The Underlying Message of CommonWell Health Alliance

CommonWell Health AllianceThe sound of HIMSS 13 has quieted and now the work continues to follow through on the connections made and the initiatives launched. The CommonWell Health Alliance is one that will be closely watched as the work unfolds.

Work is what will be required to make the CommonWell initiative happen. There are doubts as to whether or not it is just a public relations move or a real initiative. There are questions as to who can really be a part of it, too. Is it really open or is an invitation required? Who is posturing more – the vendors in the initial launch of the CommonWell Health Alliance or Epic, the nation’s largest EHR vendor who was noticeably absent from the alliance?

Moving beyond these items will be important, and the milestones achieved are what will determine the real meaning. Achieved objectives is where the words and behaviors align and real trust is empowered to make our health care system gain greater interoperability.

Perspectives

In sifting through the articles and interviews in more detail, three interesting perspectives stood out to me. They involve the concept of healthcare plumbing (i.e., healthcare integration and interoperability), patient identification, and the rise of vendor responsibility.

Perspective 1:  “Collectively, we also have a clear incentive to ‘move past the plumbing’ so that we can focus our development resources on provider higher-value functionality….” (Forbes, March 10, 2013)

The reality is this: It is all about the “plumbing.” Without the right health IT infrastructure in place and without the right healthcare standards defined, true Meaningful Use is almost impossible along with fully engaged patient care. Many organizations have tried to resolve it – IHE, committee harmonization efforts, ONC, HL7, Markle Foundation, Care Connectivity Consortium, and on and on.

Another reality is plumbing is not a commodity. The view of plumbing as just some inexpensive, easy thing to do is crap, to put it bluntly. Any builder, creator, innovator, or enterprise IT organization knows that the wrong IT infrastructure will make any stellar application fail. The right health IT infrastructure – or health IT plumbing – will make users and customers more productive, more engaged, and better utilized. Infrastructure empowers applications to be the best they can be.

We need to get the health IT infrastructure right in order to get the right patient exchange in place.

Perspective 2: The real issue is patient identifiers.

In a Healthcare IT News interview, David McCallie, vice president at Cerner, said:

“Both Farzad and Joy Pritts from ONC were in the meeting, and everyone was sort of complaining to Farzad: ‘You’ve got to go solve this identifier problem, it’s killing us.’ And Farzad said, ‘Look, it’s against the law! I can’t do it. You guys have to solve it.’ I came back and literally quoted that – ‘you guys have to solve it’….”

This is another stark reality. Without an established, consistent patient identifier, exchanging patient data is more troublesome and complex. Without a defined patient identifier to be used across the continuum of care, more and more will need to be spent in health IT infrastructure to make it work seamlessly.

This is where the CommonWell Health Alliance gets really interesting. If this community can define how to identify a patient across applications or assign a patient identifier to be used across applications, then this will be a very successful alliance.

It also highlights how limited we are because of the politics of a common patient identifier. Health IT often makes things harder and more costly than they need to be.

Perspective 3: It takes a community, and the community includes vendors.

In healthcare, as in most things in life, it takes a community to make things happen and stick. Healthcare has many participants. It starts with patients and moves through a host of characters – physicians, clinicians, government organizations, certifying bodies, trade groups, IT professionals, administrators, and vendors… plus many, many more.

Vendors are not the villain or the rule-makers. They are the enablers.

To be effective, vendors need to listen closely to the patient voices. They need to embrace their customers fully to understand their requirements and expectations. They need to understand the standards and the problems to be solved. And, then, they need to innovate, deliver, and serve with the utmost integrity and responsibility. This is no different than anyone else involved in the healthcare community.

As the CommonWell Health Alliance moves forward, it will need to be a more open, inviting community. It is the only way the patient identifier goal will be met.

Accountability

The mission of the CommonWell Health Alliance defined as:

  • Patient Linking and Matching — Provide a way for vendors to identify patients as they move from setting to setting, in a robust and seamless industry-wide data environment.
  • Patient Access and Consent Management — Foster a HIPAA-compliant, patient-controlled means to simplify the management of consents and authorizations for data sharing.
  • Record Locator Service and Directed Query — Enable providers to match the locations of patients’ previous health care encounters, no matter where the encounter occurred, and gain access to that data in an industry standard way.

