cchit town call: updating expansion roadmap

Certification Commissionfor HealthcareInformation Technology

Town Call:Updating the Expansion Roadmap -How to Participate in the ProcessMark Leavitt, MD, PhD – Chair, CCHITAlisa Ray, Executive DirectorSue Reber, Marketing and Outreach Director

Dec 1, 20084:00 pm ET / 1:00 pm PT – duration approximately 1 hourParticipant Dial-In Number: (866) 612-6319Conference ID Number: 611877

© 2008 | Slide 2 | Dec 1, 2008

Agenda

•Brief Background of CCHIT

•Expanding and Refining Health IT Certification

•Expansion Roadmap Process and Schedule

•How to Participate

•Q & A – live responses to your questionssubmitted online before and during the call atehrdecisions.com


Brief Background

© 2008 | Slide 4 | Dec 1, 2008

Mission and Goals

Accelerate the adoptionof robust, interoperablehealth IT by creatingan efficient, crediblecertification process.

• Reduce the risks ofinvesting in health IT

• Facilitate interoperabilityof health IT

• Unlock adoption incentivesand regulatory relief

• Protect the privacy ofhealth information

Goals:Mission:

CCHIT is an independent, nonprofit 501(c)3 organization

© 2008 | Slide 5 | Dec 1, 2008

Certification Programs

To be launched July 09Stand-alone ePrescribingTo be launched July 09PHR

Enterprise Launched August 08Amb+Inpt+ED

Launched August 08Emergency Dept

Launched Oct 08HIE

Launched August 07Updated August 08

Inpatient EHR

Launched July 08Cardiovascular MedicineAmbulatoryLaunched July 08Child HealthAmbulatory

Launched May 06Updated May 07Updated July 08

Ambulatory EHR

History/StatusCertification Options(Add-on to Base Domain)

Base Domain

© 2008 | Slide 6 | Dec 1, 2008

Certification Programs

To be launched July 09Stand-alone ePrescribingTo be launched July 09PHR

Enterprise Launched August 08Amb+Inpt+ED

Launched August 08Emergency Dept

Launched Oct 08HIE

Launched August 07Updated August 08

Inpatient EHR

Launched July 08Cardiovascular MedicineAmbulatoryLaunched July 08Child HealthAmbulatory

Launched May 06Updated May 07Updated July 08

Ambulatory EHR

History/StatusCertification Options(Add-on to Base Domain)

Base DomainIn original HHS contract Expansion to other domains was at the

request of stakeholders from those areas

© 2008 | Slide 7 | Dec 1, 2008

Inputs:* Scope Guidance from Commission* Roadmap (from previous year)* Future Directions (from previous year)* Environmental Scan: - Use Cases from AHIC - Standards from HITSP, SDOs - Market research - More

Development Process

DevelopDraft Criteria

Refine Criteriaand DevelopDraft Test Scripts

ProposedFinal Criteriaand Test Scripts

Final Criteriaand Test Scripts

Public Commentperiods

Pilot Test

Launch“09”

Certification(July 2009)

Plans for expansion to a new domain must be in placeat least 18 months before certification launch date

Sept2008

Dec2008

Mar2009

May2009

July2008

April2008

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Volunteer Workgroup Organization

InpatientEHR

Workgroup(IP)

AmbulatoryEHR

Workgroup(Amb)

Emerg DeptEHR

Workgroup(ED)

CardiovascularMedicine

Workgroup(CV)

Stand-aloneePrescribing

(eRx)

Child HealthWorkgroup

(CH)

Network/HIE

Workgroup(Net)

SecurityWorkgroup

(Sec)

Inter-operabilityWorkgroup

(IO)

Privacy &ComplianceWorkgroup

(PC)

PHRWorkgroup

(PHR)

Long TermCare

(Workgroupnot yetformed)

Develop BaseCriteria for a

Domain

ContributeCriteria for

SpecificAttributes

DevelopCriteria for

OptionalAdditional

Certifications

BehavioralHealth

Workgroup(BH)

Developing “09” Criteria(Planned for launch in July 2009)

Developing “10” Criteria(Planned for launch in July 2010)

Over 200 volunteers currently serving


Expanding and RefiningHealth IT Certification

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Why “Expand and Refine”Certification?

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Health Care is Complex

Med. Specialty A

Med. Specialty B

Surg. Specialty C

Nurs. Specialty D

Prof. Specialty E

ProfessionalSpecialties andSubspecialties

Specialty F

Specialty G

Etc...

CareSettings

Subspecialty G1

Subspecialty G2

Susspecialty G3

Small Office

Large Clinic

Hospital / Inpatient

Hospital / Outpat.

Extended Care

Home Health

Etc...

Populations

Children

Adolescents

Elderly

Chronic Disease

Underserved

Etc

Adults

Expectant Women

Emergency Dept

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Levels of Technology Readinessand Capabilities May Differ Widely

Med. Specialty A

Med. Specialty B

Surg. Specialty C

Nurs. Specialty D

Prof. Specialty E


Specialty F

Specialty G

Etc...

