Even as it waits for the federal government to complete some necessary work stipulated by the American Recovery and Reinvestment Act, the the Certification Commission for Healthcare Information Technology has published its final 2009-10 EHR certification criteria. However, the commission will delay testing under the new rules until it is able to review the draft standards and certification criteria that the government's HIT Standards Committee must deliver to HHS by Aug. 26. Those standards will help determine which EHR products are eligible for stimulus-related federal subsidies.

According to several published reports, the new "Concise Guide to CCHIT Criteria" ties the commission's criteria to likely ARRA EHR qualifications, though the commission has held off on a few decisions until the government defines "meaningful use" and other key rules for EHR users to qualify for stimulus funding. Notably, the CCHIT Certification Handbook will not be out until later in the summer and the commission is piloting a program to certify other forms of in-use technologies that have not previously been certified. These include open-source software, home-grown systems and best-of-breed deployments, according to HealthLeaders Media.

For more details about the new CCHIT criteria and all the ARRA-related issues:
- read the coverage in Modern Healthcare (reg req)
- see this Health Leaders Media story
- go right to the source for the "Concise Guide to CCHIT Criteria" and the actual criteria

HHS may publish proposed criteria for "meaningful use" of electronic health records sooner rather than later, according to a story in Health Data Management. The magazine reports online that the vendor-centric HIMSS EHR Association has learned that HHS may issue its proposal as soon as June 16. Meaningful use is the standard by which hospitals and physicians can qualify for Medicare or Medicaid bonuses under the American Recovery and Reinvestment Act.

The proposal, which will be subject to public comment, likely will follow current Certification Commission for Healthcare Information Technology testing criteria, EHRA Chairman Justin Barnes, representing Greenway Medical Technologies, tells HDM. According to the story, HHS does not want to force vendors to start development all over to meet an entirely new set of rules, something that would jeopardize the incentive program's Jan. 1, 2011 start date. HHS has until the end of this year to finalize its definition of meaningful use.

For more on the impending release of the proposal:
- Read the Health Data Management story

Increased government promotion of EHRs since 2004 may actually be boosting physician resistance to change, and thus slowing down adoption, though one cybersecurity expert suggests that it may not be a bad idea to ease off the accelerator for a while.

A study published in the Journal of the American Medical Informatics Association suggests that physician resistance to EHR adoption actually slowed between 2005 and 2007, compared with the 2001-04 period. It was in 2004 that President George W. Bush called for interoperable EHRs for most Americans within 10 years; then he created the Office of the National Coordinator for Health Information Technology and sent Dr. David Brailer out on a whirlwind speaking tour. The study's author suggests to iHealthBeat that the government activity had the unintended consequence of increasing bad press about EHR failures and other glitches, possibly contributing to physician resistance.

However, writing in PC World, risk, fraud and security analyst Robert Vamosi says that slow and steady is a good option because data security could get lost in the rush to replace paper records with digital versions.

To learn more about these important issues:
- check out the iHealthBeat piece
- read the abstract of the JAMIA study
- see Vamosi's commentary in PC World

The federal push for interoperable EHRs could be a "steamroller" that forces yet another round of vendor consolidation and pushes physicians in small practices to join larger groups just to survive, one consultant predicts. Leonard Fuld, a Cambridge, MA, business analyst, reached this conclusion after conducting a "war game" with students from four top graduate business schools, and shared his findings with the New York Times.

The stimulus funding for health IT, according to Fuld, could make even large health EHR vendors--like Cerner, Epic Systems and Allscripts-Misys Healthcare Solutions--attractive acquisition targets for Fortune 500 giants like IBM, Microsoft, Oracle and another familiar health IT name, McKesson. At the same time, the cost and complexity of implementing EHRs threatens to overwhelm "hundreds of thousands of doctors in small practices," the Times reports, prompting those physicians to combine with group practices.

To read the entire interview with Fuld:
- click to this New York Times blog post

In a welcome example of two large EMR vendors cooperating, Southwest General Hospital Center in Middleburg Heights, OH, has introduced an Allscripts Professional Electronic Health Record system for its employed physicians and interfaced the system with an existing Cerner inpatient EMR.

The Allscripts product also has been integrated with a MicroMD practice management system. The 356-bed community hospital chose a software-as-a-service model for the ambulatory EMR to lower upfront costs and to connect multiple clinics, physician offices and home-care services.

Jeff Bushong, executive director of Southwest General Medical Group, SGHC's employed medical group, believes that the current setup requiring a manual transport of paper files from location to location is far from effective. "The ability to interface the ambulatory care record with our Cerner hospital information system will also help physicians access lab results and hospital reports more quickly and improve the coordination of care across our enterprise," he said.

To learn more about this project:
- read this Healthcare IT News story

New York City's Primary Care Information Project could serve as a model for the network of regional health IT extension centers that the Office of the National Coordinator for Health Information Technology wants to establish to help small practices adopt and use EMRs, Government Health IT reports. In fact, one PCIP client in the Bronx is the subject of a New York Daily News story about EMRs.

> Siemens Healthcare announced the general availability of the newest version of its enterprise system, Soarian Clinicals. The update features interdisciplinary care planning as well as updates to the ED module, analytics functions and wireless support for BlackBerry and iPhone devices. Press release

> Tenet Healthcare and IT vendor Med3000 have formed a joint venture aimed at bringing EHRs to physicians in 12 states. Story

> Epic Systems beat out rivals McKesson, Cerner and Siemens to win a $40 million contract from Atlanta's Grady Memorial Hospital. Article

> Business process services company Synnex will distribute the Allscripts MyWay EHR. Press release

> Medical Network, a Maine-based PPO, will subsidize physician purchases of athenahealth's athenaClinicals EHR and athenaCollector revenue cycle management services. Press release

> A Pennsylvania hospital has developed a method for using its EMR to improve its patient handoff process. Article

> The global market for medical tourism could be the ideal testing ground for personal health records. FierceMobileHealthcare

> There's a new report out on the Canadian EMR market. Article

And Finally... No EMR, no care. Article