Partners, accreditation, frameworks for interoperability

Not surprisingly, the HIT Policy Committee’s most recent meeting had considerable focus on interoperability efforts.

The vendors comprising the CommonWell Health Alliance describe the group as an independent not-for-profit trade association organization working for the common good to improve healthcare data liquidity.

The HIT Policy Committee discussed the group, applauding industry focus in coming up with solutions to interoperability challenges while at the same time distancing themselves from active support.

Through the alliance, providers could unambiguously identify patients through a HIPAA-compliant national file and locate patient records through targeted peer-to-peer queries. The information would be integrated into EHR workflow. The alliance would incorporate a governance model with a board of directors including vendors, consumer advocate groups and patient representatives, but one representative stressed that everything is still in its formative stage.

“For me, the question is will it work?” said Farzad Mostashari, MD, ScM, national coordinator for health IT. “Will it help us move forward with any initiative that doesn’t encompass everybody? There have been many efforts to be the network and any [initiative] adds little value until you near 100 percent.”

Evelyn Gallego, Standards & Interoperability Initiative coordinator at the Office of the National Coordinator for Health IT, presented the longitudinal coordination of care (LCC) work group’s findings on the challenges and opportunities for long-term care.

There has been much discussion around transitions of care and exchange of care plans for MU Stage 3, but there are gaps in achieving MU Stage 3 proposed recommendations, she said.

Several elements are ambiguously defined in MU, she said, and impact the ability for interoperable exchange across the continuum of care for both eligible and ineligible provider groups. This is important because the average Medicare beneficiary sees seven providers from four different groups per year, she said. "The current standards do not support the requirements to exchange a care plan."

Meanwhile, the Office of the National Coordinator of Health IT (ONC) announced two new cooperative agreements designed to further support growth of HIE and interoperability. DirectTrust.org received a one-year contract for $280,000 and the New York eHealth Collaborative received a one-year contract valued at $200,000. ONC will work with the two organizations selected to develop policies, interoperability requirements and business processes that align with goals and reduce implementation costs.

DirectTrust has been working with about 45 entities to create a set of policies and an accreditation program, said David C. Kibbe, MD, MBA, president and CEO. The group of volunteers has been “working to develop a set of standards, policies and procedures around privacy and security, trust and identity so participants can be comfortable and have confidence that those exchanges will remain encrypted and won’t be sent to the wrong people.” The work already conducted on a security and trust framework will serve as the basis of an accreditation program being used by several HISPs and certification and regulatory authorities--trusted agents--who act on behalf of Direct email users.

The New York eHealth Collaborative formed its Interoperability Work Group in 2011, said David Whitlinger, executive director. They learned that many HIEs were facing similar problems, such as the ability to get the EHR and the HIE connected to each other and working together in a consistent, inexpensive way. The idea is interoperability out of the box with their local HIE so that “physicians no longer have to become ad hoc engineers and HL7 gurus to get their EHR into a network,” said Whitlinger. 

Is your organization engaging in private and secure interoperability? Please share your experiences.

Beth Walsh

Clinical Innovation + Technology editor