CommonWell wants to 'open this up'
In the year and 10 days since it was launched in New Orleans, the vendors of the CommonWell Health Alliance have been setting up the infrastructure for their vision of cross-competitive data liquidity. Now it's time to see what that interoperability can accomplish for the patient.
"In a very short period of time, we've taken some generally very highly-competitive organizations and brought them together around a common issue," said Rich Elmore, vice president for strategic initiatives at Allscripts, speaking at HIMSS14 this past February.
He was describing the alliance's original six members – McKesson, Cerner, Allscripts, athenahealth, Greenway and RelayHealth – as well as CPSI and Sunquest, who signed on to the initiative this past July.
"Putting the governance in place, a necessary prerequisite to make this work, was a pretty big deal," he added. Now, with standards set and the first pilot under way, "it's nice to see it operational."
In December, CommonWell began a small-scaled rollout at hospitals and ambulatory practices in Chicago, North Carolina and South Carolina. All of those participants are now able to enroll patients into CommonWell's service, identify whether other provider participants have data for those patients and transmit data on enrolled patients to other providers who have consent to do so.
One of those providers is Maria Parham Medical Center in Henderson, N.C., whose director of IT, Randy Williams, said he was impressed with the early results.
"In the first 24 hours our registration staff enrolled 180 patients," he told Healthcare IT News. By now, that number has well surpassed 1,500, "so that's pretty good. It's been very successful for us, at least on the enrollment side."
Just weeks into the pilot, "it's a little too early to tell" what tangible improvements to patient care might be in the offing, but "we all see the potential benefits there," said Williams. "Everybody understands the vision and the opportunity that's coming, and we're hoping for big things."
In the meantime, CommonWell continues to grow and add new members and clients. Its original participants were EHR and HIE companies. With the addition of Sunquest, a laboratory and diagnostics vendor was on board.
At HIMSS14, CommonWell announced that CVS Caremark would be joining as a contributing member, bringing the country's biggest integrated pharmacy into the fold and enabling a broader view of patients' needs.
"As pharmacies play an increasingly important role in the delivery of health care and pharmacists become more engaged in advising and counseling patients, there will be more opportunities to improve health outcomes through better data sharing across the provider community," said CVS Caremark Chief Medical Officer Troyen A. Brennan, MD, in a press statement.
CVS' participation in CommonWell, specifically it work with McKesson's HIE business, RelayHealth, will help it deliver real-time data to physician practices "to help identify opportunities to coordinate care and help the pharmacist deliver care-based messages back to patients," he said.
Another new member, MEDHOST, which develops technology for patient engagement and departmental workflow, will work toward identifying and linking patients across the community, officials say.
"The missions of CommonWell and MEDHOST are closely aligned, specifically that we both are focused on reducing healthcare costs while improving quality of care," said MEDHOST President Craig Herrod in a statement. "MEDHOST believes in CommonWell and views this initiative as an important strategic step for the healthcare industry as it works to connect communities of care."
"Over the course of the past year we've had more than 400 inquiries from people who want to join and participate," said Elmore. "Our goal is to open this up a lot more, but we're trying to do that systematically, to the point where we can support that broader community."
For the time being, he said, "We're trying to keep a focus in early days on data providers and try to make sure we have that core capability that providers are looking for, that physicians are looking for at the point of care. We're looking for anchor participants that are able to really shape the information that your doc's gonna want to see."
Under most circumstances, of course, the vendors of CommonWell are cutthroat competitors, but during their many face-to-face summits over the past year, with countless conference calls and Skype conversations in-between, they've made some interesting inroads as they worked to set up the committees – membership, standards/technology/implementation, pilot, marketing – necessary to make this interoperability happen.
The past year has "been a lot of fun," said Scott Stuewe, director of client results at Cerner and the head of CommonWell's program management committee. "There are some things we can't do (as competitors), but anything we could, we did."
For instance, "we created this new open source model for us to use a the enrollment application. That exercise was fun for us, an opportunity to do things you usually can't do with your competitors."
Not that it's necessarily been easy. "Imagine your usual pilot – a vendor, working with someone like Randy and figuring out how the system is going to work," said Elmore. "Here, to pull this off, it had to be a couple CEOs talking to each other and saying, 'We want to collaborate together,' then putting together those IT staffs, those clinical staffs, those technical systems together and getting that all to work."
Still, "the energy and enthusiasm from all participants has been great," he said. "Everyone has been super cooperative. There are some things you can't talk about because you just can't. But in terms of the mission we have, everybody is just dedicated to it and focused on it."
That mission is seemingly simple: "To be able to have the right information at the time when the doc is trying to make a decision. That's the problem we're trying to solve, and we're trying to keep a laser focus on it."
Interoperability has been maddeningly elusive, however. One reason, of course, is exactly the competitive "closedoffedness" CommonWell says it's working against. Another, Elmore suggested, might be that some are trying to do too much, too soon.
"A lot industry efforts are trying to boil the ocean," he said. "I think we've stayed really focused: at the point of care, a secure method to be able to find out where the patient's records are and allow the doc, on a targeted basis, while complying with HIPAA, to be able to ask for that record to be sent back."
One vote of confidence for CommonWell also came at HIMSS14, with the announcement that Tenet Healthcare – with its 77 hospitals, spanning 14 states – will make use of the alliance's services.
Beyond the early encouragement from the initial pilot participants, Tenet's heft and reputation would seem to bring some critical mass on the provider side. CommonWell's work with the hospital giant will focus on patient ID and matching, record location and document query and retrieval services.
"Tenet is committed to advancing technology with our hospitals and health care networks to ensure we’re providing the right information when and where it’s needed, enabling our providers to increase the efficiency and accuracy in care delivery and improve the quality of care in the communities we serve," said Bo McPartland, Tenet's vice president of IS planning and analytics, in a statement. "We look forward to working with CommonWell in breaking down the health data silos that exist today."
"Tenet is making a commitment to work with us to use the service," said Stuewe. "At this point, that's a huge statement about their commitment to interoperability. As you get more people involved, the momentum picks up and some of the barriers drop. It's a great vote of confidence that they're willing to work with us."
Going forward, "We are absolutely committed to embracing as many folks in health IT as possible," said Elmore. But that growth may just have to proceed somewhat deliberately.
"We're still just a group of volunteers," said Stuewe. "We don't have a lot of staff in the organization yet, and so, as a consequence, our ability to onboard dozens of members at this time is going to be challenged. We are trying to figure out what our demand is so we can get staff for when people really want to start joining. We need to have membership services in place so people can really get what they need from us."
In the meantime, providers are waiting and watching. And those who are already participating are looking ahead to what comes next.
"We see benefit here," said Williams. "We obviously have a real interest on the patient side; they're understanding what we're doing, so we really want to follow this. It'll be something that will further bring the hospital, the provider and the patient all into the same world – all for the good of the patient."