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Does AC have CCHIT certification yet?

If not, when?

Frank J. Paiano, DO

It is certified but the version that has certification has not been released if I understand it correctly.

Thank you Jack.

I found this link to CCHIT about Amazing Charts:

http://www.cchit.org/choose/ambulat...c_Amazing_Charts_5-Ambulatory-Child.asp.

Frank J. Paiano, DO

Version 5 has been certified - due to be released soon. Jon told me he was working on final touches and improving the GUI interfaces for the new features. Could be soon or could take months - hopefully soon.

I noticed a beta testing version on website. Is anyone beta testing V5?

I have talked with Jon a lot about Version 5 and to my knowledge he has not released Version 5 to beta.

Does he always do beta first? That means we are quite some time away!

I have seen beta only be there for a very short time --- I don't think it is a long way away.

I am curious where you found the Beta 5, there is a new Beta 4.0.72 I noticed after reading your post.

Jon is very cautious about releases. Usually his Betas would be considered final in anyone else's product. I have rarely found a beta to have significant bugs. Sometimes will, but no more than what many companies pass off for final product. Still, I will usually play with any major update for several weeks before considering it for putting it into practice.

I have not seen a Version 5 beta (check often and have talked wiht Jon about it) - I know he still feels that internal testing is appropriate. I have "beta tested" many versions and feel that he is pretty confident before he lets them go beta (agree with Wendell). We all will just have to wait and see how it progresses.

If it is being tested by CCHIT what purpose would getting a Beta version into our hands serve? Get 5.0 past CCHIT and then move on to tune it up. I hope work on Ver. 6 is moving ahead rapidly!!

>>> Get 5.0 past CCHIT and then move on to tune it up. I hope work on Ver. 6 is moving ahead rapidly!!

Actually, once they get version 5 "CCHITized", then any new version will require that they recertify (including payment of another $30000 fee and all the costs of preparation, so I betya that version 5 will be around for a long, long, long time.

Al

It's all a scam, and the people at AC and those of us in private practice get screwed financially as a result of big industry sleeping w/ the government.

Getting off-topic slightly,
A national physician union would put a stop to the flagrant rape that is occuring to every one of us. I bet it would take less than 24 hours to make sweeping changes if EVERY doctor in the U.S. said, "We are going on strike" and no one showed up to their offices/hospitals.

Lots of people might die as a result, and that would be sad. But no one is ever going to take us seriously until that day comes.

OK, I will be completely ignorant here. Al, are you saying a "new version" such as 6.0 or an update such as 5.1.1.2? If an update doesn't involve recertification, then why even move up to the next number unless it is for the support fee, etc.?

I agree about a union. It is unbelievable that doctors continue to put up with this. Even on a state level.

It would be horrible for any EMR to be CCHIT certified if every upgrade cost $30,000. Would they charge this if 5.0 was upgraded to 5.0.09 or 5.1.17 or 5.3, etc? Why would an EMR developer ever change the system thereafter?

Certainly, Al is more up on this than I am, but can you imagine every application out there having to pay some type of $30,000 surcharge everytime they added an update. Look at Firefox. They update weekly. I doubt they would if it cost them $30,000. Seems a bit illegal to me.

Now, recertifying every two to three years as we do with our license would make sense. Still a rip off, but it would make sense.

Bert,
Before unionizing, lets lobby against lobbying. Take the money out of the politicians pockets first. Then the free-market forces stand a better chance of working.
I see a huge trend going on around here. People are mad, furious, at the way government is intruding into our lives and businesses. There was a huge "Tea Party" here yesterday and a lot of demonstrating against the move towards socialized medicine. I about fell over. The local news ran a big expose' on the growing problems Canada is seeing in their health care system and the regrowth of the private sector facilities.
My patients bring it up all the time....asking me my thoughts. They are scared.
If we physicians could at the least get a few good people, physicians, elected to Congress who could then introduce befitting legislation while the rest of us made sure it was talked up I think the people would respond. They are tired of the current corruption.
Or, maybe at the least, we could have a "Million Doctor March" on Washington....scalpels, rib spreaders, vas deferens crushers and colonoscopes in hand!!
I will even make the first contribution to your campaign, Bert or Al. "WE WANT BERT, WE WANT BERT, WE WANT BERT!!"

Leslie who is a little giddy at having a 4 day holiday!!

>>> Would they charge this if 5.0 was upgraded to 5.0.09 or 5.1.17 or 5.3, etc?

