Providers who are using select major electronic health record (EHR) vendors are now sharing health information with other providers using the Carequality Interoperability Framework, officials of the Washington, D.C.-based public-private collaborative under The Sequoia Project announced on Aug. 16.
Indeed, the early adopters of Carequality have announced they've made it easier to exchange data between different EHRs record locator services (RLS), and health information exchanges (HIEs), leveraging a central provider directory and common set of rules. The vendors included are athenahealth, eClinicalWorks, Epic, HIETexas, NextGen and Surescripts, according to the announcement. Cerner is a member of Carequality, but has not yet adopted the Framework. It’s unclear if they will adopt it in the upcoming year either.
Published in December 2015, the Carequality Interoperability Framework aims to provide the necessary legal terms, policy requirements, technical specifications, and governance processes to enable interoperability between and among the many healthcare data sharing networks and programs serving diverse user communities nationwide. The Framework has been adopted by 13 health organizations that are working to help their customers, patients and providers to securely share health data across health IT platforms and geographies. Many more networks and health organizations are in various stages of adoption and implementation planning, officials have said.
“First and foremost, with this agreement, we have agreed to a framework of trust, which we think is the biggest barrier to interoperability between different healthcare delivery organizations,” Girish Navani, CEO of eClinicalWorks said at the time the Framework was published. As the initial implementers, eClinicalWorks, athenahealth, Epic, Surescripts and NextGen Healthcare, and their clients, will benefit from accelerated, less costly health data sharing agreements, according to Carequality officials.
Until now, health information exchange was preceded by one-off legal agreements between individual data sharing partners, which involved lengthy and costly negotiation and inconsistent experience in quality and quantity of data exchanged. Now, organizations that adopt the Carequality interoperability framework can establish data sharing partnerships quickly and uniformly by leveraging existing networks and business relationships, the organization’s officials said.
To date, more than 3,000 clinics and 200 hospitals are live on Carequality and capable of sharing health data, Carequality officials said. Live exchange has already occurred in four states, with expansion underway as more participants go live on a regular basis. The participating organizations, which represent healthcare's largest ambulatory vendors, leading e-prescribing and clinical information networks and 30 percent of the inpatient market, are aggressively rolling out to their user communities nationwide, according to the announcement.
Carequality is one initiative under The Sequoia Project (formerly Healtheway). The Sequoia Project supports multiple, independent health IT interoperability initiatives, most notably Carequality and the eHealth Exchange, a rapidly growing community of exchange partners who share information under a common trust framework and a common set of rules.
"Sutter Health is excited to be one of the first large healthcare organizations to take advantage of the Carequality framework to support broad clinical information exchange for improved care coordination," said Dr. Steven Lane, M.D., clinical informatics director of privacy and interoperability for Sutter Health, said in a statement. "Many of our patients also receive care from community providers utilizing a variety of EHRs. Carequality promises to remove historic barriers to sharing information between different vendors' EHRs allowing patients' information to follow them wherever they choose to receive care. We sincerely hope that all EHR vendors and existing HIE networks commit to implement Carequality's straightforward framework to finally make interoperability a part of the standard way that we provide the safest most cost-effective care to all of our patients."
The collaboration between competing health IT vendors, particularly EHR vendors, may seem surprising. Some in the industry have long complained about Epic's lack of "openness." And, Epic declined to join CommonWell Health Alliance, a vendor-led interoperability initiative, of which athenahealth is a founding member. What’s more, executives from Epic, Cerner and athenahealth traded jabs last year after an Epic executive, during a Senate committee hearing, referred to CommonWell as an "aspiring" network and pointed to CommonWell's membership and service fees. athenahealth President and CEO Jonathan Bush was quite outspoken about Epic not joining this interoperability initiative, even going as far as tweeting that his company would pay for Epic.
But now, the vendors are on the same side via Carequality. Dave Fuhrmann, vice president of interoperability for Epic, noted, "Carequality is a big win for patients and providers, and it will help promote continued innovation in interoperability. By creating a vendor and platform-neutral framework that will evolve over time, the initiative supports secure health information exchange for patients without impeding development of new technology."
Carequality is advancing the promise and potential of health data sharing among patients and providers as the standard of care, added Dave Cassel, director of Carequality. “With a single unified health data sharing agreement built upon Carequality’s ground-breaking Principles of Trust, there is no more need to negotiate one-off legal agreements with individual data sharing partners. Carequality implementers—and their clients—can connect more quickly and easily than ever before.”