A number of states and vendors focused on eliminating the barriers to sharing electronic health records (EHRs) issued a set of technical specifications to standardize connections between healthcare providers, health information exchanges (HIEs) and other data-sharing partners. The specifications are now available for the public to view at www.interopwg.org .
The objective of the EHR/HIE Interoperability Workgroup is to define a single set of standardized, easy-to-implement connections to increase the adoption of EHRs and HIE services. The effort leveraged existing published standards for interoperability from the Office of the National Coordinator (ONC). Ultimately, the specifications aim to remove impediments that make it difficult for EHRs to connect to HIEs, including technical specification differences, wait times for interface development, and high costs.
Originally formed by the New York eHealth Collaborative (NYeC), the group is comprised of its federally designated counterparts in seven states (California, Colorado, Maryland, Massachusetts, New Jersey, New York, and Oregon) representing approximately 30 percent of the country's population. The eight EHR vendor members include Allscripts, eClinicalWorks, e-MDs, Greenway Medical Technologies, McKesson Physician Practice Solutions, NextGen Healthcare, Sage Healthcare Division, and Siemens Healthcare. In addition, there are three HIE services vendors participating, including Axolotl, InterSystems, and Medicity.
The first set of specifications focuses on two use cases and the detailed data and metadata specification for a compliant Continuity of Care Document. The first use case, Statewide Send and Receive Patient Record Exchange, describes how encrypted health information can be transmitted over the internet. The second, the Statewide Patient Data Inquiry Service Use Case, describes the clinician's ability to query an HIE for relevant data on a specific patient.
Workgroup members collaborated to leverage existing HL7 standards, technical frameworks from IHE International, and HIE implementations to provide a fully detailed implementation specification. The implementation specifications were also aligned with Beacon community guidelines to be capable of gathering information required for reporting to the ONC.