lbarzin wrote on Monday, February 02, 2009:
I’m not an expert on CCHIT, but I’ve been told that certification is against a particular version of the product and that each version must be independently certified (ugh). You might want to check with the WorldVista folks. They got certified and they are freely distributed as well. Find out how they organized and paid for it.
shadisland wrote on Wednesday, February 18, 2009:
Newbie here trying to get the lay of the land…I hope you don’t mind my asking: 1) who are the major EMS players that are CCHIT certified? 2) What are the pieces that OpenEMR is missing that cost corporations $160k to add?
Thanks for your time
technotool wrote on Wednesday, February 18, 2009:
search for CCHIT on Google for their website(CCHIT). They keep a list of certified vendors on their website.
okhra wrote on Wednesday, February 18, 2009:
The more I read the stimulus package, the more I am convinced that certification through CCHIT is unnecessarily expensive and another standard organization may take over. The end result, like communicating with other docs, lab, immunization registry etc .etc should be the criteria for incentive payments from the stimulus package. May be some advocacy against CCHIT and for FOSS is needed.
balu raman
drbowen wrote on Thursday, February 19, 2009:
I think there is a lot of pressure coming down from the DHS to force interoperability. This is the current focus of the CCHIT certification process this year.
I just don’t think this is going away.
It is time to stop talking and start actually contributing.
I have donated $500 today to start the CCHIT certification fund and have already deposited the money in the OSMS account.
Sam Bowen, MD
Please remit your checks to:
Open Source Medical Software
c/o Samuel T. Bowen, MD
1470 9th Ave Dr NE
Hickory, NC 28601
openemrhq wrote on Friday, February 20, 2009:
Dr. Bowen,
Do interested parties just mail a check to the address above? We’d like to make a donation and pledge a percentage of all of our OpenEMR contracts to the cause.
David Kennerson
OpenEMR HQ, Inc.
drbowen wrote on Friday, February 20, 2009:
Dear David,
Yes.
Just mark the check as designated for the CCHIT certification fund. Checks not marked in any way will be considered as donations to the general fund (though they will also most likely need to be used for the CCHIT certification fund).
Open Source Medical Software is operated out of my private office. I pay for all of the telephone service, rent, utilities, internet service and operate the project web server all out of my office.
The web server was built by Rod Roark and and funded through a generous donation by Hickory Springs, Inc. Hickory Springs makes parts and springs of course. These are the springs in the furniture that you have in your living room and in the chairs at your office. They may even have made the springs that are in the bed you sleep on at night.
Sam Bowen, MD
drbowen wrote on Thursday, February 26, 2009:
Currently, I have donated $500 dollars to the CCHIT certification account at OSMS.
I have received one potential pledge for $2,000 from a private clinic. This has not been approved by the clinic administration yet but is in process.
I have two other organizations and one private physician who wish to donate but have not decided on a figure at this time.
I will continue to post progress on the fund as it grows.
Sam Bowen, MD
President, OSMS
fred0 wrote on Saturday, March 14, 2009:
An update on CCHIT & FOSS:
drbowen wrote on Monday, March 23, 2009:
The CCHIT certification fund is now at $1000 and growing. The target is $38,000.
Thank you to ones who have reached itno their pockets and given so generously.
Sam Bowen, MD
tmccormi wrote on Tuesday, March 24, 2009:
If all the OpenEMR based service providers contributed even a small percentage of their income derived directly from OpenEMR going forward, we could be a long way in the right direction.
–Tony
sunsetsystems wrote on Tuesday, March 24, 2009:
Reading the comments here and in the above-mentioned Slashdot article and applying my own common sense, I can only conclude that certification will a huge quagmire for quite some time. There will surely be a lot of CCHIT hitting the fan (sorry for the pun!) before this is all over.
If we accept Fred Trotter’s assessment that CCHIT is anti-FOSS, then surely supporting it financially at an early stage is wrong. Indeed, fighting it seems more appropriate. I would much rather see donations going towards meeting the technical requirements (at least the ones that actually make sense), and perhaps also some pro-FOSS lobbying, than towards the certification process. When we do meet the requirements, we become more real and can more effectively argue for a fair process.
drbowen wrote on Tuesday, March 24, 2009:
I have been in private communication with developers who have already started working on the interoperability, laboratory communication and has plans to upgrade the internal security issues such as old style insecure database connections. All with the intent of giving CCHIT certification a go.
