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A Chat with CommonWell’s Executive Director: Interoperability’s Next Steps, Data Blocking, and Epic

July 12, 2016
by Rajiv Leventhal
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It’s been a little over three years since the CommonWell Health Alliance, an industry trade group made up of many of the largest electronic health record (EHR) systems vendors and other health IT companies, formed at the Healthcare Information and Management Systems Society (HIMSS) annual conference with the goal to greatly enhance health data exchange. And, it’s been a little over a year since the Alliance tapped Jitin Asnaani as its founding executive director.

Asnaani has a background in public and private interoperability efforts, and joined CommonWell from athenahealth (Watertown, Mass.), a founding member of the Alliance, where he headed up product innovation and interoperability. Before that, Asnaani was involved with technical standards development at the Office of the National Coordinator for Health IT (ONC), product management at a health IT startup and strategy consulting at Deloitte.

Soon after the official appointment of Asnaani as CommonWell chief, Healthcare Informatics sat down with him to discuss his first directives as head of the Alliance, specifically in terms of interoperability and national patient identifier efforts, as well as the quarrel the trade organization was having with Epic, a hot industry topic at the time. At the core of that CommonWell/Epic feud was that Epic, despite its stature as the biggest EHR vendor in the industry, would not join the CommonWell Alliance.

Jitin Asnaani

A lot has changed in both the progress and perception of healthcare interoperability since CommonWell formed. As far the Alliance itself, it recently announced that as of earlier this year, its member organizations represent 72 percent of the acute care EHR market and 34 percent of the ambulatory care EHR market, even without Epic on board. Just a few days ago, Healthcare Informatics checked in again with Asnaani to discuss what’s new with the organization’s interoperability efforts, industry challenges such as data blocking, and if any headway has been made with Epic. Below are excerpts from that latest interview.

Where does the Alliance stand today, three years into its journey?

The Alliance has grown from a concept to a live network to about 4,500 live sites in the past three years, most of which have come live in the last three quarters of that time. We are speeding along, and with those sites, we are serving so many patients and providers, across all 50 states and two territories. We have a live living network; a functioning network of great scale.

From the beginning, CommonWell has been about leveraging the entire community to build the platform for clinical exchange that the country so badly needs. That began with EHRs, but doesn’t end with EHRs. We do have some great EHR companies who are members, but less than half of our members our EHR [vendors]. We also have health technology vendors across the care continuum. We announced at HIMSS that a number of our members will go live in skilled nursing facilities, home health facilities, and other [post-acute care settings].

We have proven that the model we are using works, meaning the ability to identify and search out that patient’s record in order to give him or her the best care and know exactly where he or she has been. That [information] is extremely valuable to providers, caregivers, and to the patients. But we have even more to do to make it more seamless, valuable, and have better quality data. These are the things you figure out once you have started hitting some scale.  

What have been some of the most significant interoperability lessons learned in the past year?

First of all, there is a better path towards interoperability become truly achieved other than finger pointing. Before the Alliance, there was finger pointing between the government, provider groups and vendor groups, and even amongst vendors themselves, as to why was data not flowing from a facility powered by one vendor to a facility powered by another vendor. We have learned that if you give the power to those participants who have the ability to affect the change, to create value in their products, and enable interoperability from scratch in their products, like we have done through CommonWell, then you can get some amazing collaboration achieved.

Often we will have member meetings in which a new member joins us, which is a little bit like entering the Twilight Zone, in that you have people who have discussions and share with others a level of detail and information—well within legal bounds obviously—that you wouldn’t realize they are capable of sharing with each other. And the [new member] will leave meeting with saucer-shaped eyes. They will say, “I can’t believe that a company shared screen shots with their competitors.” And I say yes, that’s the way this works.