The 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.
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.
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!