Disconnected, part 2: New interoperability approaches offer promise and challenges

Although the interoperability of electronic health records (EHRs) currently is very limited (see “Disconnected, part 1”), several moves are afoot to improve it. Some of these initiatives are well underway, while another one is in an early, experimental phase. They range from new combinations of existing techniques to a novel approach that applies widely used Internet standards to healthcare.

Most physicians are unlikely to see the fruits of these labors for some time, however. But CommonWell plans to expand to 5,000 sites by the end of 2015, and major developments in all of these projects can be expected in the next few years. Here’s a brief rundown on each of them, including how they might help you in the future.

CommonWell Health Alliance

CommonWell Health Alliance is a collaboration of EHR vendors that represent about 70% of the hospital market and 24% of the ambulatory care market. It is implementing an interoperability network that includes a common patient matching method, a nationwide record locator, and privacy and security safeguards. Launched early in 2013, CommonWell started testing at a few sites later that year.

Today, CommonWell includes the biggest EHR vendors in the acute-care market except for Epic, which is also the largest ambulatory care EHR vendor. As a result of Epic’s refusal to join CommonWell, the alliance represents less than a quarter of the ambulatory care EHR market.

Related:EHR's broken promise

CommonWell now has 29 members and expects to have 40 by year’s end, according to Jitin Asnaani, MBA, the alliance’s executive director. So far, only 73 provider sites have gone live on CommonWell, but rollouts by some big EHR vendors to their customer bases are expected to begin this fall. The 5,000-site goal includes practices and hospitals that will have the ability to connect with CommonWell but will choose not to initially, Asnaani admits. 

Three vendors-Cerner, McKesson, and athenahealth-have said they’ll make CommonWell available to their clients for free. A Cerner spokesman said the company would offer the service gratis for five years after a customer signs up for it “with the exception of a one-time setup fee.” 

It’s unclear whether the CommonWell vendors will charge usage or subscription fees later if the service catches on, Asnaani says. But for now, they’re paying fees to support the organization, and they’re bearing the cost of interfaces to RelayHealth, the McKesson subsidiary that provides the backbone for CommonWell. Cloud-based EHR vendors need write only one interface to RelayHealth; some suppliers of premise-based EHRs are connecting all their customers to a cloud-based solution that they link to RelayHealth through a single interface, Asnaani pointed out.

RelayHealth supplies peer-to-peer connectivity among participating sites, regardless of which CommonWell member’s EHR they use. CommonWell acts as a hub for patient matching, record location and retrieval, patient access, privacy, consent management, and trusted data access. 

 

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