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12/13/2013
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CommonWell Unveils EHR Interoperability Pilot

CommonWell Health Alliance, a group of EHR vendors, enlists providers in Illinois, and in North and South Carolina to try its patient matching and information exchange system.

Healthcare Robotics: Patently Incredible Inventions
Healthcare Robotics: Patently Incredible Inventions
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CommonWell Health Alliance, a coalition of EHR vendors that debuted at the annual HIMSS conference last winter, has announced the initial sites for the January launch of its interoperability system. Providers in Chicago, Ill., Elkin and Henderson, N.C., and Columbia, S.C., will participate in the pilot, and initial results will be announced at the February HIMSS meeting in Orlando, Fla. More sites in different regions will be announced later in the year, CommonWell said.

The initial communities for the pilot were chosen because many providers there use EHRs marketed by the vendors that belong to CommonWell. Those companies include Allscripts, Athenahealth, Cerner, CPSI, Greenway, McKesson, and Sunquest.

The other participant in CommonWell is McKesson subsidiary RelayHealth, which will provide services to the network. RelayHealth, which has considerable experience in developing private health information exchanges, "is currently building the foundational services that enable the members to have peer-to-peer data exchange," a CommonWell spokeperson said.

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The seven founding members of CommonWell represent 42% of the acute-care EHR market and 23% of the ambulatory EHR market. No new vendors have joined the alliance since it was announced. Nevertheless, Justin Barnes, a CommonWell board member and vice president of governmental and industry affairs for Greenway, told InformationWeek Healthcare that he's confident that more vendors will join as CommonWell proves its value.

CommonWell's initial goal, as previously reported, is to provide a reliable patient matching system that can be used by multiple acute-care and ambulatory-care EHRs. Beyond that, Barnes noted, the process of enrollment in the CommonWell system will allow patients to opt in and to control which providers are able to see their data. In most interoperability efforts in the industry, such as health information exchanges, patients don't have that type of control over their records, he said.

According to the news release, the pilot phase will include:

  • Enrolling patients in the service and managing the patient-consent protocol.
  • Identifying whether other provider participants have data for a patient enrolled in the network.
  • Transmitting data to another provider that has consent to view data on that enrolled patient.

CommonWell is experimenting with some advanced methods for exchanging information across business boundaries. Among them are the Web services profiles of Integrating the Healthcare Enterprise (IHE), which are already used within many enterprises, and HL7's Fast Healthcare Interoperability Resources (FHIR), which provides an alternative way to package clinical summaries. According to one source, CommonWell will also use the RESTful Web services model, a SOAP alternative, for transport.

Among the providers participating in the pilot are:

  • Hugh Chatham Memorial Hospital in Elkin, N.C.
  • Lake Shore Obstetrics & Gynecology in Chicago
  • Maria Parham Medical Center in Henderson, N.C.
  • Midlands Orthopaedics in Columbia, S.C.
  • Palmetto Health in Columbia, S.C.

Lee Powe, CIO of Hugh Chatham Memorial Hospital, said in an interview that past efforts to create interoperability in his area had failed. Because his community hospital uses CPSI, its owned practices use Greenway, and other local practices use Allscripts -- all CommonWell members -- the coalition's effort looks promising, he said. "This seems to be the right fit."

In the past, Hugh Chatham has tried to exchange continuity-of-care documents (CCDs) with its practices through an interface, but the project floundered because the hospital's emergency department has a different EHR from MedHost. When a doctor sent a patient to the ED and wanted to transmit a care summary for that patient, the CCD could go into the hospital system but had no way to get to the ED.

CommonWell has promised to create interoperability between the practices, the ED, and the hospital, Powe said. He doesn't know how that will be done, but if CommonWell can do it, he noted, "it would solve a huge problem."

Powe is less optimistic that CommonWell's patient matching system will help Hugh Chatham. Like many other healthcare systems, the hospital and its practices have a hard time matching patients who move between ambulatory and acute care with their medical records. The problem is differing record-numbering systems.

One common solution is to adopt one of the master patient index systems that use algorithms to uniquely identify patients. Hugh Chatham, however, installed an iris scanner and software that matches the scans with photos attached to each patient's record.

The healthcare system's biggest interoperability challenge is communicating with larger hospitals like those of Wake Forest and Baptist in Winston-Salem, N.C., when Hugh Chatham's physicians refer patients to those facilities. "We've got to get the data to them before the patient gets there," he said.

There are no regional HIEs in central North Carolina, and the statewide HIE is of no use in helping providers exchange data at the local level, Powe said. So he hopes to use Direct, the protocol for secure clinical messaging over the Internet, to push clinical summaries to providers in the Winston-Salem hospitals.

All of those facilities use Epic, the biggest EHR vendor, which does not participate in CommonWell, he added.

Ken Terry is a freelance healthcare writer, specializing in health IT. A former technology editor of Medical Economics Magazine, he is also the author of the book Rx For Healthcare Reform.

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David F. Carr
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David F. Carr,
User Rank: Author
12/13/2013 | 10:05:51 AM
How will this mesh or compete with other Healthcare Information Exchange efforts?
What problems does this solve that other HIEs do not? Or is the idea to prototype technologies and methods that could be incorporated into HIE initiatives?
Ken Terry
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Ken Terry,
User Rank: Apprentice
12/13/2013 | 10:14:50 AM
Re: How will this mesh or compete with other Healthcare Information Exchange efforts?
It's unclear how CommonWell will mesh with other interoperability efforts. Barnes would not confirm that CommonWell plans to connect to the eHealth Exchange, which would require it to meet EHE/Interoperability Work Group standards for information exchange between disparate EHRs. CommonWell's future also depends to a large extent on whether other vendors--notably Epic--join it. One aspect to watch will be CommonWell's use of nextgen standards such as FHIR and RESTful (the latter is new in the healthcare industry). These standards might turn out to have advantages for data exchange in the new healthcare delivery models.
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