I am perfectly happy helping fight the CCHIT organization politically and think we should all be writing our senators complaining about this. I will be glad to pen a letter that everyone here can use to send to their own Congressmen and Senators.
Fighting political battles is a very long, slow, agonizing process. None of this helps me see how we are going to get around the issue of the Federal Government pushing CCHIT certification and requiring certification of EMRs in the very near future. I am not a fan of CCHIT, but as a practicing physician I have to stay in business and if the Feds say I have to use a certified product, waving a flag at the Bastille is not going to keep me in practice.
Those of you who are doing this professionally ought to really be scared. It is hard enough now, convincing potential users / clients that we really do have a free, high quality, electronic health record with integrated practice management. They want to know “what’s the gimmick” “If there is no gimmick then what’s the catch?” “If there is no catch why is it broken?” If you try to sell a non-certified EMR when all physicians know you are required to be certified, just how successful do you think you are going to be?
Sam Bowen, MD
drbowen wrote on Tuesday, March 24, 2009:
The CCHIT certification fund is up to $1,500 dollars.
Sam Bowen, MD
tmccormi wrote on Tuesday, March 24, 2009:
I agree with the Rod’s view, generally here. We may be over a barrel anyway, but either way going thru the process informally is a requirement in advance of any formal attempt and funds are needed to pay for certification *or* lobbying so I don’t think we need to stop the presses.
Tony
openemrhq wrote on Wednesday, March 25, 2009:
While everything about CCHIT seems antithetical to the FOSS movement and beliefs, I think this has become one of those ‘pick your battles’ type of issues.
If our main goal as a community is to provide one of the best free EMR/PM solutions to our customers, then, as horrible as it sounds, it only makes sense to pursue CCHIT certification. If we don’t, OpenEMR and other FOSS medical software could very well be dead in the water in less than 6 years. In my mind, I don’t see any option but to pursue certification and I applaud Dr. Bowen and others who’ve began working towards this goal.
But I don’t think that achieving certification is enough. Real change needs to come to the CCHIT. There has to be room made for FOSS at their table and it needs to stand toe to doe with other comparable software. To that end, I think we need good, strong, FOSS advocates within the CCHIT working towards change. As i understand it, CCHIT has a lot of volunteer opportunities (especially when it comes to policy programs) and maybe some of us should seriously consider getting involved with that.
It’s odd finding the need to get in bed with the beast. But, really, I don’t see any other way to keep OpenEMR viable long term.
David Kennerson
mbrody wrote on Wednesday, March 25, 2009:
I do not necessarily agree that CCHIT is anti "FOSS". To that end I am already on two HITSP committees and am applying for the CCHIT committees.
As I see it, the ultimate goal of CCHIT is to ‘force’ interoperability between various EHR software packages, with all packages utilizing a common set of standards. I look at this as almost forcing commercial software to be less proprietary since they need to meet certain standards in communicating. Which is much more of an Open Source concept. (actually following standards that will allow data to be transferred from one EMR to another).
These standards will also allow users to more easily move from one EMR package to another either to or from OS packages with minimal pain.
The disadvantage to OS software is the lack of ‘funds’ to obtain certification.
I support this product getting CCHIT certification.
Michael
drbowen wrote on Wednesday, March 25, 2009:
In my own personal path I am running very hard in the direction of CCHIT while I am screaming at my Congressman and Senators about the unfairness of the whole situation.
I agree the certification process needs to be changed.
I agree that certification needs to exist to force interoperability.
I am not going to be left out in the cold because I guessed wrongly about which was the better way.
It is possible to do both at the same time.
Have ANY of you written your Congressman yet?
Sam Bowen, MD
openemrhq wrote on Thursday, March 26, 2009:
Dr. Bowen,
Do you happen to have a copy of the letter you sent to your Congressman that you’d be willing to share with the group?
David Kennerson
drbowen wrote on Friday, March 27, 2009:
Open Source Medical Software
1470 Ninth Avenue Drive NE
Hickory, North Carolina, 28601
telephone 1-828-325-0950
March 26, 2009
Congressman Patrick McHenry
87 4th St. NW, Suite A
P.O. Box 1830
Hickory, NC 28603
Open Source Software Certification
Executive Summary
Honorable Congressman McHenry:
The new Economic Recovery and Stimulus Act of 2009 requires electronic health records to be certified. As the developers of an electronic health record we agree in principle that the interoperablity standards of the Health Information Technology (HIT) division of Health and Human Services (HHS) will be good for Americans and help improve their health. We could not help but notice that the plans for HIT to spend $19 Billion dollars to study Open Source Health Care Software primarily to support rural health care, free health clinics and primary health care in the United States to help protect the fundamental health care safety net in the United States. The Act goes on to provide funds to reimburse medical practices up to 85% of the purchase price of a certified (emphasis added) electronic health record product. At the same time the Center for Medicare & Medicaid Services (CMS) has proposed an initial 2% increase in reimbursement of fees for the adoption of ePrescribing by physicians with a 7% drop over the next 7 years for physicians that do not comply.
