Montana hospital one of first to sue vendor in court over non-compliant EHR system

Healthcare providers face many challenges in trying to keep up with ever more rigorous requirements for EHR software compliance.  EHR software vendors seem to be struggling, too, in many cases causing their clients to fail the federal EHR certification requirements, thereby losing eligibility for incentive payments.  Montana’s Mountainview Medical Center, which failed the October 1, 2013 certification deadline, is one of the first healthcare providers to take this issue to court.

Via Modern Healthcare:

A small Montana hospital may be among the first of many providers to go to court to resolve their frustrations with electronic health record systems developers that are either lagging or failing to update their software to the new, more stringent testing and certification requirements of the federal EHR incentive payment program.

Mountainview Medical Center in White Sulphur Springs is suing NextGen Healthcare Information Systems in federal court for failing to provide a certified EHR system in a timely manner. 


“That's the most important thing in this whole deal, to be federally certified,” said Aaron Rogers, CEO of the 25-bed Mountainview. “This is a huge, huge deal for every hospital, and we're certainly in that group. Ultimately, the reason there is a lawsuit is because certification was not attained, plain and simple. It didn't meet the criteria that we have to have federally.”

The critical-access hospital argues in the lawsuit that it was promised “a certified electronic health record system as defined by federal law” when it licensed software from NextGen in 2012.

Under new federal requirements that went into effect Oct. 1 for hospitals (and on Jan. 1 for office-based physicians) providers are no longer eligible for EHR incentive payments if they are still using 2011 Edition-compliant software. Thus, even for hospitals and physicians seeking to meet Stage 1 meaningful use for the first time, they must use 2014 Edition software to qualify for incentive payment.

A Modern Healthcare review of the Certified Health IT Product List compiled by HHS' Office of the National Coordinator for Health Information Technology showed that in September just 79 companies, providers and other organizations had software tested and certified to 2014 Edition criteria. That's compared with nearly 1,000 IT vendors whose products were tested and certified to the 2011 Edition criteria initially suitable for Stage 1 of the program. The precipitous drop in the number of vendors with certified products suggests many providers could be left in the lurch after investing substantial sums of money on EHR systems they believed would allow them to meet the federal requirements.

Mountainview's agreement with NextGen, according to a complaint filed last month in U.S. District Court in Helena, said the EHR was to be installed no later than June 1, 2013, but when NextGen failed to meet that date, it asked for and was given an extension until Oct. 1, 2013.

In September, however, the hospital “learned that NextGen did not have an (EHR) that was certified pursuant to the 2014 (Edition) standards” required for use by hospitals after Oct. 1, 2013. The complaint is asking for economic and unspecified compensatory damages, attorney fees and other court costs.

The complaint said Mountainview has already spent “in excess of $441,000 to facilitate” the EHR installation. That includes license fees, hardware and other costs.

Rogers said the hospital has been using electronic lab and imaging systems since 2009, but does not have a complete EHR. It is seeking to meet Stage 1 meaningful use in the 2014 fiscal year.

NextGen's Inpatient Clinicals complete EHR for hospital inpatient use was certified by the Chicago-based Certification Commission for Health Information Technology as meeting the 2014 Edition criteria. But that certification didn't come until Nov. 25, according to a copy of the test results from the Office of the National Coordinator for Health Information Technology. NextGen spokeswoman Michelle Rovner said in an email that, “While we cannot comment on pending litigation, other than to say that we firmly believe the allegations made by Mountainview Medical Center regarding our inpatient application are without merit and we will defend against them vigorously, we confidently stand behind the quality and performance of our products and offerings.”

Rovner said the CCHIT certification means hospitals can use the software to meet both Stage 1 and Stage 2 meaningful use requirements.

According to the database created by the CMS and the ONC, 62 of NextGen's hospital customers have met meaningful-use criteria, giving the company a 1.3% share of the hospital inpatient complete EHR niche. NextGen ranks fourth in the database of 455 vendors of complete EHRs for use by physicians and other eligible professionals in ambulatory care with nearly 17,850 meaningful users.

By Joseph Conn

“Montana hospital sues developer over electronic health-record certification,” Modern Healthcare (January 7, 2014)

Public-private group, eHealth Exchange, to oversee development of health info network

The HHS Office of the National Coordinator for Health Information Technology is passing management of the Nationwide Health Information Network to a coalition of public and private health care organizations.

Via Modern Healthcare:

Following last month's announcement that "now is not the time" for formal regulation of a proposed network of health information exchanges, HHS' Office of the National Coordinator for Health Information Technology said it is transitioning control of that network—known as the Nationwide Health Information Network—to a public-private partnership known as the eHealth Exchange.

