While most EHR vendors can make PAMI (problem, allergy, medication, and immunization) data from outside sources usable, there are big differences in how contextual data—such as notes and labs—is managed, with Epic and Cerner standing out from the pack in this area, according to a recent KLAS report.
According to KLAS researchers, the firm’s December 2018 interoperability update validated the CommonWell-Carequality connection, which makes data sharing possible for almost any provider organization. To this point, the researchers note, “Most vendors have the ability to connect to CommonWell, Carequality, or both, and these connections are currently the only option that allows the provider organization to achieve interoperability while avoiding significant costs, delays, and organizational workload.”
But next hurdle, they say, is making shared data usable. In reporting on health IT interoperability, KLAS says it draws on information a variety of sources, including interviews with healthcare organizations, key EHR (electronic health record) vendors and other research findings. For this specific report, which is the third in the Carequality/CommonWell series, researchers focused on the progress of EHR vendors in making the data received from those networks more usable.
In November, the CommonWell Health Alliance and Carequality announced “general availability,” enabling CommonWell subscribers to engage in health data exchange through directed queries with Carequality-enabled providers, and vice versa.
CommonWell, an alliance formed five years ago, operates a health data sharing network that enables interoperability using a suite of services aiming to simplify cross-vendor nationwide data exchange. Major vendors connecting to CommonWell include athenahealth, Cerner, CPSI, eClinicalWorks, Greenway Health and Meditech.
Carequality, an initiative of The Sequoia Project that launched about a year later, is a national-level, consensus-built, common interoperability framework to enable exchange between and among health data sharing networks. Vendors using Carequality include athenahealth, Epic, eClinicalWorks and NextGen Healthcare. Nearly all major EHR vendors have aligned with one or both of these options, according to KLAS.
This latest report revealed that Epic and Cerner stand out from other EHR vendors in making less-structured data, like labs and notes, more usable. In the Epic EHR, problem, PAMI data from any vendor flows directly into native fields to be reconciled. Notes and labs from Epic sites also flow automatically, while non-Epic sites need to be individually configured for the same automation to be achieved.
KLAS also reported that most vendors send summary CCDs that include all data on a patient in one document, but Epic is the only vendor today who sends a separate CCD for each encounter.
Meanwhile, according to KLAS, Cerner users must select documents to bring in, and then the system automatically organizes the data into a summary view and shows it in the chart. Both Epic and Cerner enable clinicians to access any outside data with a search bar, which saves clinicians from needing to sort through CCDs (continuity of care documents).
As far as other vendors, tough KLAS has validated connections to CommonWell for Greenway Health, none of its customers report actually using outside data, often because they struggle to find organizations to exchange with. CPSI, meanwhile, offers only basic support for using outside data and is the only vendor that requires customers to match all patients manually.
The report further noted that Even vendors who deliver fairly strong usability still have plenty of work to do. Companies such as athenahealth, eClinicalWorks, NextGen Healthcare, and Virence Health (GE Healthcare) are all still working to make notes and labs easier to consume. Customers of all vendors report they sometimes have to deal with redundant data from multiple sources, according to KLAS.