Yup, yup, yup on all 3 upgrades. Isn't that another ripoff? The better thing that Jon could do is to make AC "CCHIT certifiable" and have each person interested in certifying pay the new $150 fee. That'll probably be the way to go if they do the $150 idea (per office) right. Probably very few would pay it, but most would get the satisfaction that the option was there.

>>> unionizing, striking

Check out Sermo- they are starting with a revolution against the AMA. They want to form a new PAC! Sermo does have 100000 physicians now, so they are a power to contend with and can really make a difference politically. Interestingly enough, Sermo recently broke with the AMA after a few posts had numerous docs lambasting it, partly for supporting CCHIT and Obama's vision of a computerized healthcare where docs work for nearly free, seeing 100 patients a day...

URLS:

-- https://md.sermo.com/medical/ticket/details?id=37791&nav=on
-- https://md.sermo.com/medical/ticket/details?id=37849&nav=on

Heck, I'll join any movement, if it's against CCHIT/HIMSS! BTW, all my MDNG political articles are listed here- http://msofficeemrproject.com/Page3.htm They so far have had good and bad effects:

1) (GOOD)
--- My MDNG blog 5/13/2009- http://www.hcplive.com/mdnglive/The_HIT_Realist/GE_healthymagination <http://www.hcplive.com/mdnglive/The_HIT_Realist/GE_healthymagination>
--- Bill O'Reilly 5/15/2009- http://www.youtube.com/watch?v=juTewVyHPzg&feature=related
2) (BAD)Shortly after my "Congress Passed the Stimulus Bill; What Should You Do Now?", the state of Maryland now has a bill ready to be voted on forcing all insurance companies to levy the same penalties as does Medicare, so docs can't switch over to PPOs and HMOs as easily as I advocated.
3) (GOOD) One politician made my article the highlight of his healthcare agenda! http://bertroche4congress.com/What_docs_are_thinking.html

So political folks do read what we docs post! That's good overall. All I know that not only on the AC site, but at emrupdate and at sermo you mention "CCHIT" or "vendor" and you get pounced on big time (all except for Jon that is). That's a big change over the past 3 years and is good too!

Oh- on 7/14/2009 I'll be doing an MDNG HIT Debate live webinar as the "HIT Realist" against Joseph Kvedar from the Harvard Center for Connected Health. Details to come out later this week...

Cheers,
Al

YES IT IS HUGE RIPOFF

Got to be a way around it. 5a, back to 4.0 which is really an upgrade. No new numbers at all.

I still think a new CCHIT license every three years would make sesnse.

I was reading about what Colonel Powerll had to say, one of the few people I trust in governmet about Obama. (No, this isn't anything bad about Obama) I had just been thinking the same thing. He seems to be taking way too many things on. I mean there was this huge agenda, and then the pirates in Somalia came along and that was another agenda item. If the price of pizza went up in the neighborhood, he would promise to take care of that.

Again, not against his policies (well I am not for them either), but stick to the war, economy and healthcare.

If I were Obama, I'd rescind the whole ARRA that has not been spent (of which only 5% has been used to date), leave healthcare alone except for a few fixes s.a. apply federal aid to poor clinics, and generally work at getting the deficit back into line. Having a deficit that will eventually leave each household with $500000 in debt is serious...

I personally can't stand the guy. I don't like "socialism" or "communism", and he represents a little bit of both. As an independent social conservative, the less big government gets involved in our economy the better, and this includes healthcare, which affects my career.

Most of the "big boy" EHR vendors get their CCHIT certification yearly, and Allscripts even gets up to 2/year. You see, a lot of them get their money back at the end of the year. CCHIT was reincorporated twice- once on 12/2006 after I found that their incorporation papers included a phrase stating that all profits would be redistributed to the founders (this can be downloaded from http://msofficeemrproject.com/Page3.htm , look for PDF1 and PDF2 at the bottom of the page. They now repay HIMSS through special schemes, s.a. rental contract payments (they SHARE THE SAME BUILDING). So these guys get their money back one way or another... but not AC and similar "small potatoes" EHRs.

I'm hoping that HITECH will cut out CCHIT once and for all and minimize the standards requirements. That would be a good thing for everyone.

Al

Al, you need to toss your stethoscope in the ring.

Leslie

Hi Leslie:

Actually I just found out today that I’ll be in a bare knuckles debate with another one of those very lofty, elitist Harvard physician types next week- Joseph Kvedar, MD, director of the Center for Connected Health.

