Mostashari, policy committee take critical look at CommonWell

'The question to ask is, will it work, will it help move us forward?'

At a meeting of the Health IT Policy Committee on April 3, National Coordinator for Health Information Technology Farzad Mostashari, MD, and other committee members took a hard look at the CommonWell Health Alliance, a new vendor-led coalition to promote interoperability.

McKesson, Cerner, Allscripts, Greenway and athenahealth, along with RelayHealth, McKesson's connectivity business, announced the alliance last month at the 2013 HIMSS Annual Conference & Exhibition in New Orleans. Leaders of the nonprofit group say its aim is to make the exchange of data easier, but Mostashari and some members of the Health IT Policy Committee questioned whether the alliance might make things worse.

The debate over the new organization followed an extensive report delivered at the meeting, in which some members of the committee said they were confused over what CommonWell has to offer. Did the alliance intend to replace HIEs? How would data exchange work? What are the goals?

[See also: Q&A: McKesson and Cerner execs discuss CommonWell Health Alliance.]

Software entrepreneur Paul Egerman, co-chair of the policy panel and one of two members to deliver the report, said the CommonWell alliance is "a nationwide endeavor; an example for the nation." Egerman, who based his report on briefings with alliance members, said the group aims to "solve" the nationwide data exchange problem, and it will do so with the following means:

  • Enabling providers to unambiguously identify patients – but not with a national patient identifier;
  • Providing a way to match patients with their healthcare records as they transition through care facilities;
  • Using existing unique identifiers (salted/hashed) such as cell phone number, email addresses or driver’s licenses for identity management;
  • Enabling patients to manage consent and authorization;
  • Creating a HIPAA-compliant and patient-centered means to simplify management of data-sharing consents and authorizations, focusing initially on the most common treatment situations;
  • Helping providers to find the location of patient records across care locations via a secure nationwide records locator service;
  • Enabling providers, with appropriate authorization, to issue targeted (directed) queries that provide for peer-to-peer (e.g., EHR to EHR) exchange.

The alliance's vision is that member EHR vendors will commit to this, and will be certified and use the CommonWell logo, according to its members. Governance is currently fluid, and still in early stages, Egerman said. "They also have a business model going forward. Vendors are going to pay. It’s a pay-to-play concept."

Charles Kennedy, CEO of Accountable Care Solutions for Aetna and co-presenter of the report, said that, although the group defends its altruistic purposes, he has his doubts, and wonders why competitors would want to cooperate. He conceded, however, that his sense from the group's founders was that they want to level the playing field for all vendors.

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