CommonWell Health Alliance – Big Stride or Baby Steps?

baby-steps1You’ve all heard my thoughts on mobility as the critical lynchpin for healthcare to achieve true clinical transformation. And, that one of the longest standing and most stubborn barriers to mobility is the lack of true interoperability across systems and devices from multiple vendors in any health system.

So during HIMSS13 back in March, I was interested to hear that some EMR vendors were joining together in the CommonWell Health Alliance to integrate their systems. It was encouraging to see these EMR vendors talk about opening up and becoming more compatible with each other – something that health systems have demanded, but that vendors’ proprietary attitudes and competition for market share have prevented. Like most of the industry, I’ve been curious to see how the Alliance would unfold and if the outcome could be experienced immediately since healthcare organizations cannot afford to wait. The need for action is NOW.

Aside from a closer look by the Health IT Policy Committee, all seemed quiet until a few days ago, when the founding members issued a joint response to a request for information from CMS and ONC, primarily calling for the two entities to better align around quality measurement and payment and Meaningful Use incentives. While it is great to see the Alliance taking actionable steps toward improving interoperability efforts, it’s worth pointing out a few areas where the Alliance is falling short:

  • Front-end integration is what physicians really need: This alliance may knit together a range of EMRs on the back-end, but the real impact of interoperability is in how physicians ultimately receive, view and react to information. Front-end integration enables physicians to dip into EMRs or any other kind of data source and display it in a single, consistent format, so that they can make better-informed care decisions anywhere, anytime. Importantly, back-end integration is the much more difficult approach, and requires an overhaul of the system that’s not necessary if you focus on integration of service to the front-end.
  • Making data mobile: While an EMR vendor might connect its data with another vendor, it’s probably not going to mobilize the other vendor’s data. Physicians no longer work in stationary environments, but rather are frequently required to move across facilities and departments. To provide care to patients regardless of location, physicians need the data available whether they are at the bedside, down the hall or at a different hospital.
  • Vendors not members of the Alliance: This partnership won’t address the data from vendors that aren’t planning or invited to participate in. This includes EMR vendors as well as vendors that cover other clinically relevant data sources, such as HIEs, imaging systems and medical devices. And, while the data from EMR systems is critical for physicians to make care decisions anytime and anywhere, it’s not the full picture. Information from all data sources as well as the ability to respond through tools like texting and video conferencing is also needed for physicians to make care decisions.

The intent of interoperability is to support caregivers in making informed care decisions across the continuum of care. The CommonWell Health Alliance is a commendable effort to address the demand for the accessibility of information across systems and facilities, and I’m glad to see movement following the initial announcement. What the Alliance needs is for all vendor categories to be represented and not just EMR/EHR data. In addition there is a strong need for enabling technologies such as mobility to be included. Mobility offers the value of integration with data coming from multiple vendors and multiple data types TODAY.

Providers need to be taking a broader view of interoperability – going well beyond the Alliance members’ EMRs. There is an immediate need to quickly bring front-end mobile integration in order to help hospitals and health systems effectively manage the healthcare transformation process.

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