Two Networks Pledge to Work Toward Interoperability

Participating Carequality members will be able to subscribe to the CommonWell record locator service. A pilot test will begin in the first half of 2017.

Sometime before mid-2017, one of the greatest divides in health IT today will start to be bridged.

Communities supporting two of the leading HIT data exchange networks, managed by CommonWell Health Alliance and Carequality, will begin participating in pilot programs to bring each network's most compelling service to members of the opposite network, according to a joint announcement this month.

Participating Carequality members will be able to subscribe to the CommonWell record locator service, previously available only to members of CommonWell, or to its clients and customers. Access to the patient-matching technology returns a variety of results based on the patient name specified in the request.

Conversely, CommonWell participants will be able to begin sending directed health information exchange queries to systems supporting the Carequality Interoperability Framework, in order to receive relevant documents for a designated patient at a designated setting of care.

Full deployment of both services will arrive near the end of 2017 or in early 2018, officials say.

Company officials noted that each service is opt-in, but that once providers opt in, they will be obligated to "share and share alike" and respond to queries from other participating providers as they would expect those providers to respond to their own queries.

Previous Roadblocks Thwarted Interoperability
CommonWell, formed in 2012 by Cerner, athenahealth, and other EHR and HIT vendors—but with the notable exception of Epic—was followed by the activation in mid-2016 of Carequality.

The Carequality framework encompassed Epic, eClinicalWorks, athenahealth and a variety of other HIT vendors.

The technical terms of the agreement require CommonWell to build an equivalent version of its record locator service for Carequality, and to link the two into a single service capable of querying and retrieving those records. CommonWell will also add query and retrieve capabilities to enable it to do so against Carequality-affiliated data sources.

These new services will require little or no modification to EHR and other HIT software provided it is already connected to their respective networks, company officials say.

"In terms of this agreement, I don't see any kind of new work that our members will have to think about, from a policy or from a technology standpoint," says Jitan Asnaani, executive director of CommonWell.

Asnaani notes that Carequality members who opt to subscribe to CommonWell's record locator service will pay a fee, but he says these fees will be "fair and even costs to help us bear the burden of whatever load they bring as they subscribe to our record locator service."

In the case of EHR vendors who choose subscribe to the record locator service, Asnaani says CommonWell will pass whatever the cost of these subscriptions on to its customers.

Many Health Info Exchange Gaps to Persist
Due to the opt-in nature of services offered by those who are members of either group, just because the interconnected services begin in 2017 does not necessarily erase all gaps in connectivity between providers, Asnaani notes.

"If you are participating in the exchange via Carequality, you are expected to share with anyone else," says Dave Cassel, director of Carequality.

"So to the extent that participants of CommonWell opt to participate through CommonWell and Carequality activities, they will have access to all the other participants, and the other participants will have access to them."

"I have not seen any cases yet where a vendor can force their clients to opt in," he says.

In addition to the two services highlighted in the joint announcement, CommonWell and the Sequoia Project, the nonprofit parent under which Carequality operates, have agreed to explore additional collaboration opportunities in the future.