According to an e-mailed news release, eHealth Exchange "represents ONC's commitment to support health information exchange innovation in the private sector." The partnership's operations will be supported by Healtheway (PDF), a Richmond, Va.-based not-for-profit organization also founded as a public-private partnership.
These operations include conformance and interoperability testing, on-boarding of new participants in eHealth Exchange, and maintenance of operating policies and procedures, the service registry and digital certificates, according to the release. 
In addition, the Chicago-based Certification Commission for Health Information Technology will participate in the effort's compliance testing and will certify that interfaces between exchanges are "consistent across multiple states and systems," according to a CCHIT news release.
More details will be announced at the New York eHealth Collaborative's Digital Health Conference, scheduled for Oct. 15-16 in New York, the release stated.

By Andis Robeznieks

ONC moves control of health info network to public-private group,” Modern Healthcare (October 11, 2012)

CCHIT certifies 19 complete EHRs and 14 EHR modules

On October 1, 2010, CCHIT announced certifications of 19 "complete" EHR products, including, for example, Epic products for both hospitals and eligible professionals, and Allscripts and GE Centricity products for eligible professionals.  

CCHIT also certified 14 "module" EHR products, from vendors which applied for certification of their products as complete EHRs "but testing could not be completed on a small number of criteria (such as electronic prescribing) because planned updates to the test procedures by NIST were not available at the time of testing." Such "EHR Module" certified products may seek certification as a complete EHRs in the near future.  Via Healthcare IT News:

The Certification Commission for Health Information Technology announced Oct. 1 that it has tested and certified 33 Electronic Health Record products under the ONC-ATCB program.

CCHIT is one of three Approved Testing and Certification Bodies, designated by the Office of the National Coordinator (ONC). The other two are the Drummond Group and InfoGard Laboratories, Inc.

The ATCBs certify that the EHRs are capable of meeting the 2011/2012 criteria supporting Stage 1 meaningful use. Certification is required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA).

The CCHIT certifications include 19 Complete EHRs, which meet all of the 2011/2012 criteria for either eligible provider or hospital technology, and 14 EHR Modules, which meet one or more – but not all – of the criteria.

"CCHIT announces 33 certifications," Healthcare IT News (October 1, 2010).


CCHIT to launch certification process on September 20, 2010

According to Karen Bell, MD, chair of the Certification Commission on Health Information Technology (CCHIT), her organization will begin accepting applications for HHS certification as early as September 20, 2010.  Via Healthcare IT News:

CCHIT is authorized to offer HHS certification for complete EHRs that meet all of the Stage 1, 2011/2012 HHS/ONC criteria, as well as certification for modular EHR products that meet one or more - but not all - of the criteria, Bell said.

According to Bell, CCHIT plans to launch its authorized HHS certification program on Sept. 20 at 1 p.m. Eastern time with a Town Call Webcast describing its application and testing process. CCHIT will take new health IT developer applications immediately after the Webcast and the first group of HHS certified complete EHRs and EHR modules will be announced within weeks of that launch.

In addition to HHS certification, CCHIT will continue to offer its CCHIT Certified program for ambulatory and inpatient EHR products that exceed the HHS/ONC criteria and are designed for hospitals and physician practices that are looking for assurance of more robust, integrated EHR products to support the unique needs of its clinicians and patients. Many of these products will also be HHS certified, Bell said.

You can read more about CCHIT's plans here.



In the news: medical ID theft on the rise; CHIME comments on meaningful; and more

  • Javelin Strategy & Research survey found over 275,000 cases of medical identity theft in 2009, with an average price tag greater than $12,000 per incident.  This is twice as many cases as in 2008.  Keeping health information safe is going to be of paramount importance in the next decade, especially considering the steep rise in use of electronic health records. According to (citing a study by IDC, a research firm), "about a quarter of all Americans -- 77 million people -- already have an EHR, up from 14% from in 2009." By 2015, experts believe the number will reach up to 60%, partially due to the transformation of the health IT industry by the HITECH Act.
  • In its comments to CMS regarding the meaningful use NPRM, College of Healthcare Information Management Executives (CHIME) insisted that the present "all or nothing" approach to achieving meaningful use is going to prevent significant numbers of eligible providers from receiving any incentive payments under the HITECH Act.  According to American Medical News:

Among CHIME's suggestions: a gradual implementation process that would allow physicians to qualify for incentives by achieving 25% of meaningful use objectives by 2011, 50% by 2013, 75% by 2015, and 100% by 2017.

'Without an approach that rewards progress or provides sufficient time, organizations with limited resources will likely have little chance of qualifying for payments, thus widening the 'digital divide' in the country,' CHIME wrote.

  • U.S. Senate passed a bill which, if approved by the House and signed by the President, would limit the definition of "hospital-based" eligible professionals to just those practicing in an inpatient or emergency room hospital setting.  If passed, this change would make the Medicare and Medicaid EHR incentive payments available to a far wider range of eligible professionals.
  • CCHIT may be getting some competition from the Drummond Group, which announced plans to become an ONC-authorized certifying body of EHR technology (ONC-ATCB).

