On Nov. 8, the EHR/HIE Interoperability Workgroup, an organization of states and vendors focused on eliminating the barriers to sharing EHRs issued a set of technical specifications to standardize connections between healthcare providers, health information exchanges (HIEs) and other data-sharing partners. The group said its objective is to define a single set of easy-to-implement connections to increase the adoption of EHRs and HIE services.
The group’s effort leveraged existing published standards for interoperability from the Office of the National Coordinator for Health Information Technology (ONC). Ultimately, the specifications, which are available here, 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 percent 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, three HIE services vendors are participating: Axolotl, InterSystems and Medicity.
Doug Fridsma, MD and PhD, director of the Office of Standards & Interoperability at ONC, 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 detailed implementation specification. The implementation specification was 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," said John Halamka, MD, co-Chair of the HIT Standards Committee, CIO of Beth Israel Deaconess Medical Center, CIO at Harvard Medical School, and chairman of the New England Healthcare Exchange Network.
Frank Irving blogs regularly at EHRWatch.com.
