CCHIT is Prejudiced and Lacks Diversity – An Indictment Until Proven Otherwise

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Searching for “The Lost Medical Providers”

[By Dr. David Edward Marcinko; FACFAS, MBA, former CPHQ™, CMP™]


[Hope Rachel Hetico; RN, MHA, former CPHQ™, CMP™]

[Managing Editor]

dave-and-hope6Right up! Let us state that, sans increased transparency and requested information to the contrary, we believe that CCHIT is a prejudiced and seriously non-diverse outfit. No. we don’t mean racial prejudice or any lacking in ethnic or gender diversity – We mean professional diversity. Why and how did this happen – we don’t know, but please allow us to explain our thought process in arriving at this opinion and formal indictment?

CCHIT Website

According to its website, the Certification Commission for Healthcare Information Technology [CCHIT] was founded to help physicians answer key questions about eHR software, such as: a) what components should be included, b) where do you begin with over 200 products in the ambulatory eHR market?


Certification Commission Composition

CCHIT is a private nonprofit organization accelerating the adoption of robust, interoperable health information technology [HIT] by creating a credible, efficient certification process.

The Commission is made up of at least two representatives each from the provider, payer, and vendor stakeholder groups, and others from stakeholder groups that include safety net providers, health care consumers, public health agencies, quality improvement organizations, clinical researchers, standards development and informatics experts and government agencies.

Currently, CHIT is composed of these commissioners, serving in two-year staggered terms:

  • Mark Leavitt, MD, PhD [Chairman]
  • Abha Agrawal, MD, FACP
  • Steve Arnold, MD, MS, MBA, CPE
  • Karen Bell, MD
  • Richard Benoit
  • Sarah T. Corley, MD, FACP
  • John F. Derr, RPh
  • Linda Hogan
  • Michael L. Kappel
  • Joy G. Keeler, MBA, FHIMSS
  • Jennifer Laughlin, MBA, RHIA
  • Christopher MacManus
  • David Merritt
  • Susan R. Miller, RN, FACMPE
  • James Morrow, MD
  • Rick Ratliff
  • David A. Ross, ScD
  • Don Rucker, MD
  • Michael Ubl
  • Jon White, MD
  • Andrew Wiesenthal, MD

What about the “Others”

Now, here’s the rub; what about the other medical professionals? The list above contains allopathic physicians, a nurse and a pharmacist; and that’s fine. But, where are the DDSs, DPMs, DOs and ODs? Should these folks assume they are included as CCHIT stakeholders, as most all dentists and even the ADA seemingly – and apparently erroneously – believed?


See CCHIT’s answer below, when one intrepid [fearless or naïve] dentist inquired about his profession’s inclusion in the CCHIT initiative.

Dr. Pruitt,

“As noted in my email to you, the Commission has not yet taken up the development of certification for software products used in dentistry. While one cannot deny the value of dental information in the management of health, it is not currently within the scope of the Commission’s work to undertake the development of criteria and test scripts that inspect the data compatibility between physician office eHRs and dentistry records. As our work progresses, it may become a future consideration.”





According to our best estimates, CCHIT left out input from these medical professionals:

  • Osteopaths: 50,000
  • Dentists: 150,000
  • Podiatrists: 10,000
  • Optometrists: 40,000

And so, we ask, where are the:

”two representatives each from the provider … groups”

 as stated and mandated, in their own CCHIT charter? Where is the outrage from the American Osteopathic Association [AOA], American Podiatric Medical Association [APMA], American Optometric Association [AOA], and the American Dental Association [ADA]? Are these folks disenfranchised; and do they know it, or not?

Board of Governors – Public Comments Desired

The CCHIT website does list Dr. Brian Foresman; DO, MS as a physician juror in 2006. And, the complete list is included below for your review: 

The CCHIT regularly requests public comment. The public comment period for ePrescribing Security, for example, is currently open until March 4, 2009.

Industry Indignation Index: 65

Hopefully, we can shame – “flame with emails” – CCHIT into finally including dentists, podiatrists, more osteopaths and optometrists in this initiative and in their larger enterprise wide goals, objectives and plans.



And so, your thoughts and comments on this Medical Executive-Post are appreciated. Please call, write, fax, email or send in your opinions to CCHIT and tell them what you think! Mark, we give you benefit-of-doubt and are on your side, but what did we miss; do tell? What sort of bureaucrat apparently overlooked these full, and limited-licensed, medical practitioners with their special skills; or do they actually have direct-indirect input? Don’t they count for anything? Where is the diversity? Where is the outrage? Stop the prejudice! Call us, let’s do lunch and discuss.

Full disclosure: We are members of AHIMA, HIMSS, MS-HUG and SUNSHINE. We just released the Dictionary of Health Information Technology and Security, with Foreword by Chief Medical Information Officer Richard J. Mata; MD MS MS-CIS, of Johns Hopkins University and the second edition of the Business of Medical Practice with Foreword by Ahmad Hashem; MD PhD, who was the Global Productivity Manager for the Microsoft Healthcare Solutions Group at the time:

Additional References

1. Getting “the CCHIT Question” Wrong, by


2. CCHIT dissolved involuntarily in April 2008 for failure to file annual report in Illinois.



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38 Responses

  1. Dear Ann, et al:

    While working on part 2 of “Consumerism,” I decided to take a quick break to say that I am fascinated by watching the current internet test that CCHIT is enduring. I may be wrong, but I think the tipping point in transparency and subsequent denunciation of CCHIT occurred right here on the Medical Executive-Post in January.

    I confess that in my secret moments of giddy, I like to think our independent cooperation played a huge part in exposing obvious CCHIT machinations – including calling into question the ethics of the government-favored non-profit’s most enthusiastic trustee, Glen Tullman.

    I hope that witnessing the fun we are having encourages others to get involved personally as well. It’s our future.

    I want to alert you, and ME-P readers, to a discussion that is currently happening on HIStalk, where Tullman was interviewed for the fourth time in the last year on February 5.

    I find it ornery-interesting that the comments following the HIStalk interviews have become increasingly negative, even as they attract more critics who are knowledgeable and respected in the healthcare IT industry – including physicians who actually use the products.

    Those who have not posted anonymously include Ross D. Martin, MD, MHA; Evan Steele, CEO of SRSsoft; Al Borges, MD; Jonathan Bertman, MD, FAAFP and Matthew Chase MD.

    At the moment, the physicians are making very good points about problems with Allscripts e-prescribing. It reminds me a little of Jeff Jarvis and Dell Hell.

    I’m not sure if watching HIT history unfold is like the beginning of a clumsy decline of a self-righteous feudal system or a slow, grinding train wreck. Either way, I don’t intend to miss the excitement.

    I’ll be back soon.

