More need for CCHIT Certification?

OpenEMR Development
1

openemrhq wrote on Sunday, February 08, 2009:

I’ve spent a good part of today going over the text of the new economic stimulus bill that’s currently being debated in the U.S. Senate.  In particular, like many of you, I’m really interested in the governments investment in health IT and how it relates to the people we serve through OpenEMR.

I noticed the following text in the bill in regards to the appropriation of the money set aside for health IT:

"(b) Limitation- None of the funds appropriated to carry out this section may be used to make significant investments in, or provide significant funds for, the acquisition of hardware or software or for the use of an electronic health or medical record, or significant components thereof, unless such investments or funds are for certified products that would permit the full and accurate electronic exchange and use of health information in a medical record, including standards for security, privacy, and quality improvement functions adopted by the Office of the National Coordinator for Health Information Technology."

I’m noticing that they specifically use the word “certified” as a delimiter to anyone getting funds to purchase software/hardware and I’m wondering how this might effect doctors wanting to use OpenEMR? Since OpenEMR is *not* certified (I’m assuming they’re talking about CCHIT here), does that mean doctors wanting to implement it cannot get money to do so?

If it does, should this be taken as yet another signal that OpenEMR is really needing to become CCHIT certified and that we should find a way to do that?

Thanks!
David Kennerson
OpenEMR HQ, Inc.

Phone: (918) 919-4624

2

cfapress wrote on Monday, February 09, 2009:

I’ll chip in with a comment here… It’s really for OpenEMR users but the developers tend to overlap with the users.

Any Agency/Practice/Office/whatever that is using OpenEMR ought to consider donating money to the OpenEMR project so that it can become certified. It’s in their best financial interest to outlay a little cash here in order to earn lots of cash from the Stimulus Bill. In my specific case, I will encourage my Agency to donate $1000+ to the OpenEMR project as long as they money goes toward guuarnteeing the software is CCHIT compliant. Thus enabling our Agency to then take in huge Medicare incentive payments.

OpenEMR is a really good investment for Agencies like mine with a technical staff that can implement the software and save $60,000+ by not resorting to commercial products.

Now, is there a responsible financial person volunteering time for OpenEMR?  Sorry Dave, I’m not sure that OpenEMR-HQ is the best vehicle for these sort of funds. I feel strange suggesting my Agency donate $$ to a for-profit company in an effort to get an open source product certified. Maybe you can convince myself, and others, otherwise?

Jason

3

drbowen wrote on Monday, February 09, 2009:

Yes.

I am the responsible financial person for the project.

Open Source Medical Software is a not-for-profit chartered in the State of North Carolina specifically for the support of this project.  I am responsible for soliciting, setting up and maintaining appropriate account to manage the funds.

See the info art this link:

http://www.oemr.org/modules/wiwimod/index.php?page=OpenSourceMedicalSoftware&back=WiwiHome

The board of directors and guidance committee consists of

Rod Roark of Fairfield, California, is the secretary.
Andres Paglayan of Sante Fe, New Mexico, is the treasurer.
James Perry, Jr., of Laurel, Maryland, is vice president.
Dr. Mark Leeds, family practice, of Oakland Park, Florida
Dr. Michiel Bosman, psychiatry, of Amsterdam, Holland
David Herman, CPA
Samuel T. Bowen, MD, internal medicine, of Hickory, North Carolina as president.

As a not-for-profit we are used to using directed donations for a specific project.  So, yes, if you wish the donation to be used specifically for CCHIT certification that is what will happen.  David Herman, a member of our board,  helps with these more complex accounting issues and was specifically recruited for this purpose.  We have filed a PF990 (not for profit tax return) for 2007 which we will be glad to provide to you if you so desire.  The 2008 PF990 has not filed as of yet.

And, yes, the federal government means precisely that you have to be CCHIT certified to get any help.  I spoke with Tina Johnson with an official of the federal government about 3-4 weeks ago.  This gentleman is in the DHS HIT.  He was very clear that there would be no assistance for our project without first achieving CCHIT certification.  It was also clear that they are going to try to force this to happen.

