CCHIT recently announced the second round of Certified EHR Products, bringing the total number to 33. This is great news. I'm curious, though about the use of the word "evolve" in this excerpt from the press release:
The certification criteria have been developed to ensure that products provide a broad foundation of functionality, will evolve to deliver standards-based interoperability with other systems, and include security features to protect the privacy of personal health information.
Oops. I thought we were doing this to achieve interoperability in the first place. One of the goals in CCHIT's About page reads: "Ensure interoperability (compatibility) of HIT products ". It turns out that is in the future, and it's not clear when interoperability standards will be delivered.
Forget all those things about being skeptical about interoperability with respect to CCHIT's efforts (for example, see CCHIT EMR Certs: The Prisoner's Dilemma Revisited). CCHIT is starting from a different Square One than I was assuming, so at least some of my complaints are off-target. My bad.
Further down the About page, it says:
CCHIT works in a dynamic environment, collaborating with HHS and AHIC. Some standards are just gaining consensus while standards for interoperability are at an earlier state of development.
Reading through the whole page, it is suddenly dawning on me that I have been thinking too far ahead of the game here. I work mainly in the area of achieving interoperability between healthcare systems, albeit in our case for research purposes. I was projecting my problem onto the customer base of CCHIT. I went back up to the top of the page and re-read the first four paragraphs:
In April 2004, and every year since, President George W. Bush has called for widespread use of health information technology (HIT), and for electronic health records (EHRs) to be in use for most Americans by 2014.
Since 2004, the Office of the National Coordinator for Health Information Technology (ONCHIT) and the American Health Information Community (AHIC) were established by the Department of Health and Human Services (HHS) with the goal of improving healthcare through information technology.
One of the key actions indicated by ONCHIT to move the nation toward the President's goal was the private sector certification of health information technology products.
To that end, the Certification Commission for Healthcare Information Technology (CCHITSM) was created.
Now the pieces of the puzzle begin to make sense. I recently posted about a study that proved few US doctors use EMRs - in fact they make very little use of information technology at all, in contrast to doctors in countries with a universal interoperable EMR, such as the UK. CCHIT's mission isn't to achieve interoperability, or at least that isn't the first and largest step. The first step is to get physicians using an EHR at all. Standards and certification are aimed at reducing the risk physicians perceive when they think about switching to an EMR. Being late adopters (or "late majority" in the parlance of Geoffrey Moore's Crossing the Chasm model of market segments), reducing perceived risk is a necessary step in getting them to shell out serious bucks. I know from listening to my friends at Velos and Cielo MedSolutions how hard it is to get doctors to spend money on things they need. Docs in private practice are the hardest, because they work long hours for relatively low pay, as physician paychecks go.
Message to Alisa Ray, Executive Director of CCHIT: You go, girl! My apologies for any perceived political incorrectness, but this message is intended the same way as when Oprah Winfrey says it. You've got the challenge of a lifetime ahead of you. If there's any way I can help with the interoperability standards effort, let me know.