    Darrell K. Pruitt; DDS


  2. Ann,
    CCHIT is suffering from accountability. Dana Blankenhorn of ZDNet just piled on.

    Darrell K. Pruitt; DDS


  3. Dave, Hope and Darrell,

    The Certification Commission for Healthcare Information Technology [CCHIT] plans to speed development of its advanced technology certification programs to keep pace with federal health IT initiatives. The commission recently said that it will accelerate the rollout of its Advanced Clinical Decision Support and Advanced Security programs. Originally slated for completion in 2011, those programs will now be finished in the 2009-2010 development cycle, which begins July 1 and runs through June 30, 2010.




  4. So what do you think caused CCHIT to suddenly get in a hurry? Is it the American Recovery and Reinvestment Act like they would have us believe, or is it Sam’s Club rollout of an eHR system that threatens Allscripts profits?


  5. The Wal-Mart / eClinicalWorks (eCW) partnership strikes us as an odd couple. While we think eCW will benefit from this arrangement, we don’t see the relationship lasting over the long term.

    The intent is good: simplify a traditionally complex and expensive purchase by distributing through a low-cost distribution channel. However, we don’t think EMR software presents the same economies of scale that Wal-Mart relies on to deliver “everyday low prices.” Wal-Mart can sell a wide range of products at low prices because they negotiate massive bulk purchases, run dramatically efficient logistics and efficiently manage inventory. Those strengths may make a difference for the Dell hardware they are selling as part of this deal, but it doesn’t mean much when it comes to software.

    We don’t think the partnership will fail. On the contrary, we think it will accelerate eCW’s growth in the market. The awareness generated by the relationship will be well worth it for eCW.


    Houston Neal
    Software Advice


  6. Chad Terhune, Keith Epstein and Catherine Arnst are Journalists


    Wow! After years of waiting on this day of personal validation in the blogosphere, that expression of raw, pent-up energy actually felt especially good on a day off. It doesn’t get any giddier than this.

    This is an unsolicited introduction to “The Mad Dash to Digitize Medical Records” by Chad Terhune, Keith Epstein and Catherine Arnst, that describes how, “GE, Google, and others, in a stimulus-fueled frenzy, are piling into the business. But electronic health records have a dubious history.”

    The article copied below, describes the tyrannical nightmare I so over-told starting three years ago in far too many comments that are searchable to this day. (And they all still ring true). Yet, home, home again on the dysfunctional range, never is heard a discouraging word, and the skies are not cloudy all damn day.

    Comes a thunderstorm. Tide’s up. Sandbags, anyone?

    As one reads their serious, landmark piece, one might recognize the names Newt Gingrich, Mark Leavitt, and of course, Glen Tullman, as names from my earlier comments. All three are proud, major stakeholders in healthcare IT – each with their unique angle(s) to political power that cleverly bypass providers and patients. And each one is partially to blame for the approaching, pre-funded and slow-moving HIT blunder.

    “[Allscripts CEO Tullman] compares the skeptics of health info tech to doctors who questioned the introduction of the stethoscope in the 19th century: ‘There have been Luddites in every industry.’”

    Hey, Tullman. Yea, you. There have been Madoffs as well. So which causes irreversible damage faster? A hand loom or a heavily funded, poorly researched, monster piece of untried but nevertheless CCHI-certified textile machinery with lots of moving parts and a bucket full of hope and random add-ons for everyone?

    Dentists of America: You are already taking part in modern, meaningful grass-roots negotiation. Do your best to protect our turf. I said, “our” turf – as in, “not theirs.”

    Colleagues, I suggest you passively drag your feet to protect your patients from harm. Don’t be tricked into making rash decisions about healthcare reform out of patriotism. As readers probably know, digitized records that include personal information attract special attention from the HHS through HIPAA, and from the FTC through the Red Flags Rule. But here is some breaking news I discovered this morning: The FDA has just announced their interest in a spot at the HIT table as well (read below). Twenty billion dollars draws a crowd – public, private and in-between – like CCHIT.

    If one is waiting to read about the FDA’s new involvement in dentist-patient relationships in the official ADA News Online, it will probably be mid-July before this concern is mentioned. Considering their slow reaction to the Red Flags Rule, I wonder if the ADA Legal Division is all over it yet. I bet they at least win us a delay.

    The news of a brand new HIT player just has to be yet another unexpected blow that further undermines the ADA’s department of the National Health Information Infrastructure (NHII) and its goal to promote paperless dental practices in the nation. The news of a further setback for informatics arrives only a week before the compliance deadline for the Red Flags Rule. That’s got to hurt.

    Since I witnessed over a year ago, when the IRS was granted a piece of the NPI number, I was not shocked to read that the FDA wants healthcare IT products to be ruled medical devices. The FDA fines that a dentist will possibly face following a breach, such as a stolen, or otherwise missing computer or flash drive, will probably be added to the HIPAA and FTC fines. But what’s worse, if the breach involves more than 500 patients, not only will each have to be immediately notified, but one or more organizations already require public announcement of the breach, soon to be an Internet site, I assume. This means that even if a computer stolen in a burglary is dutifully reported, it means certain bankruptcy for the unfortunate dentist. The (threat of) HIPAA fines were overkill even before the FTC parks its fat butt on us next week. That makes meaningless FDA fines ostentatious.

    Since I recently deemed myself worthy of the title “Dental Advisor,” and granted myself said title and all the privileges that are conferred with it in a private ceremony, here is my first bit of cheap advice: If you are one of the 4% of dentists still using pegboard and ledger cards, and are considering computerization, I suggest you read the article below. It would be a tragic for one to allow a slick HIT salesperson like Newt Gingrich, Mark Leavitt or Glen Tullman to rush a friend into agony so early when it is much more interesting to watch them rush other poor slobs into agony. That is my learned opinion.

    D. Kellus Pruitt; DDS

    Business Week: Economic Stimulus for Medical Records
    April 23, 2009, 5:00PM EST

    The Mad Dash to Digitize Medical Records

    GE, Google, and others, in a stimulus-fueled frenzy, are piling into the business. But electronic health records have a dubious history

    By Chad Terhune, Keith Epstein and Catherine Arnst

    Neal Patterson likens the current scramble in health information technology to the 19th century land rush that opened his native Oklahoma to homesteaders. Cerner (CERN), the large medical vendor Patterson heads, is jockeying for new business spurred by a $19.6 billion federal initiative to computerize a health system buried in paper. “It’s a beautiful opportunity for us,” the CEO says.

    The billions in taxpayer funds—part of the $787 billion economic stimulus—also have energized tech titans General Electric (GE), Intel (INTC), and IBM (IBM), all of which are challenging Cerner and other traditional medical suppliers. Microsoft (MSFT) and Google (GOOG) aim to put medical records in the hands of patients via the Web. Wal-Mart (WMT) is teaming with computer maker Dell (DELL) and digital vendor eClinicalWorks to sell information technology to doctors through Sam’s Club stores.