The initial application fee, I believe, is $38,000.  Additional software modifications will be necessary to be able to be certified.  Rod Roark is in the process of estimating the costs of completing the certification.  Perusing the Internet, the estimated total cost averages around $200,000.  Of course most of this is software development costs for large for profit software companies.  Only 2.5% of the available software projects are currently certified. 

We could of course benefit from OpenemrHQ and persons like yourself who could make some of the modifications necessary to pass certification.  This would save a lot of money.  We would still have to come up with the application fee.

Contributions can be made to any of the members of the board of directors:

Open Source Medical Software
c/o Samuel T. Bowen, MD
1470 9th Ave. Dr. NE
Hickory, NC 28601

Telephone 1-828-325-0950

4

openemrhq wrote on Monday, February 09, 2009:

Jason,

I like your idea about the users chipping in towards certification. You’re right, it is indeed to their benefit that OpenEMR gets certified. I know a few people who would do that in leiu of the major money they’re saving over traditional, commercial, EMR’s.

We might also want to consider encouraging companies who work within the OpenEMR sphere to donate a percentage of income towards certification. I know it’s something we’ve considered here and I’m sure many other companies would too because it’s in their best interests to help get OpenEMR certified.

I agree, OpenEMR HQ isn’t the best vehicle for manning the certification funds. We discussed setting up a fund a while back but decided that it needed to be managed by someone outside of the commercial sphere. Shortly after that, I saw a post here by Dr. Bowen (who’s also responded to this post) talking about the OSMS and how it would handle the funds.  Really, that is the best solution. A totally non-commercial entity with a vested interest in OpenEMR.

Now, a question to Dr. Bowen: Someone asked me this the other day and I didn’t know the answer offhand: once the software is certified is it certified for “life” or does it need to be re certified with each new release? If so, does that necessitate paying that fee in full again?

As to OpenEMR HQ, I can tell you that we are definitely eager to jump in and help. We’ll donate money, development time, whatever it takes to get this thing done. It’s important and we know, like everyone else here, that OpenEMR is a valuable piece of software real estate.

David Kennerson
OpenEMR HQ, Inc.

5

drbowen wrote on Monday, February 09, 2009:

My understanding is that the initial certification fee is $38,000.  This is a one time certification.  Recertification of the this product is then paid out of "a percentage of our profits".  I am not sure what that means for us exactly. But, where i went to school, something multiplied time zero is zero.  I suspect the CCHIT is not going to like this line of reasoning no matter how reasonable it may be to us.

It is also my understanding that you have to pay again to certify another version.  We pay to certify OpenEMR "3.0".  Then we can likely release "security updates" and patches and such.  When we get to "4.0" and release our next version we have to pay again.  This is my interpretation from reading the materials on the site.

The most expensive part is the development cost of adding the pieces that we don’t have.  For most commercial companies this is around $160,000.  The nature of the OpenEMR project is such that we could divy up the work load among the active developers.

I have personally funded two time employees for a couple of years to help get the not-for-profit company, OSMS, up and running.  Since, March 2005, I have contributed, around $7,000 a year in donated internet connection time, stationery, telephones and other general office expenses for the project.  I have raised $3,500 in donated funds and contributed several thousand dollars in cash to this project.  I incorporated the not-for-profit and I have been running the public web server since October, 2005.

We can not fund this project successfully unless you, as volunteers, step up and give both donated software development costs and money to this project.

Sam Bowen, MD
President, Open Source Medical Software

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markleeds wrote on Tuesday, February 10, 2009:

Is this the correct document for our project?

http://www.cchit.org/files/certification/08/Ambulatory/CCHITCriteriaAMBULATORY08FINAL.pdf

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drbowen wrote on Tuesday, February 10, 2009:

Yes, I believe so.  67 pages.  Not bad for a government document.

Sam Bowen, MD

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voipbound wrote on Sunday, February 15, 2009:

I do not have much money or knowledge to contribute.  But whatever dimes n nickels I have left over from my new practice, I will certainly donate to this worthwhile cause.