To the Editor:

Much work is currently being done to develop standards that organize and make transportable a set of basic information about a patient's health care, known as the Continuity of Care Record that can be read or processed by various EHR systems. [Read more about the Continuity of Care Record on the AAFP Web site at http://www.centerforhit.org/x201.xml.]

Does the contract Dr. Kenneth Adler's practice signed with its EHR vendor [“Why It's Time to Purchase an Electronic Health Record System,” November/December 2004, page 43] provide for updates that may be needed to bring their system into compliance with these standards down the road?

Author's response:

The vendor we partnered with, like all the other vendors we looked at, charges an annual software license subscription fee. This fee entitles us to ongoing technical support and access to software upgrades as they occur. Our vendor anticipates at least one major upgrade per year.

Hopefully future upgrades will include the CCR standards. The CCR is a voluntary standard data set designed to provide a snapshot of a patient's health status at one point in time. Ideally, the CCR would form a bridge between EHRs that can't and don't talk to one another.

Currently, implementation of the CCR depends on its voluntary adoption by EHR software vendors. This will only happen if EHR users demand it or, more likely, if the newly formed Certification Commission for Healthcare Information Technology (CCHIT) requires it. [Editor's note: Read more about the CCHIT on page 27.]