Although many health IT vendors are joining CommonWell for interoperability, the definition of what interoperability will look like over the coming years is still somewhat vague.
Since CommonWell's launch at the annual HIMSS conference two years ago, the organization has grown to one of the largest coalitions in the industry. The nonprofit launched in 2013 with five members — Kansas City, Mo.-based Cerner, Chicago-based Allscripts, Watertown, Mass.-based athenahealth, Carrollton, Ga.-based Greenway Health, San Francisco-based McKesson and Atlanta-based Relay Health. Today, it has 25 member companies that collectively serve approximately 70 percent of the acute-care EHR market.
Last week, Westwood, Mass.-based MEDITECH, one of the largest EHR providers in the country, joined CommonWell alongside Irvine, Calif.-based EHR provider Kareo and Chicago-based Merge Healthcare, which provides medical imaging systems. Three healthcare organizations — South Bend, Ind,-based Beacon Health System, Fisher-Titus Medical Center in Norwalk, Ohio, and Bowling Green, Ohio-based Wood County Hospital — have signed on to receive CommonWell services in the last week alone.
But in a recent webinar hosted by McKesson, Arien Malec, the vice president of platform solutions for RelayHealth, a clinical communication software company owned by McKesson, and Joe Ganley, vice president of federal government affairs at McKesson, pointed out that interoperability is not clearly defined, and they argue it should be more patient-centric.
Mr. Malec said the government and the industry currently have a somewhat vague idea of what to make of interoperability. Point-to-point interoperability, with EHRs only communicating minimally, will not be enough, and neither will intraoperability — the ability of multiple providers to communicate electronically but only if they are on the same vendor's system. Instead, the government should more clearly define its goals for interoperability and then let the industry innovate.
"I think it's important that policymakers avoid the temptation to micromanage the effort through steps and an overly bureaucratic system," Mr. Ganley said. "Government needs to pay attention to the 'what' of interoperability and the 'by when' rather than the 'how' and 'who.'"
To focus the conversation on advancements in interoperability, Mr. Ganley outlined three recommendations for future policymaking. First, he said the ONC should set a high bar for interoperability between systems, not just among facilities with the same vendor's system, to push for innovation. Second, he said the government needs to set a deadline for full interoperability. Mr. Ganley acknowledged the ONC's proposed deadline of 2017 but said the deadline needs to accompany a clearer definition of interoperability to avoid loopholes. Finally, he said all stakeholders should be held accountable for interoperability by federal programs. He added that because the government itself is a large consumer of healthcare, it needs to act as a force in the marketplace as well as a regulator.
"We need to not lose sight of the fact that the government is a very significant consumer of healthcare," Mr. Ganley said. "I think the government has the opportunity in the marketplace as a consumer to push for more patient-centered interoperability."
Creating patient-centric interoperability requires that physicians are able to obtain the entirety of a patient's record from all previous sites of care. Both Mr. Malec and Mr. Ganley discussed CommonWell's ultimate goal of developing a nationwide record locater service to make it easier for providers to find patients' records. The coalition has enough members now to meet the interoperability standards being handed down from the ONC and CMS, but Mr. Malec said the organization would like to include even more members in the record locater to ensure the same level of care to all patients, no matter which EHR vendors their providers use.
"We have enough folks that are part of the CommonWell health alliance now to drive interoperability, and I very strongly believe that a record locater service is a foundational need," Mr. Malec said. "Some folks don't want to join our group, but I believe at the end of the day that we'll recognize that it's a foundational need."