I’m not attending the HIMSS show in Chicago this year.  Since I’m currently neither buying nor selling hospital information systems, there’s wasn’t enough to justify the trip. But if I were going, I’d show up to the CCHIT leadership meeting with open source advocates.

Here’s the challenge: it’s hard to take an open source software package and run it through an expensive certification process.  When the Certification Commission for Health IT was originally proposed, the idea was to provide physicians with an extra level of confidence in their prospective EHR purchases.  From what I’ve been able to tell, the impact in this respect has been pretty modest – not least because virtually every major vendor spent the money and got the certification.

The American Recovery and Reinvestment Act Health IT provisions (including $17 billion in funding for EHR use) may change the equation. The law requires “meaningful use” of EHRs to qualify for money, and that’s generally been taken as meaning certification. It’s not clear that CCHIT, as an organization, is going to be the organization that provides that certification. But, realistically, there isn’t anybody else out there who can do it.  And there’s an appropriateness issue that has not been entirely settled. In technology, certification works best when there’s something concrete to certify. Interoperability certifications, for instance, make a lot of sense, and they’re quite common in the network infrastructure world. Still, despite excellent work that’s been done on standards, it’s still early days.

To my mind, this leaves the government with two options. One is to embrace CCHIT certification as the marker for “meaningful” EHR use.  The other is to set a much lower bar – possibly a simple checklist, including features like support for the main electronic prescribing transactions.  It’s easy paperwork, and it wouldn’t be hard for the government to audit.  Providers using any CCHIT certified system can automatically be covered, but the ARRA threshold can be set lower.

More (from the FOSS side) from Fred Trotter, here. Includes the excellent line “like offering to meet with the Rebel Alliance at the annual Death Star conference.” And I thought HIMSS was supposed to be a boat show!