GHIT Notebook

September 3, 2008

Is three a crowd?

By John Moore

At least three organizations are looking to establish a commercial seal of approval for fledgling health information exchanges and regional health information organizations.

The Certification Commission for Health Information Technology (CCHIT) earlier this year kicked off a pilot program that seeks to certify HIEs. Officials in New York, meanwhile, are studying the feasibility of accrediting the state’s regional health information organizations (RHIOs). And in August, the Electronic Health Network Accreditation Commission (EHNAC) said it will devise a program to accredit RHIOs and HIEs.

It will be months before some of the programs are fully operational, but early signs point to a level of collaboration among the different groups. “What we are trying to do here is not be duplicative,” said Lee Barrett, the executive director of EHNACH, an organization whose roots go back to the beginnings of the electronic data interchange industry.

Marc Holland, program director with research firm Health Industry Insights, said the participation of multiple entities is only good if their work proves synergistic. The issue, he said, is whether the different groups can develop conforming standards and requirements.

Different Paths

CCHIT’s testing and certification program for HIEs will likely become the first of the programs to go live, based on its scheduled October launch date. The commission’s program will initially concentrate on security and interoperability. CCHIT will test participating HIEs on security-oriented core criteria and transaction set criteria.

While the CCHIT program prepares for its debut, New York is considering options for evaluating and accrediting the state’s RHIOs. RHIOs play a governance role in the statewide health information infrastructure and the state believes accreditations will help assure stakeholders that a given RHIO is up to that task.

EHNAC, for its part, aims to develop a wide-ranging HIE accreditation program that the organization describes as designed for RHIOs and “other groups that promote data sharing across multiple, independent stakeholders.” EHNAC, working toward a spring 2009 program rollout, offers a variation on HIE/RHIO evaluation, Barrett said.

EHNAC’s program will go beyond the operational aspects of security and privacy to examine a participant’s technical performance, business practices, and organizational resources, according to EHNAC. “We are looking to really provide … a broader platform and to answer some of the big questions out there regarding trust,” Barrett said.

EHNAC’s program will consist of a self-assessment and site review. In the self-assessment, participants will provide evidence that they meet the commission’s accreditation criteria. Once that evidence is submitted to EHNAC, the commission will schedule a site review to validate the self-assessment.

Common Ground?

EHNAC also plans to cross reference its accreditation criteria with those of CCHIT. For example, EHNAC plans to map CCHIT’s privacy and security criteria against its own. Barrett said the objective is to have CCHIT accept EHNAC accreditation toward CCHIT certification and vice versa. That way, an HIE that has successfully undertaken CCHIT’s security test would not have to repeat that assessment with EHNAC to obtain accreditation.

Barrett said EHNAC has opened a dialog with CCHIT to that end, noting that EHNAC’s program “should be synergistic with their certification.”

A spokeswoman for CCHIT said discussions with EHNAC have yet to become formal. “As we have with many health care industry groups, CCHIT has had informal discussions with these folks to update them on our work but we have no formal business relationship with EHNAC nor have we begun any substantive discussions about coordinating programs,” she said.

There’s also the potential for EHNAC to link up with New York’s RHIO accreditation program. Barrett said the state has assessed accreditation bodies and listed EHNAC and three other organizations in a report.

“We plan to follow up with all four of the organizations we identified, including EHNAC,” said Rachel Block, executive director of the New York eHealth Collaborative. “However, at the moment we are mainly focused on establishing our own requirements so it is not possible to determine whether and how well EHNAC’s program might fit for us.”