Since EMR/EHR is a long-term investment, choosing the right solution is imperative and certification can help with the evaluation and selection process by narrowing down the initial set of solutions. Some small vendors feel that a certification means certain death for their company because many cannot afford the $28,000 certification fee and many practices do not need the 300+ features mandated and evaluated by CCHIT for certification.

Reid Coleman, MD, FACP, medical director for LIFESPAN, a multi-hospital health care delivery system in RI, feels that the benefits of CCHIT far outweigh the price to acquire certification. "CCHIT certification is a great first step in guaranteeing HIT programs work together seamlessly enabling us to share critical clinical data between different products used in different facilities." When a certified product is selected, important guidelines for functionality, interoperability and security are met - vital in ensuring health care moves forward as an industry through the use of systems and technology.

"The CCHIT certification on a product is a help to purchasers of EMRs in at least three ways. First, there is predictability about the level of functionality and interoperability in the product. Second, it helps purchasers hold the vendors accountable for the quality of their software. If something in the system met the certification criteria, but is not working, the vendor has an incentive to get it fixed quickly. Third, it is helpful to know the certification requirements for future enhancements. When we know the timeframes for increased functionality that vendors must adhere to in order maintain certification, we can plan our implementations better," says Carol Cotter, senior vice president, chief information officer, LIFESPAN.

Not without controversy

Just as FDA certification of a medical device does not necessarily mean it can be used for all purposes, CCHIT certification does not guarantee a product is the right one for a practice or hospital-wide system (a certification process for hospital-based EMRs is in the works).

Questions have been raised in the medical community as to the validity of CCHIT certification. The key point of contention is the question as to its status as a legal entity. According to Sue Reber, Marketing Director, "CCHIT was founded originally as a LLC, but has subsequently transitioned to a private, nonprofit 501c 3 organization. CCHIT operates with a paid staff of about 20 personnel who support the work of the Commission and its 15 volunteer work groups, administer the certification inspections and provide outreach to its diverse stakeholders. CCHIT operates independently of HIMSS, AHIMA and NAHIT - its founding organizations and no money provided by ONC for development or by vendors for the conduction of inspections is returned to those organizations."

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