You can understand my chagrin after speaking to Dr. David Hughes of HIT at 11:00 AM on January 19th, 2009, that my not-for-profit free open source software company can not apply for assistance or compete for this project in any way because we are not certified. They will provide no assistance for us to get certified. He explicitly stated that we had to be CCHIT certified. Currently the Certification Commission for Health Information Technology requires a $29,000 initial fee and requires at the same time a $6,000 annual software maintenance fee. If we want to add child health this requires an additional $6,500 and $1,500 software maintenance fee. This a total of $43,000 for a EHR that wants ambulatory care certification with a pediatric indication. The actual reported cost to gt certified by certified by the companies that have been able to manage this is $200,000. The difference being made up in the additional development necessary to achieve certification.
So what is the problem with this? There are over 400 companies in the United States that offer ambulatory Electronic Healthcare Record software. At this time only 21 one have managed to become certified in 2008 and in 2007 only 47 companies. The roll call of these companies reads like a roll call of the whose who of the Rich-N-Famous of American software companies. The smaller companies simply cannot afford this cost of this certification. In comparison, Open Source Medical Software, is a not-for-profit free open source software company. We give our software away for free. We do not have on income stream. Our past, present and future profit is intentionally zero. If the for profit companies struggle with this cost how believes that we can do this with an intentional profit of zero. In fact this type of operation is typical of many open source software companies.
Now I want to reiterate something. I am giving away for free $54 million dollars of software a month to anyone and everyone I can convince for free. I am trying to give to the United States government this fully functional software for free. The US government is refusing my free software because I don’t have the $200,000 to get certified. Now the US government in the Economic Recovery and Stimulus Act is planning to spend $19 BILLION dollars between now and 2010 to investigate how to provide what I am giving away for free. In addition the US Government has officially made law an offer to spend many more tens of Billions of dollars reimbursing well-to-do medical practices what they would have to buy on their own anyway. Congressman, this is so outrageous that I think it makes the jokes about $50 ashtrays and $1,200 toilets seem like a grains of sand on the entire coast of California. Am I the only one that gets the irony of this?
Congressman, We need your help.
Obviously we are not playing on a level field and the Laws being passed are forcing us into an untenable position. You can help by either convincing the CCHIT to lower their fees to include supporting an organization that has no income such as ours. (They have shown no inclination to do this when asked by multiple companies.) Or by helping us to setup a second certification body created for those software companies that cannot afford these outrageous fees.
The Federal Government is obviously hopeless lost when it comes to free open source software projects. The majority of these open source projects work as not-for-profits. The Mitre Corporation performed a study of Free Open Source Systems (FOSS) used by the Department of Defense (DOD) in 2001. 115 FOSS systems were identified and were being used in about 251 applications. When the Mitre Corporation queried the DOD staff about the use of the software and whether it proposed a security risk to the DOD and the United States. The Mitre Corporation found that that FOSS systems were being used in 4 departments that identified FOSS software as mission critical and these included: Infrastructure Support, Software Development, Security, and Research. Te department that objected most strenuously was the IT security department who felt a number, up to 13, of the FOSS systems were especially important in their jobs of protecting the DOD. The Mitre study and “The Cathedral and the Bazaar,” by Eric Raymond, O’Reilly Associates, 1999 will go a long way towards educating the Lawmakers of our country on the strengths and values of Free Open Source Software.
After reading several portions of the Economic Recovery and Stimulus Act of 2009. I am still trying to understand how the US government is going to spend $19 Billion dollars studying something that OSMS already has, gives away for free, and could get certified for much less than 0.01% of the what is just a tiny portion of the entire Act. With all the “Pork” in this massive Act, wouldn’t you, Congressman, pluck out just a single hair on the behalf of this worthy cause?
Sincerely,
Samuel T. Bowen, MD
President
Open Source Medical Software