- The federal Certified Technology Comparison (CTC) Task Force is on the clock to come up with recommendations that may eventually help providers build out their health IT infrastructure.
CTC, an advisory body to the national coordinator for health IT, is formulating recommendations on the benefits of, and resources needed, to develop and maintain a certified health IT comparison tool. CTC heard comments from an expert panel of providers on Jan. 7 and will host a similar group of vendor experts tomorrow. The information gathering and discussion leads up to presentation of final recommendations to a joint meeting of the Health IT Policy and Standards committees on Jan. 20.
The health IT comparison tool under contemplation — which, if eventually developed, could replace the Office of the National Coordinator for Health IT (ONC)’s Certified Health IT Product List (CHPL) — would be useful, according to CTC, for providers: making their first purchase of a health IT product; considering a modular component purchase to meet new health IT needs; or as part of an ongoing IT strategy to size up products in the market and assess future purchase needs.
CTC member David Schlossman, MD, an oncologist at Missouri Cancer Associates, added during a Jan. 8 public meeting, “One important goal or outcome that most practitioners would like to see associated with this kind of tool and this kind of a process is to drive innovation and improvement in health IT in general.”
Steering the discussion, CTC co-chair Cris Ross, CIO of Mayo Clinic, pointed out that a new health IT comparison tool would need to be “consumable” by practices with limited IT support. “Going forward, this needs to be something that is management-readable and technical-readable,” he explained.
Co-chair Anita Somplasky, director of transformation and development services for Quality Insights of Pennsylvania, commented that complexity is one of the problems with the current CHPL site. “That was where the regional extension centers were able to really help [small practices] navigate, but most of the RECs are gone now and these practices don’t have the money to pay a consultant to come help them,” she remarked.
Dawn Heisey-Grove, a public health analyst at ONC and liaison to CTC, summarized that aside from not meeting the specific needs of small practice providers or specialists, existing comparison tools have gaps in the following areas:
- Certified health IT cost information is not available for comparison.
- Likewise, usability information is not available for comparison.
- Providers need information beyond what is captured through ONC’s current certification program.
- Comparison metrics for health IT products are needed to meet evolving requirements of emerging alternative payment models and the Merit-Based Incentive Payment System that will go into effect for Medicare providers in 2019.
Where from here?
All said, CTC has a huge job ahead in refining its recommendations in a short time span.
“The goal in my mind would be to create a vision for a structure into which all of this stuff could feed. Provide enough structure into what are the major domains that are important to be covered, and for the most important, some of the ways we would like them to be covered,” said CTC member Steven Stack, MD, president of the American Medical Association. “I see that as a way to have simplicity in design, but hopefully create something worthwhile enough and robust enough to inspire and foster others to provide the complexity of detail that gets to many of these important specific use cases that certain users will need to know.”
Creating an infrastructure incorporating an ongoing quality assurance, evaluative component would also allow individuals to voice their opinions about products, noted Jorge Ferrer, MD, ex-officio CTC member and a biomedical informatician with the Veterans Health Administration.
As CTC refines its forthcoming proposals, it’s likely to emphasize the idea of data collection by ONC as part of the health IT certification process in order to support whatever tool would be developed — whether by ONC or another party, according to Ross. For example, CTC may suggest that health IT vendors be required by ONC to populate data in a comparison tool as a requirement of certification.
“A subsequent piece would be to say that we see the power of both expert and peer-to-peer rankings, and that our belief is — given the dynamics of the health IT market and the fact that these purchases are complex — a combination of objective data, expert data where it exists, and peer-to-peer where it can be fostered, is a good idea,” Ross explained.
Stack stated, “I think this could be a substantial, usable tool. If we can do it well enough with the structure on the front end, I wouldn’t underestimate the power of recommendations. I think [it could] create a useful input into the journey of finding something that can help health IT be more transparent and more purchasable and adaptable to those of us who are frustrated right now with the current state of affairs because it’s too opaque and not responding to our needs.”
In whatever manner a proposed comparison tool takes shape, CTC indicates that it won’t ask for a built-in scoring or rating system. “I’m not sure what degree of credibility or reliability or reproducibility you could create unless you put in place a much more robust infrastructure like Consumer Reports, which rigorously creates methodologies for each major category,” observed Stack.
Going down that path would be a “boiling-the-ocean activity,” according to Stack. “I’m not so sure that this tool itself should by design ensure that there is a scoring or rating system — though it should allow for the possibility that contributions to it provide some of that facet,” he said.
A more likely scenario would be to design the tool with so-called “buckets” to collect user or third-party feedback on products. At this point, the buckets appear to be narrowed down to cost, usability and how well the product integrates with other IT components, according to Heisey-Grove.
Stay tuned for further reporting as CTC nears the final recommendation stage.
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