    Under the federal stimulus program enacted in February, hospitals can seek several million dollars apiece for tech purchases over the next five years. Individual physicians can receive up to $44,000. These carrots should encourage the proliferation of technology that will computerize physician orders, automate dispensing of drugs, and digitally store patient records. If providers participate broadly, those files are supposed to be accessible no matter where a consumer goes for treatment. President Barack Obama says the changes will improve care, eliminate errors, and eventually save billions of dollars a year. There’s also a stick: The federal government will cut Medicare reimbursement for hospitals and medical practices that don’t go electronic by 2015.

    The incentives are working. R. Andrew Eckert, CEO of tech provider Eclipsys, says one client, a 250-bed hospital that shelved a software order in the fall after losing $50 million in the stock market, has reinstated the order. The move is “100% due to the stimulus,” says Eckert (who won’t name the hospital). Brandon Savage, chief medical officer at GE’s health unit, says his company’s technology will leapfrog the competition by not just replacing paper but also guiding doctors to the best, least-costly treatments.

    In Washington, where partisan bickering over how to revive the economy flares on several fronts, sweet consensus reigns on health-tech spending. Congressional Republicans sound just as enthusiastic as the White House. Encouraged by former House Speaker Newt Gingrich, now an influential industry consultant, lawmakers cheer electronic records as a business-based remedy for much that ails medical care.


    That rare agreement, however, is obscuring the checkered history of computerized medical files and drowning out legitimate questions about their effectiveness. Cerner, based in Kansas City, Mo., and other industry leaders are pushing expensive systems with serious shortcomings, some doctors say. The high cost and questionable quality of products currently on the market are important reasons why barely 1 in 50 hospitals has a comprehensive electronic records system, according to a study published in March in the New England Journal of Medicine. Only 17% of physicians use any type of electronic records.

    Hospitals and medical practices that plugged in early have experienced pricey setbacks and serious computer errors. Suddenly dumping more money on hospitals, which will then funnel the cash to tech vendors, won’t necessarily improve the situation, say many doctors and administrators.

    Studies have shown that some large networks, such as the Veterans Administration and the Kaiser Permanente system, based in Oakland, Calif., have used electronic records to help cut costs and improve care. But so far there’s little conclusive evidence that computerizing all of medicine will yield significant savings. And improvements to patient care may be modest. An analysis of four years of Medicare data published in March in the scholarly journal Health Affairs found only marginal improvement in patient safety due to electronic records—specifically, the avoidance of two infections a year at the average U.S. hospital. “Health IT’s true value remains uncertain,” wrote Stephen Parente and Jeffrey McCullough, researchers at the University of Minnesota.

    Part of the problem stems from a fundamental tension. Info tech companies want to sell mass-produced software. But officials at large hospitals say such systems, once installed, require time-consuming and costly customization. The alterations often make it difficult for different hospitals and medical offices to share data—a key goal. Meantime, the health IT industry has successfully lobbied against government oversight.

    “Most big health IT projects have been clear disasters,” says Dr. David Kibbe, senior technology adviser to the American Academy of Family Physicians. “This [digital push] is a microcosm for health-care reform….Will the narrow special interests win out over the public good?”


    Britain’s experience shows that technology alone doesn’t offer an automatic advantage. An $18.6 billion initiative to digitize Britain’s government-run health system is four years behind schedule because of software snafus and vendor troubles. Few British doctors have been able to use electronic records, and there’s little proof that they have saved money or helped patients. “There is a belief that technology solves all of our problems,” says Ross Koppel, a sociologist at the University of Pennsylvania School of Medicine. “[But] more data does not equate to better medical care.”

    Administration officials insist they are proceeding cautiously and will learn from any missteps. But red flags raised by doctors and researchers haven’t gotten much attention in Washington, in part because the health-tech industry has forged strong ties to the President, his top medical advisers, and Republican heavyweights such as Gingrich.

    Nancy-Ann DeParle, the new White House health-reform czar, recently stepped down after eight years as a member of Cerner’s board of directors. A former administrator of Medicare and Medicaid during the Clinton Administration, DeParle worked from 2006 through 2008 as a managing director at CCMP Capital Advisors, a private equity firm that invests in health-care businesses. She has sold shares in Cerner for about $950,000 and is disposing of investments related to CCMP, according to the White House.

    DeParle declined to comment. Obama spokeswoman Linda Douglass says DeParle will delegate any decisions related to Cerner to a subordinate. “She is not going to be involved in implementing health IT,” Douglass adds. Cerner CEO Patterson says DeParle’s ascension won’t benefit his company, which had $1.7 billion in revenue in 2008. “I think that actually works to our disadvantage,” he argues. “I’m not sure I’ll even be able to talk with her now.”

    Glen Tullman, CEO of Allscripts-Misys (MDRX) Healthcare Solutions, a big Chicago vendor to doctors, became acquainted with Obama when he ran for the Senate in 2004. The pair worked out at the same Chicago gym and occasionally played basketball. At that time, Tullman gave Obama a personal demonstration of his company’s software at Allscripts’ headquarters and went on to serve on Obama’s Presidential campaign finance committee. “I feel fortunate that before he became President we had the opportunity to help him better understand the value of electronic health records as a necessary condition to fixing health care,” Tullman says.

    Shortly after the stimulus became law two months ago, Tullman and Gingrich hosted a Webcast for thousands of hospital officials and doctors promoting the financial incentives. Since then, Tullman has worked with a client, the University of South Florida Health system in Tampa, to seek $15 million in stimulus money to hire 130 e-health “ambassadors” who would pass out free samples of Allscripts’ prescribing software to physicians. If the funding comes through, the $50,000-a-year representatives would receive a two-week training course from Allscripts, though the marketers otherwise are supposed to be independent of the company.

    “This is all about getting doctors moving and considering an electronic health record,” Tullman says. “The market is so big, we will get our fair share.” U.S. Representative Kathy Castor, a Tampa Democrat, is helping. She has brought the Allscripts proposal to the attention of officials at the U.S. Health & Human Services Dept. whose job it is to dole out the tech incentives. Castor says the program will create good jobs during a recession.

    Allscripts’ rivals want their share, too. Lobbyists for McKesson (MCK), a large medical supplier based in San Francisco that already generates $3 billion a year in health technology sales, are distributing a position paper to members of Congress and Administration officials that could help steer stimulus dollars toward the company. The document, reviewed by BusinessWeek, addresses the definition of “meaningful use” of electronic records. That is the standard Congress set for hospitals and doctors seeking incentive money; it is now up to the Obama Administration to refine the term. The McKesson paper urges a requirement that recipients “build on existing technologies”—language that could favor products of McKesson and other established vendors.

    Dr. David Blumenthal, the new head of health tech at HHS, will play a big role in fine-tuning this language. Formerly director of the Institute for Health Policy at Harvard Medical School, he declined to comment. HHS spokesman Nicholas Papas says: “Health IT has the potential to save the federal government more than $12 billion over 10 years, improve the quality of care, and make our health-care system more efficient. We have work to do to achieve this potential… and we will ensure that everyone has a seat at the table.” McKesson says it’s just trying to speed the process. “Our big message is: ‘Please do this quickly. Uncertainty creates a slowdown,’ ” says Ann Richardson Berkey, senior vice-president for government strategy.

