E-health committee calls for multiple groups to certify records systems

The top federal panel that sets policies for electronic health records so that a national system can be adopted made recommendations on Friday that would allow multiple organizations to certify electronic record products instead of the one certifying body that exists today.

Doctors and hospitals are slated to receive up to $17 billion in stimulus funds to help pay for health information technology systems. But the payments are dependent on doctors using systems that meet "meaningful use" criteria, standards the Health Information Technology Policy Committee is developing.

The stimulus package, included in the 2009 American Recovery and Reinvestment Act, required the committee to recommend a policy framework for the development and adoption of a nationwide health information infrastructure -- including standards for the exchange of patient medical information and certifications criteria -- to the Office of the National Coordinator for Health Information Technology at the Health and Human Services Department.

Currently, only the Certification Commission for Healthcare Information Technology (CCHIT) certifies electronic health records systems. Critics have charged that CCHIT has been influenced by health care information technology vendors, which helped form the group in 2004.

Paul Egerman, co-chairman of the policy committee's certification and adoption work group and the founder of IDX Systems Corp., a health IT system vendor acquired by General Electric Co. for $1.2 billion in 2006, recommended forming multiple certification bodies. Marc Probst, the other co-chairman and chief information officer of Intermountain Healthcare in Salt Lake City, also supported the recommendation.

Egerman and Probst also suggested the committee expand certification to include a range of software sources, including open source software and open systems based on the Veterans Health Information Systems and Technology Architecture, which the Veterans Affairs Department operates.

The recommendation to establish multiple certification organizations will break the hold health IT vendors have on the certification process and open up new approaches such as Web-based health IT systems, said Brian Klepper, a health care analyst. He co-authored an Aug. 11 letter to David Blumenthal, the national coordinator for health information technology, criticizing the role CCHIT plays in the certification process.

Earlier in August, Eric Schmidt, chief executive officer at Google, said at a meeting of the President's Council of Advisors on Science and Technology that a national health IT system should be based on Web records that patients control.

Egerman and Probst urged the Health Information Technology Policy Committee to put more emphasis on interoperability among health IT systems so patient data could be easily exchanged.

Christine Bechtel, a committee member from the National Partnership for Women & Families, suggested interoperability could be fostered by the exchange of scanned patient records in the Portable Document Format, better known as PDF. "This would facilitate the movement of data ... by getting a piece of paper to go with the patient" in an electronic format, she said.

Roger Baker, chief information officer at VA, told the technology policy committee that PDFs work fairly well for the exchange of patient information. He added that VA and the Defense Department have extensive experience with exchanging patient information among large health care organizations and urged the committee to rely on that experience.

The policy committee advises HHS, which signs off on recommendations after collecting public comments.