting started, but CCHIT and Drummond Group are cranking them out. I’m guessing right now demand for their service is strong and they can certify them as quick as they can. It will be interesting to see what happens to these organizations post EMR Stimulus money, but they have a few years before they have to worry about that.

Of course, this is only the temporary ONC EHR Certification. ONC will have the official one and then all the EMR vendors will likely have to re-certify again. Let’s call it the EHR certifying body stimulus program.

Many people were worried that we wouldn’t have many certified EHR available for 2011. I wasn’t one of those people, but they were out there. Seems to me that this really won’t be an issue at all. There’s 130 partial or complete EHR companies on the official ONC certified EHR list. That’s a lot of software and it’s only the beginning of December. I expect we’ll have 200 or so more ONC-ATCB certified EHR software by the first quarter of 2011.

The good people at HITECH Answers have done the hard work putting together the number of systems certified. Check out the numbers:
85 Complete EHR
- 65 Ambulatory systems
- 20 Inpatient systems
45 Modular EHR
- 27 Ambulatory systems
- 18 Inpatient systems

That’s right. 65 Complete Certified Ambulatory EHR. 27 other modular certified EHR and I’m sure that many of those are just doing the modular as a stepping stone to the full certification.

ONC and HHS have finally released the official list of ONC-ATCB Certified EHR which is essential to those providers interested in the ARRA EMR stimulus money. Of course, ONC is just providing the data that Drummond Group, CCHIT and other ONC-ATCB bodies (assuming more will start certifying) are providing them. I mentioned that we could look forward to this official list in my Drummond Group ONC-ATCB EHR Certifications post and my CCHIT ONC-ATCB EHR certifications post.

Looks like quite a few more EMR vendors are now ONC-ATCB certified since those first posts. Watch for many many more (almost all) of the EMR vendors to be certified by the end of the year or early 2011.

Looks like ONC is working on a version 2 of the list. Here’s their description of the next version of the ONC-ATCB Certified EHR list:

Please note: This is Version 1.0 of the Certified Health IT Product List (CHPL). Version 2.0 is under development and is expected to provide additional information, such as a list of the Clinical Quality Measures to which a given product was tested; and additional functionality, such as different ways to query and sort the data for viewing. The later version will also provide the above-mentioned reporting number that will be accepted by CMS for purposes of attestation under the EHR (“meaningful use”) incentives programs.

That number is going to be key next year for those wanting stimulus money. I’m glad they’re making access to the reporting number needed for attestation for EHR incentives easy to find.

Only problem with the above list is that it hasn’t been updates since Nov. 1. I wonder how often they’ll update it. Although, it probably won’t matter much in the long run.

In case you missed the announcements on Thursday and Friday, Drummond Group announced the first ONC-ATCB certified EHR (3 of them) and CCHIT announced their first set of ONC-ATCB certified EHR (21 full ONC-ATCB EHR). I also got word today that HHS finally updated their website with the Drummond Group ONC-ATCB.

Of course, we have a few hundred more EHR software out there that are going to be announced. It’s just a matter of how quickly the ONC-ATCB are going to be able to pump out the certifications. Not to mention the EMR vendors completing the list of requirements.

As one EMR vendor told me this weekend. We could have easily rolled out the features that the EHR certification requires to become certified. However, that wouldn’t have been very useful for our users. Then, he went on to say that he’d rather spend an extra month or two to make the certified EHR requirements part of a really nice and useful dashboard than to just roll out some shoddy features that satisfy the EHR certification requirements, but don’t make sense to doctors.

Makes you wonder about these first EHR vendors that have been certified. Just because the EMR is an official ONC-ATCB doesn’t mean you will actually want to use that EMR software.

InfoGard Laboratories, the nation’s first accredited IT security testing laboratory, is approved by the Health and Human Services, Office of the National Coordinator for Health IT as an ONC-Authorized Testing and Certification Body (ONC-ATCB) for the certification of Complete EHRs and EHR Modules for both ambulatory and inpatient settings. -Source

And now there are three official ONC-ATCB for EMR vendors looking to get their EHR software certified. Looks like InfoGard has been doing NIST certifications for a long time now and EHR certification will just be another certification for them.

Info Gard will be the third officially approved ONC-ATCB alongside Drummond Group and CCHIT which were announced previously. There’s also been rumors that Weno Healthcare is trying to become an ONC-ATCB as well.

Maybe I’m just missing it, but I wasn’t able to find other details on InfoGard’s EHR certification plans, pricing, and timeline. If someone else finds it, please let me know. It’s a little disappointing that their press release didn’t include a link to this type of information like Drummond Group and CCHIT did.

Drummond Group has recently published an FAQ about EHR certification. I’m guessing that the FAQ will continue to grow over time. They do cover some important topics. Here’s one of the FAQ that I found particularly interesting (and pretty sad too).

Q: My software is developed for a specialty practice (e.g. dental, etc.) and some criteria are not relevant for my customers. To be a Complete EHR, do I still need to certify over all the criteria?

A: There is not a specialized criteria set beyond the general categories of ambulatory or inpatient, and thus specialized software are required to satisfy the same criteria as general EHRs. The concept is that even if a user will not utilize all the features of a certified EHR that the certified EHR must still have this functionality present within it. Regarding criteria that do not fit a specialty’s typical use, ONC address this type of situation in their Standards and Certification Criteria Final Rule. They talk more of the situation with ED/inpatient settings and comments that growth charts are not needed. Here are the relevant sections that show the aggregated comments they received and their response.

Comments.  A few commenters noted this certification criterion applies more

directly to specialties that predominantly treat children.  For other specialties, this criterion would add unnecessary cost and complexity to many HIT products that they would use.  Many commenters suggested that a growth chart component should not be required for EHR technology designed for an inpatient setting, as it is not feasible to track this data in a meaningful way over a long enough period of time in an inpatient setting (which is typically of a short and infrequent duration).  A couple of commenters suggested that non-traditional forms of growth charts should be accepted.  One commenter suggested that the certification criterion establish a baseline, but should not limit the expansion of this capability to other ages.  Other commenters made specific suggestions for different age ranges, such as including children under the age of two and lowering the upper age to ages less than 20 years old (e.g., 18).

Response.  As we stated above with respect to the calculation of BMI, we believe

that Certified EHR Technology should be capable of performing this capability

regardless of the setting for which it is designed.  Moreover, with respect to whether growth charts should be applicable to Complete EHRs and EHR Modules designed for an inpatient setting, we remind commenters that children’s hospitals qualify as eligible hospitals under the Medicaid EHR incentive program and will also need to demonstrate meaningful use of Certified EHR Technology.  We do not preclude Complete EHR and EHR Module developers from designing novel approaches to displaying growth charts.  Finally, we concur with the commenter that suggested this certification criterion should be a baseline.  We reiterate that this certification criterion establishes a floor, not a ceiling, and we encourage Complete EHR and EHR Module developers to include additional functionality where it will enhance the quality of care that eligible professionals and eligible hospitals can provide.