    There are potential benefits to patients and taxpayers if the promise of electronic medical records can be fulfilled. In theory, a computer screen can supplant reams of paper and offer instant access to patient histories, dangerous drug interactions, and allergies. Treatment of diabetes, cancer, and other illnesses can be tracked more effectively.


    Geisinger Health System in Danville, Pa., wanted all that when it spent $35 million to purchase and install software from Epic Systems, a large vendor in Verona, Wis. But in June 2005, during a pilot run of a computerized order-entry system at Geisinger’s flagship medical center, errors began appearing at a rate of several a week in the hospital’s psychiatric unit. “The pharmacy would interpret an order as one drug at one dosage, and the patients were ordered the wrong medications at different dosages,” recalls Jean Adams, a nurse in charge of the IT team. Fortunately, astute staffers discovered the problem after a few weeks and began verifying the computer drug orders using the phone. Full implementation of the Epic system was put on hold. Adams says Geisinger traced the trouble to incompatibility between a common pharmacy database and Epic’s system.

    Epic CEO Judith Faulkner says the episode at Geisinger, and similar incidents at other hospitals, taught her company that physician orders and pharmacy records cannot use distinct technologies. “It doesn’t work when you mix and match vendors,” Faulkner says. “It has to be one system, or it can be dangerous for patients.”

    To resolve its problem, Geisinger spent an additional $2 million on fixes that took 18 months, according to Dr. James M. Walker, the hospital chain’s chief health information officer. An internist and former minister, Walker is one of health technology’s best-known advocates. Tech boosters frequently cite Geisinger as an illustration of IT’s sunny future. But Walker concedes that the stimulus-fueled rush to adopt existing technology could cause other providers to suffer through expensive fixes with potentially harmful consequences for patients. Vendors such as Epic, Walker says, sell relatively rudimentary electronic tools and expect hospitals and doctors to assure accuracy and safety. “This can be very tricky,” Walker adds. “A lot of us are trying to say: ‘Look, let’s slow down.’ ”


    The Joint Commission, a nonprofit group that inspects and accredits 15,000 health-care organizations, has expressed similar caution. The commission, based in Oakbrook Terrace, Ill., issued a warning in December about problems with complex health-tech systems. It cited one U.S. pharmaceutical database that found 43,372 medication mistakes, or about 25% of the total reported in 2006, involved computer technology. The problems included flaws in data entry, inadequate software, and confusing screens.

    Koppel, the researcher at Penn, has sounded some of the loudest alarms. In 2005 he published a study in The Journal of the American Medical Association that examined an Eclipsys system at the university’s academic hospital. He found that use of computers introduced 22 new types of medication errors. His goal was to discover why young medical interns make so many errors. He hypothesized that long hours were to blame. To his surprise, the problems stemmed mostly from software installed to prevent mistakes.

    Eclipsys CEO Eckert says Koppel’s study examined a technology that has been updated. “The industry has grown up,” he says. “There are months of testing by the client and us before someone activates a system.”

    When health technology fails for one medical provider, there is no central mechanism for reporting problems to others who use it. The federal government collects and disseminates this kind of information on drugs and medical devices. But tech contracts routinely bar medical providers from disclosing systemic flaws. Koppel contends this is unethical and risky: “We need to collect what we know and head off [any potential] tragedy.”

    Companies counter that confidentiality agreements protect their proprietary technology and that privacy laws prevent disclosure of patient and physician information without consent. “To the extent we are required to report information, or are allowed to, we would, of course, like to do that,” says Allscripts CEO Tullman. He compares the skeptics of health info tech to doctors who questioned the introduction of the stethoscope in the 19th century: “There have been Luddites in every industry.”

    Disputes over health-tech failures are often resolved in private, making them difficult to sort out. Seattle Children’s Hospital sued Eclipsys in 2002, claiming the company missed installation deadlines and failed to fix software errors. This resulted in “sizeable cost overruns and delays,” the suit alleged. Eclipsys and the hospital reached a confidential settlement in 2003. A spokeswoman for Eclipsys says “isolated problems in Seattle don’t reflect our company’s overall success. Every vendor in the industry has had accounts with implementation issues.”

    “That was a bad marriage,” says Dr. Mark Del Beccaro, chief medical information officer at Seattle Children’s Hospital. “It taught us to get a better prenuptial agreement next time.” The hospital turned to Cerner for a new system, but Del Beccaro soon became troubled by incidents of children suffering medication overdoses despite alerts from the Cerner software. He asked the doctors involved whether they had seen the alerts onscreen. “They told me, ‘I get so many alerts, I click through [them],’ ” Del Beccaro says. “They do become mind-numbing.”

    “Alert fatigue” is a common concern at hospitals. The Joint Commission, in its December bulletin, warned about doctors and nurses overriding them and impairing patient safety. At Seattle Children’s, Del Beccaro says, it took considerable effort to reduce online warnings. “There are definitely times Cerner could be more responsive to our problems, but we are pretty happy with them,” he says.

    Children’s National Medical Center in Washington, D.C., has had a similar experience. In 2006 doctors and nurses there say they discovered an eightfold increase in dosage errors for high-risk medications. They attributed the trend to a Cerner system installed six months earlier. The mistakes were caught, and no patients were harmed, according to the center. But the hospital reverted to a process using paper notes. “I felt betrayed by a system I was supposed to trust,” says Cherise Aldridge, a neonatal intensive-care nurse.

    For three years, Cerner has resisted making adjustments to its software, which cost the Children’s Center $30 million, says Linda Talley, the hospital’s director of nursing systems. Today nurses use the Cerner network in combination with one assembled by the hospital’s tech department. Nurses retype drug dosages, babies’ weights, and other information from the Cerner computer into the homemade system to double-check how much medicine to administer. This time-consuming process has brought the dosage-error rate back down, says Talley. But she warns that other hospitals use the Cerner system without a backstop like the one her institution cobbled together.

    Dick Flanigan, a senior vice-president at Cerner, says the company responds swiftly to requests for improvements and is “absolutely focused on making systems as safe and effective as possible.” There are divergent opinions as to which technology works best, he adds. Cerner has developed a more expensive system that uses bar codes for medication and is capable of better integrating a wide array of data, he says. “We are flexible on this, and at times we incorporate what is done by the client.” CEO Patterson adds that hospitals “are much safer [with Cerner technology] than without it.”