"U.S. Senate backs expanded physician eligibility for MU," (March 11, 2010).

"Drummond Group in EHR testing for the 'long term'," Healthcare IT News (March 12, 2010).

"Patient Billed for Liposuction as Medical Theft Rises," (March 23, 2010).

"As health data goes digital, security risks grow," (March 22, 2010).

"EMR meaningful use rules warrant gradual approach," American Medical News (March 17, 2010).

CCHIT certifies EHR products for Preliminary ARRA 2011 program

Via Healthcare IT News:

The Certification Commission for Health Information Technology has certified 14 electronic health record products that pass muster for provider use under the American Recovery and Reinvestment Act of 2009 (ARRA).

"We believe it will be a challenge for providers who have not yet begun to evaluate products to purchase and implement EHR technology and achieve meaningful use in time for the 2011-2012 incentives," said Alisa Ray, the CCHIT's executive director. "We have received more than 30 applications for our 2011 certification programs – more than half of which are for the comprehensive program – and are announcing new certifications regularly so providers can begin to consider EHR technology that demonstrates compliance with the proposed federal standards."

According to Ray, the Preliminary ARRA 2011 program is a modular, limited certification and inspects technology only against the federal standards. It offers flexibility for health IT companies, developers and providers in meeting ARRA 2011-2012 certification requirements.


The ARRA certification component of both programs is considered preliminary because the definitions of meaningful use, criteria and standards have been proposed but not yet finalized by the Department of Health and Human Services, according to Ray. Health IT companies testing against the proposed standards now will be provided the opportunity to close any gaps after the final rules are published in the Federal Register in spring 2010.

CCHIT has certified the following companies under the Preliminary ARRA 2011 program:

* eHealth Made Easy's eHealth Made Easy 3 for hospitals
* eHealth Made Easy's eHealth Made Easy 3 for eligible providers
* IOS Health Systems' Medios 4.5
* Kaulkin Information Systems' KIS Track 5.1
* NGG Medical Systems' Perfect Care EHR 3.35
* Order Optimizer's Order Optimizer 3.01
* Sajix's iHelix MD 2010

"CCHIT certifies 14 products for meaningful use," Healthcare IT News (December 21, 2009).


CCHIT to launch Preliminary ARRA Certification program next month

While the ONCHIT Advisory Committees continue to work on defining "meaningful use," the Certification Commission for Health Information Technology (CCHIT) plans to launch a new certification program for electronic health records systems based on the new requirements for such systems to qualify for incentive payments under the American Recovery and Reinvestment Act of 2009 (ARRA).  

On October 7, 2009, CCHIT will "offer a modular certification program called Preliminary ARRA 2011 that is limited to the standards for qualifying EHR technology under the American Recovery and Reinvestment Act (ARRA)."

More from the CCHIT press release:

The Commission has followed and analyzed the emerging recommendations of the health information technology advisory committees to the Office of the National Coordinator (ONC), and believes there is sufficient information to offer the preliminary ARRA certification now.

HHS criteria and standards are expected to be published by the end of 2009. Final rules on Meaningful Use are expected later in the Spring of 2010. If that process results in the introduction of new requirements, the Commission will offer vendors with preliminary certifications an incremental inspection at no additional fee to bring their certifications into alignment with the final rules. The Commission’s certification materials including criteria, test scripts and certification policies for both programs will be published at on September 24. Applications for certification will open online on October 7.

"Certification Commission Launching 2011 Certification Programs In October," CCHIT press release (September 8, 2009).

"Federal committees to continue work on meaningful use," Healthcare IT News (September 11, 2009).

Government Health IT: CCHIT to serve temporarily as sole EHR certifier

Via Government Health IT:

The federal Health IT Policy Committee today endorsed recommendations that would leave the Certification Commission for Health IT in the short term as the sole organization authorized to certify health IT systems that qualified for funding under the economic stimulus plan. More certifying organizations would be added later.

Certification of electronic health record systems that met federal criteria for “meaningful use” of health IT could start as early as October, members of the Department of Health and Human Services’ Health IT Policy Committee said at the August 14th meeting.

Under the plan, CCHIT would provide a preliminary stamp of approval that health IT systems were HHS-qualified or certified until a final meaningful use regulation is published at the end of the year, said Marc Probst, chief information office of Intermountain Healthcare and co-chairman of the Committee’s certification work group.

Preliminary certification is meant to give providers and vendors enough certainty to proceed with planning, designing and purchasing systems in 2010. The HHS certification-qualification would mean that a provider purchasing the systems would be eligible for Medicare and Medicaid incentive payments under the stimulus law beginning in 2011.

"CCHIT will be sole health IT certifier, for now," Government Health IT (August 14, 2009).