Anyone interested in listening in on the provocative discussion can sign up here- https://www1.gotomeeting.com/register/646034233 Here's a quote from the webpage announcement:

The Great Debate

Tuesday, July 14, 2009 12:30 PM - 2:00 PM EDT

"HCPLive.com blogger and author of the MDNG column “The Health IT Realist” Alberto Borges, MD, will debate Joseph Kvedar, MD, director of the Center for Connected Health. Topics up for discussion include the HITECH Act incentives and their likely effect on health IT adoption, the problem of “usability” and where it fits in with the push for “certified EHRs,” the use of health IT to improve quality and patient safety, and more."

Heck, for the past 4 years of fighting HIMSS, CCHIT, and now HITECH, I've been a creampuff! No more... I'll see if I can shatter through the transparency window to get at the read dirt!

Cheers,
Al

Al, I will try very hard to listen in. If not, would you be able to post a transcript somewhere?

Leslie

I'll ask the organizer; I'm sure there will be a transcript.

Al

How about taking all the $$ spent purchasing insurance for federal employees and put it in the medicare system placing all the federal folks under medicare? It would help medicare remain solvent and put a big dent in the private insurance monopoly.

Medicare is about to become insolvent on 2017. If you burden it with more patients, the timetable will move up quicker.




























I personally PREFER the "private insurance monopoly". If I had to choose between it and a "government run monopoly" with penalties and other onerous reimbursement practices s.a. kicking back claims for minutia of so called "errors", I'd prefer the former. Medicare is failing, so let's let it go softly and eventually RIP.

That said, the motto in my office is:














AL

So...give me some hope. Has ANYTHING in the government just dwindled away and then disappeared? Didn't it take an act of congress to close some useless military bases? Most of my patients don't get it. They think that if their insurance company or the government is paying for it , then it's "free" ( to them at least). They don't see the huge amount of money spent on all the administrative salaries which do not provide an ounce of health care.

The "huge amount of money spent on administrative salaries" occurs in the private insurance sector. Medicare operates at 3% administrative costs.

85% of our patients are Medicare, 15% are private insurance. For that 15%, we are burdened by having to accept 41 different insurance plans.

For that 15% we are forced to pay 7% of our revenue, for a billing company to do our billing.

For that 15% we have to hire a person at 35000 to deal with the requirements of 41 different insurance plans.

That 15% of our patients costs us 100,000.00 annually.

People want to complain that medicare is costly, I look at it this way: the for-profit insurers get the patients from age 0 to 65; at 65, just when the actuarial tables show they are most likely to have chronic and expensive medical needs, they are turfed to medicare. By definition Medicare provides for the sickest population demographic. This is a great gig for the insurance companies.

It's like saying, I'll provide you a car warranty for the first 60,000 miles, after that the government has to insure you. But the government is not allowed to insure you from zero miles.

If the interests interest of the insurance industry were the same as the physician's, why aren't physician reimbursements rising in proportion to the rise in insurance rates, or insurance CEO salaries?

I am not a fan of the insurance companies either. They are equally maddening to deal with. (However, they are responsive to pressure from the employer who buys the insurance if the employer is big enough. And once I got CHAMPUS to budge by complaining to the IG.) I don't know what the answer is....but I do think that the patients view-point about what they need changes if they are paying for something directly as opposed to paying for it indirectly.

Hot news from Histalk:

"Chip at PCC blogs from this week’s CCHIT meetings. He’s got a lot of interesting observations (changing CCHIT membership, some friction between Mark Leavitt and one of its work groups, [color:#FF0000]dropping the “version lockdown” certification requirement, and disagreement over whether an increase in applicants means CCHIT is doing a good job). Kudos to Bill Zerhellen, MD who said this directly to them: “If our goal is to certify to get ARRA payments, we’re doing the wrong thing. We should be focusing on improving health care.” Leavitt actually agreed and suggested that perhaps CCHIT’s mission statement should be changed to emphasize outcomes improvement instead of HIT adoption (not exactly an original thought since AMDIS and other groups have pressed CCHIT on that previously). I take that to mean that (a) all the CCHIT criticism and potential competition from other certification agencies has made CCHIT more responsive, or (b) it’s at least awakened a belated need to pretend to be more responsive. "[/color]

URL: http://histalk2.com/2009/07/18/monday-morning-update-72009/

So it seems that the CCHIT version lockdown that I mentioned earlier may be lifted. So if AC version 5 becomes version 6 in a matter of months, it'll still be certified if these changes are implimented.

Focusing on outcomes rather than eliminating competition HIT adoption is also a long sought after and welcome change. The question remains- will these changes be enough to avert the marginalization of CCHIT? I personally don't think so...

Al