    The company faced more questions over its technology at the University of Pittsburgh Medical Center (UPMC). In 2005 researchers there found that at the university’s Children’s Hospital, patient deaths more than doubled, to 6.6% of intensive-care admissions, in the five months following the installation of a computerized order-entry system. The research on child patient deaths at the University of Pittsburgh found a “direct association between [computerized records] and increased mortality,” according to an article published in December 2005 in the medical journal Pediatrics. Digital technology slowed treatment in several ways, the researchers concluded. One example: Doctors and nurses in the intensive-care unit were accustomed to ordering medications and tests while a sick child was en route to the hospital. The Cerner system required that orders be submitted only when the patient arrived, costing crucial time. The authors of the Pediatrics article acknowledged that their work clashed with other studies showing that digitization decreases errors and shortens hospital stays.

    G. Daniel Martich, chief medical information officer at UPMC, says the Pediatrics study was flawed. Factors other than the installation of computers, such as the centralization of pharmacy services, also disrupted care, he emphasizes. The problems identified in the 2005 paper have all been resolved, Martich adds. “There were workflow issues,” he says. “We learned the hard way because we were pioneers.” Over the long run, he says, technology has helped decrease mortality rates and cut medication errors in half at Children’s Hospital since 2003 .


    Cerner CEO Patterson says the 2005 Pittsburgh study “certainly got our attention” and prompted an internal review. But that inquiry and others since have found no pattern of ill effects, he says. “We have more clients doing more orders than anybody,” Patterson says. “If I had a systemic problem, you’d be reading about it on the front page.”

    The U.S. Food & Drug Administration has been considering whether to regulate health technology in the manner it oversees medication and implants. That decision now falls to the Obama Administration, which faces opposition from industry groups arguing that additional red tape would impede adoption of helpful technology.

    Companies are lobbying the Administration to keep product-testing and standard-setting within the sole jurisdiction of a nonprofit body called the Certification Commission for Healthcare Information Technology. Founded in 2004 with industry money and grants from nonprofits, CCHIT now receives $7.5 million a year under a contract with the federal government. The other half of CCHIT’s $15 million budget comes from fees paid by companies.

    Mark Leavitt, chairman of CCHIT, is a former tech vendor. He sold his electronic health-records company to GE (GE) in 2002 and later became chief medical officer of the Healthcare Information & Management Systems Society, a trade group in Chicago. Seven of the CCHIT’s 19 voting members work for vendors or for-profit tech consulting firms. “We try to strike a fair balance between medical providers and vendors,” Leavitt says. “People need to trust what we do.”

    But another commissioner at the CCHIT, Michael L. Kappel, the senior vice-president for government and industry relations at McKesson Technology Solutions, acknowledges that preserving purely private-sector oversight will be tough in the wake of the financial crisis. “I’m having a hard time with this issue because people read about these financial companies, and there is a feeling that government lacks enough regulation,” Kappel says. But regulating health info tech “is a recipe for disaster,” he adds. “I am very sensitive to criticism that [CCHIT] is vendor-dominated. That couldn’t be further from the truth.”

    Blumenthal, the new Obama health-tech chief, declined to comment on CCHIT. But in an article published this month in the New England Journal of Medicine, he said the body needs to set stricter standards: “Many certified [electronic health records] are neither user-friendly nor designed to meet [the stimulus law’s] ambitious goal of improving quality and efficiency in the health-care system.”

    Sharona Hoffman, a professor of law and bioethics at Case Western Reserve University in Cleveland, says CCHIT’s product testing, typically completed in a single day, isn’t rigorous enough. In an article last December in the Harvard Journal of Law & Technology, she and a co-author faulted the group for telling vendors the testing scenarios in advance and for not conducting ongoing monitoring. Without better oversight, she argues, hospitals and doctors probably will not spend their stimulus money wisely.

    Barry Hendrix, a primary-care physician in Paragould, Ark., says he paid dearly for just such a mistake, wasting $100,000 on an electronic records system. “It was a complete disaster,” he says of the equipment he bought from NextGen in 2005 and abandoned within months. The system generated patient notes with stray asterisks and other gibberish, he says, and it didn’t work properly with NextGen’s billing software. Hendrix says he couldn’t get technical support from the company or its authorized reseller. NextGen, a unit of Quality Systems (QSII) in Horsham, Pa., counters that Hendrix is a rare exception among thousands of loyal customers. It adds that it has terminated the reseller that served him.

    Hendrix, however, has advice for doctors looking to go electronic: “Never believe a slick salesman.”

    Business Exchange: Read, save, and add content on BW’s new Web 2.0 topic network Obama’s Point Man on Health IT Weighs In

    Businesses angling for a share of federal health – technology stimulus money will want to study an Apr. 9 New England Journal of Medicine article written by the new Obama Administration health info tech overseer, David Blumenthal. Overall, “Stimulating the Adoption of Health Information Technology” conveys a strong sense of caution. “Huge challenges await,” Blumenthal writes.

    To read the full NEJM piece, go to

    Terhune is a senior writer for BusinessWeek based in Florida. Epstein is a correspondent in BusinessWeek’s Washington bureau. Arnst is a senior writer for BusinessWeek based in New York.

    Copyright 2000-2009 by The McGraw-Hill Companies Inc. All rights reserved.


  7. Glen,

    It is probably not a good idea to dis potential clients.



  8. More on CCHIT

    It seems that CCHIT is not a slam-dunk after all. Here is a white-paper and link for your review of: “Health industry groups differ on new certification framework.”


    It seems as though the ME-P has done it again; not accepting the status quo – conventional wisdom – mindlessly. Great job on this post.

    A CCHIT Doubter


  9. Dr. Marcinko and All ME-P Subscribers

    Here is an interesting video of Mark Leavitt, Chair of CCHIT, on the current controversy. It is from The Health Care Blog; good site too – different focus.




  10. I thought it was interesting that just before Mark Leavitt’s interview mentioned by Jan, Glen Tullman, CEO of Allscripts and CCHIT Trustee, told Matt Holt that not only should the field of certified eHRs be narrowed down to only 5 or 6 vendors (including Allscripts, of course), but he also claims that the government is in agreement with the trustee’s plans.

    A few minutes later, when Holt asked Mark Leavitt about Tullman’s opinion, Leavitt immediately made it clear to Holt (and Tullman) that he wasn’t about to contradict the Allscripts CEO, but nevertheless, Leavitt cautiously added “The CCHIT does not have any explicit purpose to reduce the number of vendors.”

    Even though it can be really difficult to sort out the basic intentions of CCHIT, it’s not hard to see who’s in charge.

    D. Kellus Pruitt; DDS


  11. Hope, Dr. Pruitt and Dr. Marcinko,

    Here is an interesting article on eHR standardization:

    Certifying Health IT: Let’s Set the (Electronic Health) Record Straight
    By Mark Leavitt




  12. An even better link is my editorial on the full Leavitt/Kibbe feud here:

    The Kibbe/Leavitt Rumble in the High Tech Jungle!
    Wednesday, May 27, 2009

    Enjoy too!



  13. All ME-P Readers and Subscribers,

    Regardless of your position on this topic, we encourage everyone to read the link suggested by Dr. Borges and visit his website. We thank him for his cogent contribution and encourage more of the same so that we may learn from him.

