October 12th, 2006 - Geneva, Switzerland
Certification of Electronic Medical Record Systems
 Presenters:
Georges De Moor, MD, Phd, President EUROREC, Belgium
Dennis Niebergal, Secretary CHITTA & Chair CHITTA POS, Canada
Alisa Ray, Executive Director, CCHIT, USA
Panel Chair:
Jean-Francois Penciolelli, Business Development Director, Europe, Middle East & Africa (EMEA), Oracle, France
Panel:
Georges De Moor
Dennis Niebergal
Alisa Ray
Jean-Francois Penciolelli
Ilias Iakovodis, PhD, Deputy Head of Unit, ICT for Health DG Information Society and Media European Commission, Belgium
General Consensus: Vendors must be an equal stakeholder.
- Evidence clearly shows that when vendors participate as equal stakeholders the outcome has the necessary breadth and depth and has greater buy-in. Alberta with POSP and US with CCHIT are clear examples of how this can work when there is equal vendor representation.
- Equal stakeholder also means more chance of success implementing IT initiatives.
- Given that vendors work closely with their clinical customers, they have a clear and deep understanding of what is necessary and important to them. This leads to significantly better user specifications.
Recommendations from Panel Discussion:
- Simply making funds available does not guarantee uptake by end users. There are many examples where giving money without some kind of audit and/or confirmation mechanism that the physician has actually begun and continues to use the product has not led to sustained uptake and adoption of an of EMR / EHR .
- Users would find great value from the use of scorecards or consumer-base reports provided by an independent 3rd party organization that are not funded by the vendors or funding organizations. These scorecards should be generated from data sourced by actual users of the software and services to ensure credibility and would provide a good tool for physicians when selecting a certified product. Without this, physicians have no unbiased tool for differentiating between various products and their relative clinical and business value.
- Certification itself provides one perspective on the value and quality of a particular product. This needs to be balanced with other independent evaluation tools for assessment. This is necessary to avoid creating the perception that certification by itself is a “gold stamp of approval”. The US currently uses tools such as KLAS to assist in evaluating various products and to help them make an informed buying decision.
- There is a compelling need for strong representation by the vendor community in defining both the process for certification as well as the associated specifications themselves. This process is currently being practiced quite effectively by organizations such as CCHIT and EuroRec.
- Alternative models for certification were also discussed as the process matured. For example, the potential for self-certification, once vendors and associations establish a high degree of credibility would be possible. The process might include vendors associations being responsible for defining the specification and certification process with independent 3rd party organization responsible for the approvals and conducting the actual certifications. This model has been created and followed for years by the ProRec centres in Europe (EuroRec).
- There was some debate surrounding the length of the certifcationertification period. It was suggested that it should last for a minimum of 3 years as is with organizations such as CCHIT. Other organizations however, such as EuroRec (ProRec centres in each European country) believe that 3 years is a bit too long therefore the individual national ProRec organizations independently establish the standard regarding the length of time for a product to remain certified. CCHIT’s alternative approach was also considered valid solution since the vendor can get certified to the next level of certification (once a year) which replaces the previous certified vendor’s product. Vendors that do not choose to move up can maintain their certification for the remaining 3 years for their current certified version. This allows the vendor’s customers the choice to upgrade as appropriate and necessary since it is very expensive to change or upgrade customers unless there is some big benefit or advantage to the users / customers.
- For Interoperability to reduce costs to the end users, we need national standards (better if international) that don't change that often. Also, need a testing or certification organization (one that has no conflict of interest) that certifies not only the vendors of products, but also the Health regions, Trusts, Hospitals, Governments, etc that are importing / exporting / exchanging Health Information.
- It has been suggested that CCHIT, EuroRec, and POSP/OntarioMD/CHITTA/Infoway should join forces and harmonize criteria and processes.
The World Heath IT Conference 2006, Geneva (https://www.worldofhealthit.org)
EuroRec 2006 conference, Geneva, Oct 10th, 2006 (https://www.eurorec.org/)
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