This is a vital mission, one that has not been resolved well by another entity. As a healthcare community, we need to encourage their success while holding them accountable to make meaningful progress during the next year. The objective is to pilot these element within the year. Let’s make it happen!

Jon_Mertz

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Jon Mertz serves as the editor at HL7Standards.com and vice president of marketing at Corepoint Health. Jon is an advocate for strong patient engagement in their health and understands the key roles health literacy, patient data, and healthcare interoperability play in developing a better health care model. Follow Jon on Twitter.

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4 Responses to The Underlying Message of CommonWell Health Alliance

  1. ReasObBob March 28, 2013 at 7:31 pm #

    We also wish CommonWell success in their endeavor. But their approach is not the
    only approach available. We favor a different approach. We believe that until
    the healthcare community defines what it wants from health IT – and health IT
    vendors – we will continue to witness disappointment in the marketplace and variations of the EHR backlash we see today.

    We refer to the approach we favor as Plan C. We regard the original, pre-incentive marketplace activity as Plan A. Then, the whole meaningful use, incentive and explosion in the number of certified EHR vendors extravaganza can be classified as Plan B. So what are the results? If you think about it for a minute, you’ll realize why we think it’s time for a slightly different approach if we’re really serious about getting a handle on health information.

    CommonWell is addressing some important shortcomings in the intertwined Plans A & B that seem to be guiding our current activities. But, in standing back and looking at all the activity around EHRs, it’s important to ask if we’re having commensurate successes. We believe that it’s time to devote some energy to proven practices used in good IT systems design and large scale project management.

    Based on our research, we’ve assembled or developed a variety of constructs, tools,
    techniques and protocols from industries and disciplines, including some from outside healthcare, that can enable the healthcare community to define its wants and needs in relation to the health IT systems it uses. Like you, we believe this is a community issue that must be addressed by the community.

    We invite you and your readers to learn more at TheCUREProject dot org.

    – Bob Brown

  2. Jon Mertz March 28, 2013 at 8:30 pm #

    Thank you, Bob, for your comment. I looked at The CURE Project but I need to spend more time reviewing your information and approach. I do believe we need to ensure we are on the right track, especially as it relates to health exchanges. We need to ensure we are leveraging new thinking and technologies. We are investing a lot. We need to ensure we will get the triple aim from it all. Thanks again! Jon

  3. RegisterPatient.com April 2, 2013 at 12:09 pm #

    Quoting”And Farzad said, ‘Look, it’s against the law! I can’t do it. You guys have to solve it.’ I came back and literally quoted that – ‘you guys have to solve it’….”

    Then we need to change the law and make it legal. Oh yes that requires congress to actually do something and pass it. Does anybody remember the School House Rock cartoon when we were kids “I just a Bill”? This is an option that should be able to be addressed. I don’t see why that is so complicated to get a law passed the would solve such a huge problem and reduce the entire amount of funds spent by all the parties involved. What does the law actually say. Jon can you find and provide a link to the “Law” that makes it illegal? Thank for the article!

    School House Rock Video Link: http://www.youtube.com/watch?v=tyeJ55o3El0

    David Wiliams

Trackbacks/Pingbacks

  1. The Underlying Message of CommonWell Health Alliance by @JonMertz | #HITsm | Scoop.it - March 28, 2013

    […] Work is what will be required to make the CommonWell initiative happen. There are doubts as to whether or not it is just a public relations move or a real initiative. There are questions as to who can really be a part of it, too. Is it really open or is an invitation required? Who is posturing more – the vendors in the initial launch of the CommonWell Health Alliance or Epic, the nation’s largest EHR vendor who was noticeably absent from the alliance?Moving beyond these items will be important, and the milestones achieved are what will determine the real meaning. Achieved objectives is where the words and behaviors align and real trust is empowered to make our health care system gain greater interoperability.  […]