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We are trying to construct a list of comments to cchit which will then be parsed into 2 lists. One list will come from ACEP, the other from the vendors.

The URL for the docs is here: http://www.cchit.org/participate/public-comment/index.asp

Here are the titles we are commenting on: 1/17/2008 Emergency Department Criteria 2008 (Second Draft) PDF 1/17/2008 Emergency Department Test Script 2008 (First Draft) PDF

The biggest question is, “should CCHIT go easier the first year?”

Initial comments

Here is the first draft of the vendor letter to CCHIT for your critique. cchit vendor letter draft CT

The primary mission of emergency medicine is to accurately identify a patient’s chief complaint and to rapidly treat those diagnoses that present the most immediate risk for loss of life or limb. The federal government mandates that these services be rendered to anyone who presents to the emergency department. Today’s reality is that the emergency department is the only place that a person can go without an appointment at any time to get treatment for any medical problem with all the tools for diagnosis and all the methods of treatment available. Thus, the emergency department has become the safety net for overbooked doctor offices, understaffed hospital wards, and patients seeking the most immediate answers to their medical questions. Emergency departments provide emergency medicine and convenience medicine with limited human and physical resources, no method of controlling patient volume, and no guarantee of payment.

Health information technology holds great promise for improved efficiency and decreased cost in the nearly impossible environment that today’s emergency departments find themselves. Today, very few emergency departments are leveraging this technology. CCHIT can change that. Their mission is to accelerate the adoption of health information technology by creating an efficient, credible and sustainable certification program.

Given the current sense of urgency and a lack of metrics for usability, it is understandable that CCHIT certification to date has focused on features and functionality while ignoring the more elusive issue of usability. But successful implementation of any information technology requires both functionality and usability. A product that has all the functionality can be rendered useless if the implementation requires too many keystrokes or is cluttered with additional unnecessary requirements.

When evaluating an electronic information system, functionality is a measure of quantity and usability is a measure of quality. With the current trend in medical reimbursement focusing on quality over quantity, a similar approach for health information technology could be anticipated.

To date, CCHIT certification has been limited to products for the general medical practices of ambulatory medicine and inpatient medicine. As CCHIT starts to focus on the specialized practice of emergency medicine, the need for a focus on quality (usability) will become more acute. While initial certification may not incorporate usability metrics, CCHIT will need to be certain that they do not eliminate products that excel in usability by placing too much focus on a broad range of functionality. Furthermore, CCHIT will need to distinguish those aspects of functionality that are necessary for a hospital information system from those that are necessary for an emergency department medical information system. Failure to recognize these priorities could result in CCHIT certification being an indication of those emergency medicine products to avoid because of their scope is too broad and there is no indication that they are usable.

- Jack

Here is the first draft of the vendor letter to CCHIT for your critique. cchit vendor letter draft CT

Comment 3


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