These are the companies the certify the medical record systems that will enable hospitals and physicians to get their stimulus incentives.  They too have issues and questions.  A lot of it is just the way technologies have evolved along with bringing in revenue cycling and more data and integration from insurance companies.  As we all know it’s not a big secret in the industry that the focus of being a tool for doctors with medical records, has shifted to an even bigger focus as being the tool for the payers who want all the data formatted for claim payments and Medicare is right in there as well.  There are areas to where this needs to come together like clearinghouses to scrub claims which have been around for quite a while as well as the ability to submit electronic claims with a medical records system.

The CCHIT was the lone group for a while that did all the certifications but as the number of companies grew, there were a few more added on to perform the same with medical record vendors.   There are medical record vendors out there who are not certified either so I thought that was worth a quick mention here as to be qualified for the stimulus dollars, a certified software program is needed by a doctor or a hospital.  It was just in January that trade groups were wanting to know when the certification software would be up and running again as they had some software issues. 

EMR Trade Group Asking the ONC When Are You Going to Have the Certification Software Up and Working Again-Can’t Get Systems Approved for Stage Two Meaningful Use–”Killer Algorithms Chapter 52”

Along this journey due to complexities some “certified” records systems had issues and stalled the attestation process for some of their clients, like GE.  Part one of Meaningful use was pretty straight forward but like everything else when the parameters of part two were added there was a lot of other things going on that had either a direct or non direct impact, and software just builds on itself.

GE Centricity EHRs Need To Fix Their Algorithms (Math)-Some Customers May Not Be Able to Attest Until The End of November After the Software Update

You can read some of the comments below but right now Stage 2 is a bit of a struggle if you will.  Some doctors may end up giving up, but we shall see how it evolves here.  One vendor said there has been a drop off of vendors seeking certification.  Again the software vendors have to work, rewrite, recompile their software over and over before even attempting certification of course.

The ONC gave SureScripts the ability to certify EHR modules for e-prescribing but  not complete EHRs so it gets a little more complicated.  What we are going to end up with are fewer vendors for doctors and hospitals to choose from it appears.  CMS could certainly use the ability to “model” a bit better as they drive hospitals and doctors nut at times with their parameters they want met as sometimes better record keeping gets confused with in government  thinking doctors and hospitals are big cheaters on billing.

Electronic Medical Records Still Bug CMS With Doctors Creating Better Documentation For Their Services–A Big Reason For The Increases-They Can Bill For Their Actual Time Easier Without Risking Stalling Claim Payments

In summary EHR vendors are looking to perhaps  need more time to prepare to be certified as well as the certifying agencies themselves to make sure they are completely on target with Meaningful Use Two.  Nobody intended all of this to grow to where we are today, but just look at what insurance has grown to with complexities and they do a lot of it by design as it increases their profits in some areas as well.  Of course all of this keeps the folks at the ONC very busy as again you may think you have everything set and all it takes is something or some algorithm out of the blue and it’s right back to the drawing board.  BD

As the end of 2013 closes in, most federal certification bodies are noticing an uptick in the number of vendors who are applying to become certified under the 2014 criteria — the same criteria that will be required for the EHR products providers must use to attest to meaningful use Stage 2.

“It has been a slow start. They’re working hard. They’re struggling a little bit, said Alisa Ray, executive director and CEO of the Certification Commission for Health Information Technology, CCHIT, adding that when comparing Stage 1 to Stage 2 certification, vendors are “navigating a higher bar and increased complexity.”

Ray said there are three areas of Stage 2 that are proving the most challenging for certification: clinical quality measures, interoperability, and automated measure calculation for reporting metrics.

Automated measure calculation “requires almost a whole day of testing,” she said. “There are just a lot fewer products than were there with the Stage 1 or 2011 criteria.”

And without naming names, Ray said that “almost everyone has struggled and been surprised by the complexities,” and a number of them have had to go through several certification trials, after not meeting certain criteria.

Mark Shin, COO at InfoGard Laboratories, Inc. said when the meaningful use Stage 2 requirements came out earlier this year, his company saw “an extreme drop-off” in the number of applications for certification.


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