Interoperability breakthrough: 5 things physicians should know

Kevin B. O'Reilly , Senior News Editor

An agreement formed by two health-information connectors represents a major advance for nationwide interoperability, potentially enabling more than 15,000 hospitals, clinics and other health care organizations to share data. This would allow, for example, a Miami physician to access the electronic records of a patient from Seattle who presents at the emergency department while vacationing. Here are five things physicians should understand about what this collaboration will mean for health-data sharing and care delivery.

The AMA is one of the founding members of the Sequoia Project’s Carequality initiative, which counts Epic, GE Healthcare, Surescripts, eClinicalWorks and others as members. The CommonWell Health Alliance’s founding members include Cerner, Allscripts, McKesson and Sunquest. Greenway Health and athenahealth are members of both initiatives.

Together, the members of CommonWell and those participating in Carequality represent more than 90 percent of the electronic health record (EHR) marketplace in acute care settings and nearly 60 percent of the office-based EHR market.

Carequality is a platform- and vendor-neutral framework designed to connect health data across vendor networks as well as independent networks. Health care organizations in all 50 states are using Carequality’s framework to share health data. CommonWell takes a different approach to interoperability, focusing on patient identification management and record location and retrieval services. Another way to think of what distinguishes the initiatives is that CommonWell is a health-data-sharing network, and Carequality is a framework to enable health-data sharing between and among networks.

Under the agreement—in the works for a year—CommonWell will enable its subscribers to direct queries to any organization participating in the Carequality initiative. Carequality sites will be able to query organizations within Commonwell. Carequality will also work with CommonWell to create a version of its record-locating service that will be available to health care organizations taking part in Carequality.  Alongside the Surescripts National Record Locator Service (NLRS), this will be the second, optional RLS available to Carequality members. The technical aspects of the connectivity effort are expected to be completed in the first half of 2017, according to an explanatory document on the agreement.

Because CommonWell and Carequality’s members represent the vast majority of clinics and hospitals that today are capable of exchanging health information, the deal will greatly increase opportunities for nationwide data-sharing. This includes aiding health-information exchange for networks that are not vendor-based, as Carequality also connects regional and state health information exchange networks, payer networks, personal health record networks and other types of data networks. Physicians working in a CommonWell-enabled organization that agrees to Carequality’s connection terms will be able to exchange health data for treatment with any Carequality-enabled provider.

The agreement is a “win-win for patients, providers and their networks,” Carequality Director Dave Cassel said in a statement. Jitin Asnaani, CommonWell’s executive director, added that its “vision has always been for a patient’s health data to follow him or her regardless of where care occurs, and in turn give providers and caregivers increased access to critical health data when and where it is needed.” He said the new agreement will further that vision and said “there will be no turning back for American health care.”

AMA Executive Vice President and CEO James L. Madara, MD, said the Association is “thrilled” with the agreement, noting that the “alignment will greatly increase the nationwide exchange of health data that can be converted into actionable information for physicians as they care for patients.”

The push to advance interoperability is one of several ways the AMA has advocated changes in health information technology that move medicine forward while protecting patients. Earlier this week, the AMA helped found a new nonprofit, Xcertia, that will collaborate with the mobile health app industry to set guidelines for the technology so that it contributes to high-quality care. The AMA also has set out clear principles to help guide EHR vendors toward making their systems more usable.

Regional or state health information organizations (HIO) remain an option for data-sharing. Physicians can also ask their EHR vendor or HIO to get connected through Carequality or CommonWell, or contact officials at each initiative for more information.

No. A variety of data-exchange tools, interfaces and standards will persist. The changing market likely will offer a choice of interoperability options for different types of customers, and the Carequality framework is specifically designed to connect existing health data networks and scale to accommodate new technologies and networks as they evolve. Regional and state HIOs are unlikely to vanish, either. They often feature public health reporting and other elements that are vital to their communities but not currently available through nationwide interoperability initiatives such as Carequality or CommonWell.