Today, the EHR/HIE Interoperability Workgroup, originally formed by the New York eHealth Collaborative (NYeC), will announce the collaborative work of seven states (California, Colorado, Maryland, Massachusetts, New Jersey, New York, and Oregon), eight EHR vendors (Allscripts, eClinicalWorks, e-MDs, Greenway, McKesson Physician Practice Solutions, NextGen Healthcare, Sage, and Siemens Healthcare), and three HIE vendors (Axolotl, InterSystems, and Medicity.)
The objective of the EHR/HIE Interoperability Workgroup has been to define a single set of standardized, easy-to-implement interoperability specifications that will increase the adoption of EHRs and Health Information Exchange services. The effort leverages existing published standards for interoperability from the Office of the National Coordinator (ONC).
The work includes refinements to mature, well tested standards including:
*A summary of care implementation guide that further constrains the CCD/C32
*An enhanced Direct specification including SMTP/SMINE, XDR for connection to HISPs, and PKI/Certificate distribution.
The work also includes enhanced guides for those standards that the HIT Standards Committee felt required additional testing and refinement including:
*A detailed guide for implementing HPD/LDAP provider directories
*An updated guide to the components of the NwHIN Exchange specifications for "pulling" data from multiple data sources.
I offered the following quote to describe their work:
"I applaud the work that the EHR/HIE Interoperability Workgroup is doing to move states from implementation guides to production. Their selection of Consolidated CDA and Direct is well aligned with HIT Standards Committee discussions. The EHR/HIE Interoperability Workgroup is also doing important work with NwHIN Exchange and Provider Directories that will provide the country with lessons learned, so that the HIT Standards Committee can recommend refinements to these emerging technologies. 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."
Massachusetts is rapidly implementing Direct for exchange of clinical summaries. It's very likely that our implementation will be able to leverage the work of EHR/HIE Interoperability Workgroup for multi-state compatibility and reusability.
It's going to be a great year for HIE.
This is a commendable attempt to leverage some purchasing power and some state-level political influence to cause EHR vendors and their hospital clients to open up and reduce the costs of interfacing to data they think they own. In a recent post, I propose that a cost-based approach is needed to actually achieve interoperability. HIEs as conveners will help push standards in the right direction only if they learn from past experience and favor low-cost, patient and physician-centered approaches such as OAuth 2.0 over expensive and unscalable institutional adventures into Master Patient Indexes and centralized privacy databases.
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