Fishman is aware of hundreds of different EMR company programs, has analyzed a significant percentage of them and reviewed the parameters of most. He believes since physicians are the ones paying for the service and third parties are the ones benefiting (like government and patients), the imbalance to physicians is disconcerting and can tend to hold back widespread adoption of electronic record keeping. Now that there is $20 billion in the recently passed economic stimulus program, this problem appears to have been fixed. And, he says, "Despite the significant amount of time and cost, essentially every physician who has been involved with a successful implementation says they would never go back to a paper office, and that includes me."

Fishman also believes that physician malpractice insurers commonly will offer discounts to offices that utilize EMRs. "Physicians who can provide greater quality of care will not only have greater gross revenue due to pay-for-performance, but will also be offered more meaningful malpractice insurance discounts," says Fishman. He emphasized, however, "One cannot implement a state-of-the-art, easily interconnected EHR for $5,000. What you can do is take the first step and automate your reports, but a number of those simpler systems are not CCHIT-certified.

CCHIT Certification

The Certification Commission for Healthcare Information Technology (CCHIT) has gained strength since its inception in 2004. It has a role in how EHR functionality is defined and promotes standards for EHR interoperability and security. It has also generated some controversy. Many EHR buyers use the certification titles as a way of helping to determine which products they should purchase. This often leaves non-certified vendors out of contention even if they may be as good - or better - than a certified competitor.

Because there are hundreds of EMR software products on the market, each with different functions, it can be easy to become confused by the choices. Since most physicians are not experts, it's hard for them to know which EMR system will best suit their needs. CCHIT, founded by HIMSS, AHIMA and NAHIT, is an independent non-profit, private sector initiative that certifies EMR/EHR software based on a specified set of parameters. Its mission is to accelerate the adoption of robust, interoperable health information technology by creating a credible and efficient product certification process (see http://cchit.org/files/CCHITPhysiciansGuide08.pdf for more information).

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