    Note: Alberto Borges, MD, is in private practice and is an assistant clinical professor of medicine at The George Washington University School of Medicine and Health Sciences in Washington, DC. Check out his website at

    Hope Hetico; RN, MHA
    [Managing Editor]


  14. I found a timely comment from Congressman Ron Paul from Texas. He often posts comments on Small Gov Times. I think we drank the same water growing up.

    Fight government encroachment into Healthcare!

    June 2, 2009 by Ron Paul

    With a faltering economy, and skyrocketing costs, healthcare continues to be a critical issue for all Americans. Unfortunately government encroachment into the doctor/patient relationship is poised to exacerbate our problems with healthcare.

    As an OB/GYN with over 30 years of experience in private practice, I understand that one of the foundations of quality healthcare is the patient’s confidence that all information shared with his or her healthcare provider will remain private. And yet, the Federal Government plans to undermine this trust with establishment of mandatory electronic medical records collections and “unique health identifier” numbers assigned to all Americans. Funding for this program was among the numerous provisions jammed into the stimulus bill rushed through Congress earlier this year.

    Electronic medical records that are part of the federal system will only receive the protection granted by the federal “medical privacy rule.” This misnamed rule actually protects the ability of government officials and state-favored special interests to view private medical records without patient consent.

    Aside from those concerns, the government’s ability to protect medical records is highly questionable. After all, we are all familiar with cases where third parties obtained access to electronic veteran, tax, and other records because of errors made by federal bureaucrats. We should also consider the abuse of IRS records by administrations of both parties. What would happen if unscrupulous politicians gained the power to access their political enemies’ electronic medical records?

    For these reasons I have introduced the Protect Patients’ and Physicians’ Privacy Act, HR 2630, which allows patients and physicians to opt out of any federally mandated, created, or funded electronic medical records system. The bill also repeals sections of federal law establishing a “unique health identifier” and requires patient consent before any electronic medical records can be released to a 3rd party.

    I have also introduced the Coercion is Not Health Care Act, HR 2629. This legislation forbids the federal government from forcing any American to purchase health insurance, or conditioning participation in any federal program on the purchase of health insurance. Forcing Americans to purchase government-approved health insurance is a back door approach to creating a government-controlled healthcare system. Congress would define what policies and coverage requirements satisfy their mandate. Does anyone then doubt that what conditions and treatments are covered would be determined by who has the most effective lobby? Or that Congress would be capable of writing a mandatory insurance policy that fits the unique needs of every individual in the United States?

    With these conditions in place, I foresee the eventual imposition of price controls and limitations on what procedures and treatments that are covered. This will result in an increasing number of providers turning to “cash only” practices, making it difficult for those relying on the government-mandated insurance to find healthcare – the exact opposite of the desired result! Consider the increasing number of physicians who are already withdrawing from the Medicare program because of the low reimbursement and constant bureaucratic harassment from the Centers for Medicare and Medicaid Services.

    Congress should put the American people back in charge of healthcare by expanding healthcare tax credits and deductions, increasing access to Health Savings Accounts, respecting privacy and the doctor/patient relationship. Further politicizing and bureaucratizing of healthcare will only increase costs and reduce quality, as demonstrated by most other countries with socialized medicine.

    Submitted to the ME-P by,
    Darrell K. Pruitt; DDS


  15. Congratulations Dr. Brody

    We are pleased to announce that CCHIT will be including Dr. Michael L. Brody to serve as a member of the Ambulatory eHR work group for the upcoming certification development cycle.

    Dr. Brody has been working with HITSP and the New York E-Health Collaborative and is gratified to assume the role. As one of the few doctors involved in private practice, he has taken an active role in Health Information Technology. He maintains a private practice in Southold, NY and works part-time teaching in the clinical environment at the Northport Podiatry Residency Program, and regularly lectures on Health Information Technology at various CME meetings.

    As the committee’s first podiatrist, Dr. Brody is strong supporter of open source software and strives to represent the needs of the small medical provider when working with diverse organizations to help shape the direction of various HIT initiatives.

    Ann Miller; RN, MHA
    [Executive Director]


  16. Ann

    CCHIT may be “IT” for now! Enjoy this updated link on CCHIT; and be afraid – very afraid!



  17. Hold on Richard,

    The Health Information Technology Policy Committee just recommended to the Dept. of Health and Human Services [HHS] that electronic health record products should be certified by multiple organizations.

    So, it seems as though ME-P folks like Dr. Marcinko and Dr. Pruitt may be right, once again!



  18. If anyone’s interested, I predict that when (almost) all is said and done around 2016, virtually all eMRs, including electronic dental records, will be open-source for natural reasons of flexibility and cost. If that doesn’t get you excited, I am almost sure that even though yearly re-certification of providers’ software will become necessary in order to maintain interoperability with changing technology, the good news is, the upgrades will only require inexpensive patches and plug-ins, and providers will happily purchase these add-ons on the free-market because they want them for their patients’ benefit, not to avoid fines (an absurd authoritarian idea which will be quietly abandoned before a single fine is levied).

    And the CCHIT will justifiably go the way of the WPA, its low-tech cousin. But then, I’m just an optimistic dentist.

    D. Kellus Pruitt; DDS


  19. CCHIT Responding to Critics?

    Darrell, did you know that the Certification Commission for Healthcare Information Technology [CCHIT] is preparing a new, “modular” certification program specifically designed to help providers meet federal “meaningful use” requirements and qualify for EMR subsidies? It’s true.



  20. Jackson, thanks for the heads up. I haven’t had a chance to look into the modular idea, so all I know is what is posted on the FierceEMR link you provided …

    Does this mean that HHS is going to use something like operant conditioning to mold behavior of providers with the ultimate goal of complete compliancy when the provider has shown meaningful use of each modular component – sort of like merit badges?

    Or, does this mean that someone finally got through to CCHIT and convinced them that one size doesn’t fit even most? Does modularization possibly mean user-friendly flexibility for the many various disciplines of health care?

    Anyone? … Anyone?

    D. Kellus Pruitt; DDS


  21. CCHIT Competition

    Did you hear that The Drummond Group, an interoperability testing laboratory based in Austin, Texas, wants to expand its testing programs to include EHRs?



  22. Thanks, Joseph

    Actually, The Drummond Group is based in Fort Worth, Texas. It will be locally interesting how well this venture goes for the group. I wish them luck.

    D. Kellus Pruitt; DDS


  23. Apparently Mark Leavitt will be quitting CCHIT, in March 2010, citing an impending 60th birthday.

    Good try – wrong guy.



  24. Would I be crossing the line of professionalism to suggest that sometime in the future Dr. Mark Leavitt will publicly admit that being caught between Blumenthal, Tullman and Obama was a hell he couldn’t stand any longer?

    Then again, that’s just a rumor I started.