CareSettings

Subspecialty G1

Subspecialty G2

Susspecialty G3

Etc...

Small Office

Large Clinic


Hospital / Outpat.

Extended Care

Home Health

Etc...

Populations

Children

Adolescents

Elderly

Chronic Disease

Underserved

Etc

Adults

Expectant Women

Emergency Dept

Basic?Intermediate?

Advanced?

© 2008 | Slide 13 | Dec 1, 2008

CCHIT’s First Steps in Certification:


CareSettings

Small Office

Large Clinic


Hospital / Outpat.

Extended Care

Home Health

Etc...

PatientPopulations

Children

Adolescents

Elderly

Chronic Disease

Underserved

Etc

Adult Men

Adult Women

Emergency Dept

2006

2007

•Two broadly defined care settings: ambulatory and inpatient•No differentiation by specialty or population•No differentiation of basic vs advanced capabilities

Med. Specialty A

Med. Specialty B

Surg. Specialty C

Nurs. Specialty D

Prof. Specialty E

Specialty F

Specialty G

Etc...

Subspecialty G1

Subspecialty G2

Susspecialty G3

Etc...

© 2008 | Slide 14 | Dec 1, 2008

Med. Specialty A

Med. Specialty B

Surg. Specialty C

Nurs. Specialty D

Prof. Specialty E

Specialty F

Specialty G

Etc...

Subspecialty G1

Subspecialty G2

Susspecialty G3

Etc...

Expansion Roadmap


Small Office

Large Clinic


Hospital / Outpat.

Extended Care

Home Health

Etc...

Children

Adolescents

Elderly

Chronic Disease

Underserved

Etc

Adult Men

Adult Women

Emergency Dept

A schedule for adding new certification programs moreprecisely tailored to various specialties, settings, populations,and levels of technology readiness/capabilities

CareSettings

PatientPopulations

Add Setting T: ‘10

Add Setting U: ‘12

Population W: ‘11Add Specialty R: ‘09

Add Subspecialty X: ‘11

Population V: ‘10

Add AdvancedCapability S: ‘10


Expansion RoadmapProcess and Schedule

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Process and Schedule

• Environmental scan– Dec 1 – Town Call inviting interested organizations to submit

environmental scan forms advocating expansion/refinement– Forms accepted via email Dec 1 – 31, 2008

• Review submissions and success potentials; develop andapprove draft expansion roadmap

– Commission meeting of Jan 13, 2009

• Public Comment on draft expansion roadmap– Jan 15 – Feb 5, 2009

• Finalization of updated expansion roadmap– Commission meeting of Feb 17, 2009

© 2008 | Slide 17 | Dec 1, 2008

Opportunities

• We continually receive inquiries regarding expansionof certification to other practice areas

– Now is your opportunity to make a formal request,supported with evidence

• Already committed for launch in ‘10:– Behavioral Health– Long Term Care– Additional area(s) still possible

• 2011 and beyond is still ‘wide open’

© 2008 | Slide 18 | Dec 1, 2008

Prioritization is Based on aValue Equation

• Environmental Scan – gather data on three key parameters foreach expansion area:

– Benefit of expanding certification

– Readiness for certification

– Cost to develop certification

• Assess potential for success:

– Potential for Success = ( Benefit x Readiness ) / Cost• Commission and Trustees will review environmental scan data

and success potentials before setting priorities for expansion

© 2008 | Slide 19 | Dec 1, 2008

Fiscal Realities

• Developing the first set of Ambulatory EHR criteria took 2years, ~$3M in funds, and thousands of volunteer hours

• Levels of continued Federal funding are uncertain

• CCHIT must focus its expansion efforts by deployingresources where they can deliver the most value

• CCHIT will take into account potential sources ofdevelopment support as well as self-sustainability of theresulting certification program

© 2008 | Slide 20 | Dec 1, 2008

Relative Costs of CertificationDevelopment

• Commission will favor expansion opportunities that canleverage our existing base of knowledge

• Before launching development of highly resource-intensiveexpansions, funding sources must be identified

Existing Domain (e.g., Ambulatory EHR)

Optional Add-On(e.g. Cardiology)

New Domain(e.g. Long Term Care)

New Specialty(e.g. Behavioral

Health)

Low Medium HighDevelopment resourcesrequired:

Many criteriaand test steps

reusable

Completereview orredesignneeded


How to Participate

© 2008 | Slide 22 | Dec 1, 2008

How to Participate• Review the Town Call material

– Presentation and audio podcast available atwww.cchit.org/expansion

• Download the Environmental Scan form– Also available at www.cchit.org/expansion

• In preparing your submission, collaborate with otherstakeholders in your domain if possible

• Submit the form as an email attachment [email protected] between Dec 1 – Dec 31, 2008– Additional supporting materials may be attached or submitted

as web links• Watch for publication of the draft expansion roadmap Jan 15,

2009 and submit any further comments

Thank you!

Q & A SessionSubmit questions onlineat any time before orduring the Town Callat ehrdecisions.com

For more information:www.cchit.org

cchit town call: updating expansion roadmap

Health & Medicine