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LTC Certification Could Shorten Providers' Software Searches

MacKenzie Kimball, for HealthLeaders Media, May 8, 2009

If your nursing facility is looking for new software, chances are your team will spend a significant amount of time drafting a request for proposal for vendors, a lengthy document that specifies your software requirements. But the selection process could soon become simpler for long-term care providers.

The Certification Commission for Healthcare Information Technology (CCHIT) announced in April that it aims to begin certifying long-term care electronic health record (EHR) software products by July 2010.

A certification establishes standards for long-term care software, giving long-term care providers a fast, reliable way to know what a software product can do. And with more nursing facilities adopting electronic records and new policies placing an emphasis on electronic health records in healthcare, a long-term care software certification could be a useful tool for providers.

A long-term care certification will give providers a shortcut through the software selection process, says Nathan Lake, RN, BSN, MSHA, director of clinical design for American Health Tech in Jackson, MS. Lake is also a member of the CCHIT Advisory Task Force, a volunteer group of industry stakeholders that will advise the work group CCHIT will form to create the long-term care certification.

When providers look for a new software program, they typically spend a good deal of time vetting new products, he says. Some providers send vendors hefty documents outlining their specifications for software. With a certification, long-term care providers can simply determine whether a product is certified to find out if the software meets key performance requirements, Lake says.

The long-term care industry has adopted electronic records at a rate that is comparable, if not higher, than acute care and private physician practices, says Majd Alwan, PhD, director for the Center for Aging Services and Technologies in Washington, D.C.

However, many nursing homes are not using fully integrated or interoperable electronic records, Alwan says. "Interoperability" refers to the ability to share information with other healthcare providers.

A certification would ensure buyers that certified long-term care software products would work seamlessly with other certified software products, Alwan says.

The American Recovery and Reinvestment Act, also known as the economic stimulus package, is putting a lot of emphasis on standards-based interoperable health IT to guarantee every American has a health record that is portable or can allow the exchange of information, Alwan said. The certification is an indication that the investment in a software product is somewhat protected and the system will not become obsolete because it is not compliant with national standards for interoperability, he says.

Achieving interoperability in long-term care EHRs is especially important because the sector serves residents who often have multiple chronic conditions and multiple care providers, such as physicians, pharmacists, and long-term care providers, Alwan says.

The population also tends to move across the several care settings. For example, if an elder falls and breaks a hip, he or she may move from a hospital to a skilled nursing facility for rehab before transitioning to an assisted living facility within a relatively short period of time, he says. Also, sharing electronic records may be useful because seniors in long-term care facilities may have a primary care physician or geriatrician who works outside of the long-term care facility.

"The benefits of interoperable HIT across settings would be maximized in this segment of the population," Alwan says.

Although certification is voluntary for software vendors, the marketplace is starting to request it, says John Morrissey, communications director for CCHIT.

Certification will become critical for software vendors in the next five years, Lake says, adding that when a software certification is established, nursing homes will be less likely to consider uncertified products.

"Five years from now, the first question out of a facility's mouth is going to be 'Are you certified?'" Lake says. "If you [a vendor] say 'yes,' you're going to be in the door for testing. If you say 'no,' they're not even going to continue talking to you."

Some vendors may choose not to become certified, and may ultimately go out of business.

Certification may raise the cost of software, Lake says.

Certification is an expensive process for vendors, costing acute care software vendors around $25,000 to initially become certified, Lake says. Vendors also need to become re-certified every two years, although recertification isn't as costly, he says.

Lake's group is examining how to make certification less expensive for the long-term care sector because the industry's profit margins are lower than those in acute care.


MacKenzie Kimball is an associate editor in the long-term care market at HCPro. She writes PPS Alert for Long-term Care and manages MDSCentral.

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