EHRs: Fewer certified programs could mean higher prices

Certified EHRs are supposed to be the best, and the kind the feds want you to buy, but the number of programs attaining this status has tailed off big-time.

EHR certification is part of the federal push for a nationwide health information network. The US Department of Health and Human Services contracts with a private group called the Certification Commission for Healthcare Information Technology to certify EHR programs that can perform basic tasks such as creating and displaying problem lists, checking for drug interactions, and issuing reminders about overdue tests. The feds won’t let a hospital subsidize an EHR for you unless it has this stamp of approval.

Ninety programs were certified under the initial set of standards that CCHIT issued in 2006. However, CCHIT introduces new and tougher standards each year. That may explain why only 24 programs have been certified so far based on 2007 CCHIT criteria. The organization is still processing 27 applications that came in by the March 31 deadline for certification based on last year’s standards. However, even if all of them are approved, the total number of programs certified as meeting the 2007 criteria would only come to 51.

One key reason for the fall-off is the CCHIT requirement introduced in 2007 for electronic prescribing, says Mark Anderson, CEO of AC Group, a healthcare IT consulting firm in Montgomery, TX. “A lot of vendors don’t have this,” says Anderson, who notes that true e-prescribing is not merely faxing an Rx to a pharmacy, but transmitting it on a computer-to-computer basis.  Anderson predicts that vendors will have an even harder time meeting the proposed criteria for 2008, which require EHRs, among other things, to be able to swap patient medical summaries with each other.

Adding such features to an EHR can translate into hundreds of thousands of dollars in programming costs for a vendor. In light of this expense, only the biggest and most well-heeled companies will be able to keep up with ever changing CCHIT criteria. “I think only 27 vendors will be able to pass this next set,” says Anderson.

EHR vendors lacking certified products probably won’t survive in the marketplace, says Anderson, who expects the number of EHR vendors to decline from roughly 390 today to less than 50 in 2012. While a smaller field of vendors simplifies shopping for an EHR, it also will raise prices, he notes.

Many doctors consider EHRs already too pricey. The average cost for nine programs certified under the 2007 CCHIT criteria was close to $30,000 per doctor over three years, according to a recent study by AC Group.

CCHIT spokesperson Sue Reber says another reason for the decline in certified programs is that since certification is good for three years, some vendors in the CCHIT class of 2006 may wait until 2009 before they reapply. Nevertheless, CCHIT is pleased with the number of vendors that have sought certification under the 2007 criteria, says Reber. “Vendors see certification as a competitive necessity.”