TEPR 06 Highlights

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Towards the Electronic Patient Record | May 20-24, Baltimore

Certification as a catalyst to accelerate HIT adoption

The Certification Commission for Health Information Technology (CCHIT) announced at TEPR it is well on its way to meeting the aggressive timeframe of certifying the first EHR products this year.

The mission of CCHIT is to accelerate the adoption of robust, interoperable healthcare information technology throughout the United States by creating an efficient, credible, sustainable mechanism for the certification of healthcare IT products. In September 2005, CCHIT was awarded a contract by the U.S. Department of Health and Human Services to develop, create prototypes for, and evaluate the certification criteria and inspection process for electronic health records (EHRs) and the infrastructure components through which they interoperate.

After extensive planning, via pilot testing and open comment periods, among other steps, the Commission settled on a $28,000 fee for the first year of certification, followed by a much lower annual maintenance fee. Once certified, a vendor can market its product as “2006 certified” for three years. There will be an open application period four times a year.

Overall, the Commission focused on creating a fair, balanced certification process that it hopes is not too complicated.

Speakers urge HIT adoption

Twenty-two years ago at the first TEPR conference, some speakers thought electronic medical records would be here within three years. But, more than 20 years later, rather than a paperless healthcare industry, the stakeholders are still debating different standards. “There is no reason to wait,” said C. Peter Waegemann, CEO of the Medical Records Institute, who has spoken at TEPR for years. “It’s the only way to go. We need to get serious about IT as a nation.”

To get there, the federal government must make substantial investments in healthcare IT and stop cutting physician reimbursements to reap the benefits of a wired healthcare system, said Joseph Heyman, MD, secretary of the American Medical Association. He accused the government of sending mixed messages. Doctors cannot be expected to make substantial investments in technology when their Medicare reimbursement payments are cut and the cost of care increases, Heyman said.

The government also should do more to help the 46 million uninsured Americans, he said, adding, “all of the accomplishments with health IT are worthless if patients cannot access care.”

A first look at care record

TEPR 2006 provided a first opportunity to see the ASTM continuity of care record (CCR), an open XML standard, in action. The TEPR CCR demo explored two capabilities: how physicians and patients can jump-start a continuity of care record by using claims data, avoiding the need to populate a new electronic system; and how portable the CCR can be. The demo used the ASTM CCR as the vehicle for transporting a core set of clinically relevant personal health data between different software applications, such as a PHR used by a patient and an EHR used in a physician office or a hospital.

Attendees could see how a patient-centered and standardized clinical data set — CCR XML file — can be created for a patient using readily available health claims data as a starting point. Then, they could see the exchange of the health information among different software applications from different vendors. Data can be transported via USB drive, cell phone and web-based patient registry.

The CCR XML file is non-proprietary and viewable within a web browser or as a PDF file.