KLAS: CommonWell-Carequality Connection the Key to Interoperability Value

March 2, 2018
The CommonWell Health Alliance’s interoperability efforts are being hindered by a lack of provider adoption, but when CommonWell and Carequality eventually connect, “instant value” will be created for users, according to a new report from Orem, Utah-based

The CommonWell Health Alliance’s interoperability efforts are being hindered by a lack of provider adoption, but when CommonWell and Carequality eventually connect, “instant value” will be created for users, according to a new report from Orem, Utah-based KLAS Research.

In December 2016, CommonWell Health Alliance and Carequality announced connectivity and collaboration efforts with the aim to provide additional health data sharing options for stakeholders. Specifically, CommonWell, per the agreement, would become a Carequality implementer on behalf of its members and their clients, enabling CommonWell subscribers to engage in health information exchange through directed queries with any Carequality participant. What’s more, Carequality will work with CommonWell to make a Carequality-compliant version of the CommonWell record locator service available to any provider organization participating in Carequality.

CommonWell operates a health data sharing network that enables interoperability using a suite of services aiming to simplify cross-vendor nationwide data exchange. Services include patient ID management, advanced record location, and query/retrieve broker services, allowing a single query to retrieve multiple records for a patient from member systems. Meanwhile, Carequality, an initiative of The Sequoia Project, is a national-level, consensus-built, common interoperability framework to enable exchange between and among health data sharing networks.

Together, CommonWell members and Carequality participants represent more than 90 percent of the acute EHR market and nearly 60 percent of the ambulatory EHR (electronic health record) market, officials attest.

In a September interview with Healthcare Informatics, Micky Tripathi, Ph.D., president and CEO of the Massachusetts eHealth Collaborative, and who directly observes and participates in conversations with Carequality and CommonWell, said that there are “active talks about implementation” and that “Epic and Cerner are working cordially and collaboratively.”

What KLAS Found

According to the KLAS report, “Interoperability: An Inside Look at Plug-and-Play Patient-Record Sharing,” the major hurdle impacting the value of CommonWell is indeed lack of adoption—“there likely is not a critical mass of participating providers in your area to drive value,” according to KLAS. “Most CommonWell EMR vendors require their customers to onboard one at a time, and only athenahealth has driven adoption in mass. This is even true if you are using Cerner, who has been one of the most valiant and prominent CommonWell promoters. Because sharing among Epic customers is already universal, when CommonWell connects to Carequality, the entire Epic base will become available, creating instant value for most areas of the country,” the report said.

Currently, Epic is not a member of CommonWell, despite other major EHR vendors pushing them in that direction. Back in 2015, athenahealth CEO Jonathan Bush famously tweeted to Epic’s CEO Judy Faulkner that his company would pay for Epic to join.

Indeed, KLAS reported that CommonWell will likely see a significant adoption increase with a solid Carequality connection. “Since its launch five years ago, the tendency to over-market the level of adoption of CommonWell has created apprehension and a lack of trust among potential participants and prompted this report, showing a snapshot of providers’ success,” the researchers said.

The KLAS report noted that today’s successful plug-and-play scenario is for “each EMR vendor to integrate their EMR product with a single network and then get their EMR clients to participate in mass.” Examples of these networks include the athenahealth network, Epic Care Everywhere (its internal health information exchange solution), and a multi-vendor network offered by CommonWell. Once established, these networks can connect with one another based on a common standards framework from Carequality, the report stated.

But vendors such as athenahealth and Epic give their customers “a head start by enabling automatic, plug-and-play sharing between all customers,” KLAS researchers said, noting that athenahealth has been the most proactive in pursuing all reasonable channels for sharing.

The report went on to say that for essentially all of athenahealth and Epic clients, plug-and-play sharing is a “normal, everyday occurrence.” The report continued, “Both vendors have similar approaches in removing barriers such as operational/technical effort, governance, and onboarding choices; resolving barriers like improving the utility of records shared is next on the docket. Other EMR vendors leave their clients to deal with issues around governance, risk, operational involvement, and participation requirements on their own.”

According to KLAS, Epic's recipe of Care Everywhere, VA connectivity, and Carequality “has opened the door to the most successful sharing to date. EMR vendors initially relying on CommonWell alone are expanding to other options, including Carequality,” the report stated.

But for a vendor such as Cerner, which is CommonWell’s largest member, “diluted adoption of CommonWell means your sharing is greatly limited,” according to the report. Meanwhile, “Carequality connection may open the floodgates; then you will share with the much larger Carequality community (Epic clients plus others),” KLAS researchers stated.

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