Multiple States and Vendors Agree on Standard Health Data Connectivity Specifications
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.
The workgroup was originally formed by the New York eHealth Collaborative (NYeC) and is comprised of its federally designated counterparts in seven states (California, Colorado, Maryland, Massachusetts, New Jersey, New York, and Oregon) representing approximately 30% 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.
Doug Fridsma, MD and PhD, Director of the Office of Standards & Interoperability at the Office of the National Coordinator of Health Information Technology, commented, "I am encouraged by and excited about this type of collaboration, which has the potential to advance real-world pilots, implementation and feedback on standards for health information exchange. The results of this kind of initiative can help us advance health IT nationwide."
"This is a crucial step," said David Whitlinger, Executive Director of NYeC. "We started this as a New York State initiative, but we soon realized that many other states were facing the same interoperability challenges and many of the EHR and HIE vendors were also looking for clarity from the marketplace to define their product roadmaps. Collectively, the group is now looking forward to widespread adoption and market preference for the products that employ the specifications."
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.
The 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.
"I applaud the work that the EHR/HIE Interoperability Workgroup is doing to move states from implementation guides to production. I expect that the flexibility and agility of the EHR/HIE Interoperability Workgroup will serve as an ideal laboratory for standards that are rapidly evolving," stated John Halamka, MD, Co-Chair of the HIT Standards Committee, Chief Information Officer of Beth Israel Deaconess Medical Center, Chief Information Officer at Harvard Medical School, Chairman of the New England Healthcare Exchange Network.
Visit www.interopwg.org  for quotes from:
- Phyllis Albritton, Executive Director of CORHIO (Colorado)
- Robert Barker, Manager of Interoperability & Standards for NextGen Healthcare
- Justin Barnes, Vice President of Marketing, Industry and Government Affairs of Greenway and member of the Integrating the Healthcare Enterprise (IHE-USA) Board of Directors
- Dominick Bizzarro, HealthShare Business Manager, InterSystems Corporation
- John Glaser, PhD, CEO, Siemens Healthcare, Health Services Business Unit
- John Halamka, Co-Chair of the HIT Standards Committee, Chief Information Officer of Beth Israel Deaconess Medical Center, Chief Information Officer at Harvard Medical School, Chairman of the New England Healthcare Exchange Network (NEHEN)
- David Henriksen, SVP and GM of McKesson Physician Practice Solutions
- David Horrocks, President of the Chesapeake Regional Information System for Our Patients (CRISP), Maryland's Statewide Health Information Exchange
- Glenn Keet, President of Axolotl, now OptumInsight
- David Minch, HIE Director for John Muir Health and Technical Advisor to Cal eConnect, California's State Designated Entity
- Girish Kumar Navani, CEO and Co-Founder of eClinicalWorks
- Betty Otter-Nickerson, Sage Healthcare Division President
- Carol Robinson, Administrator of OHIT and Oregon's State Coordinator for Health IT
- Ashish V. Shah, Chief Architect and Senior VP of Medicity
- Rick Shoup, PhD, State HIT Coordinator and Director of the Massachusetts e-Health Institute
- Michael Stearns, MD, President and CEO of e-MDs
- Glen Tullman, Chief Executive Officer of Allscripts
- Dave Whitlinger, Executive Director, New York eHealth Collaborative
- Colleen Woods, New Jersey Health IT Coordinator