    D. Kellus Pruitt; DDS


  25. Mark Leavitt Resigns

    Here is the formal announcement of Leavitt’s departure.



  26. Three eHR Systems Pass Stimulus Certification

    Three electronic health-record systems are the first to pass muster with the Certification Commission for Health Information Technology (CCHIT) under its new preliminary testing program for compliance with the “meaningful-use” criteria under the American Recovery and Reinvestment Act of 2009, the Chicago-based not-for-profit organization has announced.

    The three products are eHealth Made Easy, Version 3, supporting two of 27 applicable meaningful-use objectives for eligible providers; KIS Track, Version 5.1, by Kaulkin Information Systems, supporting two of 27 applicable objectives for eligible providers; and Medios, Version 4.5, by IOS Health Systems, supporting 27 of 27 applicable objectives for eligible providers, according to CCHIT.

    The new testing regime differs from previous CCHIT certification programs in that it does not require that a vendor pass all test criteria. Checklists of those criteria passed for each product are listed on the CCHIT Web site. The certification also is considered “preliminary,” since the CMS is not expected to issue its first interim definitions of meaningful use until later this month. CCHIT based its testing criteria and standards on those that have been proposed but not yet finalized by HHS, the organization said. CCHIT officials have said they intend to upgrade the certification criteria and retest systems once the final meaningful-use criteria are released, which is expected sometime in the spring.

    Source: Joseph Conn, Health IT Strategist [12/1/09]


  27. David Kibbe MD [New ONC Standards Make CCHIT ‘Irrelevant’]

    The Certification Commission for Healthcare Information Technology [CCHIT] has had its fair share of critics. Some have been the kind of anonymous Internet ranters with either a personal axe to grind or perhaps a screw loose, but many have been both respectful and professional in airing their grievances.

    Read more:

    Hope Hetico; RN, MHA
    [Managing Editor]


  28. Hope

    “Some have been the kind of anonymous Internet ranters with either a personal axe to grind or perhaps a screw loose.” That can’t be me. I’m not anonymous.

    I also discovered the FierceEMR article featuring Kibbe. Here is what I posted:
    I bet that’s a kick in the butt for CCHIT officer Glen Tullman CEO of Allscripts.

    He’s so arrogant. A year ago he said that “providers should have to invest in eHRs so that doctors will have some skin in the game.”

    And the CCHIT officer sells eHRs that CCHIT certifies. Sweet, Glen. Some CEOs have all the luck.

    D. Kellus Pruitt; DDS


  29. In addition to the above, the Certification Commission for Health Information Technology (CCHIT) just said it believes the Interim Final Rule (IFR) on standards and certification might cause “unintended deceleration in the pace of adoption.”



  30. Don’t let informatics-types harm your patients

    Have you heard of Pay for Performance? And do you have an NPI number?

    The following press release was posted recently by the National Quality Forum (NQF) – a quasi-governmental “non-profit” advisory service or something like that. It doesn’t really matter. Whoever they are, they’ve got no dental representatives on its new Health IT Advisory Committee, and the President’s ear.

    UnitedHealth and Cigna are represented. Where are you, ADA? Why oh why isn’t someone raising hell besides me?

    NQF Forms New Health IT Advisory Committee

    Washington, DC – To guide its ongoing work in health information technology, the National Quality Forum (NQF) has formed a new Health Information Technology Advisory Committee (HITAC). Members of the new advisory committee represent a wide range of healthcare stakeholders, including consumers, providers, clinicians, purchasers, suppliers, and public and community healthcare.

    The NQF Board of Directors approved the creation of HITAC, charging the body with:

    – developing a strategic plan and providing ongoing guidance for NQF’s HIT portfolio;

    – offering input on HIT projects, such as maintenance of the Quality Data Set and specification of testing requirements for eMeasures;

    – reviewing electronic specifications for NQF-endorsed® and candidate standards;

    – making recommendations on the endorsement and maintenance of HIT-related consensus standards.

    “HIT has great potential to accelerate quality improvement in healthcare,” said Janet Corrigan, NQF president and CEO. “We’re fortunate to have such a diverse group of experts from across the healthcare system to guide NQF’s work in this area. Their expertise will help guide work to ensure electronic health records and personal health records are capable of measuring and reporting on quality to drive transformations in care delivery. They will also play a key role in the integration of HIT and performance measures.”

    HITAC is a standing committee of the NQF Board of Directors and includes non-voting federal liaisons from the Agency for Healthcare Research and Quality, Centers for Medicare & Medicaid Services, Indian Health Service, the Office of the National Coordinator for HIT, and the Veterans Health Administration. Members of HITAC are eligible to serve three-year terms. To stagger the future appointment cycle, inaugural HITAC members will serve one-, two-, or three-year terms.

    The mission of the National Quality Forum is to improve the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. NQF, a non-profit organization ( with diverse stakeholders across the public and private health sectors, was established in 1999 and is based in Washington, DC.

    Health Information Technology Advisory Committee (HITAC) Members

    Paul C. Tang, MD, MS (Chair)

    Vice President and Chief Medical Information Director, Palo Alto Medical Foundation and Consulting Associate Professor of Medicine, Stanford University

    Patricia A. Abbott, PhD, RN-BC

    Associate Professor, The Johns Hopkins School of Nursing and The Johns Hopkins

    University School of Medicine, Division of Health Sciences Informatics

    Richard J. Baron, MD

    President and CEO, Greenhouse Internists

    David W. Bates, MD, MSc

    Chief, Division of General Internal Medicine, Brigham and Women’s Hospital and

    Medical Director of Clinical and Quality Analysis, Partners HealthCare System, Inc.

    Chad Bennett

    Director of Health Informatics and Product Strategy, Iowa Foundation for Medical Care

    A. John Blair, III, MD

    President, Taconic IPA, Inc.

    Marilyn Jane Bowman-Hayes, RN, MSN, MBA

    Informatics Nurse Specialist, Association of periOperative Registered Nurses

    Becky J. Cherney

    President and CEO, Florida Health Care Coalition

    Ian Z. Chuang, MD, MS

    Medical Officer, Applied Informatics, CIGNA HealthCare

    John F. Derr, RPh

    Senior Vice President and Chief Technology Strategic Officer, Golden Living, LLC

    Caterina E.M. Lasome, PhD, MSN, MBA, MHA, RN, CPHIMS

    Chief Operating Officer, National Cancer Institute Center for Biomedical Informatics & Information Technology

    Christoph U. Lehmann, MD

    Director, Clinical Information Technology, Johns Hopkins University and

    Associate Professor, Department of Pediatrics, The Johns Hopkins University School of Medicine

    Michael I. Lieberman, MD, MS

    Director, Medical Quality Improvement Consortium, GE Healthcare IT

    Blackford Middleton, MD, MPH, MSc

    Corporate Director, Clinical Informatics Research & Development, Partners HealthCare System, Inc.

    J. Marc Overhage, MD, PhD

    Director of Medical Informatics, Regenstrief Institute

    Stanley L. Pestotnik, MS, RPh

    General Manager, TheraDoc, Hospira, Inc.

    Eva M. Powell, MSW, CPHQ

    Director, Health Information Technology Project, National Partnership for Women & Families

    Christopher J. Queram, MA

    President and CEO, Wisconsin Collaborative for Healthcare Quality

    Deborah A. Reid, JD, MHA

    Senior Attorney, National Health Law Program

    Martha A. Roherty, MPP

    Executive Director, National Association of State Units on Aging

    John Seibel, MD

    Medical Director, New Mexico Medical Review Association

    Shannon Sims, MD, PhD

    Director of Health Informatics in Performance Improvement, Rush University Medical Center

    Christopher S. Snyder, DO

    Chief Medical Information Officer, Peninsula Regional Medical Center

    David A. Stumpf, MD, PhD

    Senior Vice President for Clinical Data Strategies, United Health Group

    Marcia Thomas-Brown, MHSA, LNHA, CHE

    Chief Operating Officer, National Health IT Collaborative for the Underserved


    Note: In addition to UnitedHealth and Cigna, GE Healthcare IT and the Association of periOperative Registered Nurses have a seat at the table. But no dentists.

    How well do you think those trousers will fit?

    D. Kellus Pruitt; DDS

    Editor’s Note: No podiatrists or optometrists, etiher!


  31. CCHIT Creates Alternative Certification

    Dr. Marcinko and Ms. Hetico … The Chicago-based Certification Commission for Health Information Technology just announced the December 15th launch of a certification program for electronic health-record systems for hospitals that have either home-grown EHRs or systems developed with component parts that are not otherwise certified as compliant with requirements of the federal IT subsidy program under the American Recovery and Reinvestment Act [ARRA] of 2009.

    Systems tested and certified under the new program, dubbed the EHR Alternative Certification for Hospitals [EACH] will be recognized by the Office of the National Coordinator for Health Information Technology as meeting certification criteria under the stimulus law and be on equal legal footing as commercial systems that have been tested and certified
    Source: Joseph Conn, Health IT Strategist [11/10/10]


  32. So is this a “dumbing down” of the requirements, or is it a more realistic approach … or both?



  33. CCHIT-certified eHRs and dark humor

    Over the last decade, healthcare STAKEHOLDERS inside and outside the medical field hitched careers as well as healthcare reform funding to nothing more than HIT industry sales pitches for electronic health records. All the while, doctors and patients – the healthcare PRINCIPALS – silently let stakeholders get away with wasting billions of dollars of our grandchildren’s money because far too few of us were paying attention. Some were busy fighting off being marginalized by STAKEHOLDERS.

    The marketplace result of state-supported unaccountability to consumers is not unlike Soviet rot. However, in the land of the free, truth eventually overcomes lies. It just might take a few years.

    On November 18, “Why EHRs aren’t meaningful to doctors and hospitals,” by Richard Reece, MD was posted on blog.

    Dr. Reece writes, “Electronic health record (EHR) advocates in Washington don’t seem to get it. They don’t seem to understand that hospitals and doctors aren’t rushing to install EHRs because many EHRs, despite the constant talk that EHRs are a prerequisite for good care. Caregivers are not walking the talk, because in their view, EHRs,

    – aren’t ready for prime time

    – slow productivity

    – decrease revenues,

    – show scant returns on investment

    – don’t talk to one another

    – distract from time spent with patients

    – are limited as communication tools.


    Physicians and especially hospitals need the efficiency of eHRs far worse than dentists. Yet as Dr. Reece says, even hospitals which have millions of charts “aren’t rushing to install EHRs” – even with ARRA stimulus help. It sounds to me like principals in dental care stand a better chance of a return on investment, more transparency and safer dentistry from a Ponzi scheme.

    Did you know that up until about a year ago the Advocacy page of featured a claim that eDRs will save money in dental care? I pointed out the deceptive, committee-approved talking point to ADA leaders as long ago as August 2007 after reading this and other unfounded claims about the benefits of eDRs that were given as testimony to the NCVHS by the ADA’s HIT expert Dr. Robert Ahlstrom.

    Dr. Ahlstrom said, “Cost savings to providers and plans will translate in less costly health care for consumers. Premiums and charges will be lowered.” – From “Testimony of the American Dental Association

    National Committee on Vital and Health Statistics Subcommittee on Standards and Security, July 31, 2007”

    Click to access 070731p08.pdf

    Contrary to ADA testimony from 2007, eDRs have never saved money on dental care. And with the ever-increasing liability of data breaches, the value of eDRs to consumers will continue to fall as the cost rises.

    So what happened to the misleading money-saving claim on the ADA Advocacy page? The ADA took it down hours after I pointed out the lie on a half-dozen Facebook pages belonging to ADA state organizations across the nation. While obediently voicing dissent in the ADA-approved way will reliably marginalize a troublemaker, sudden transparency means instant personal accountability from even good ol’ boys.

    The ADA has no other choice now than to come forward and discuss the truth about eHRs in dentistry. The perfect place to clear the air of ADA smoke is the ADA Facebook where there are over 8000 principals waiting to hear the ADA’s story. Can you handle the honesty we now demand from stakeholders like you, ADA? You are running out of time and I guarantee you that the truth about eDRs will serve you much better than evasion from this moment forward.

    Now then, wasn’t that funny?

    D. Kellus Pruitt DDS


  34. About My Colleague,

    Darrell – Did you know that Richard L. Reece MD and I first worked together more than two decade ago when he was the editor of a print medical office management newsletter and I was an occasional specialty contributing writer. His encouragement is still remembered and appreciated.

    Dr. Reece is now retired but blogs here and elsewhere at:

    He is also the author of [Obama, Doctors, and Health Reform]

    Dr. David Edward Marcinko MBA


  35. CCHIT Ending Testing and Certification of EHRs

    The Certification Commission for Health Information Technology is getting out of the business of testing and certifying electronic health-record systems after nearly a decade as the first and still most-commonly used provider of those services in the U.S. The organization also stopped taking applications for testing and certification services from vendors Tuesday, and will finish work on about 70 of those systems it has in the pipeline and wind down that part of its operations by April or May, CCHIT Executive Director Alisa Ray said.

    Today, roughly half of all health IT systems on the official Certified Health IT Product List kept by the Office of the National Coordinator for Health Information Technology at HHS have been tested and certified by CCHIT.

    Source: Joseph Conn, Modern Healthcare [1/29/14]

    PS: Proven – We were five years early.


  36. R.I.P. – CCHIT set to close its operations

    The Certification Commission for Health Information Technology (CCHIT) has announced that it will end all of its business operations by November 14th.

    How appropriate during the Halloween Season.
    Next to go – MU and ONC?



  37. OMG,

    Dr. Marcinko – You were at least 5 [documented] years ahead of the CCHIT cautionary pack. Well done.



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