CommonWell Health Alliance

CommonWell Health Alliance is a trade association, working to make interoperability an inherent part of health IT. Launched in 2013, they have had services live nationwide since the end of 2014. Services include patient enrollment, record location, patient identification & linking and data query & retrieval. Their aim is to leverage existing standards and policies to make interoperability a reality.

In this HIE inPractice Feature, Jitin Asnaani, Executive Director of CommonWell Health Alliance joins us to discuss the history of CommonWell, current initiatives and challenges that have been overcome. He emphasizes the importance of engaging patients in their care as well as the need to overcome the status quo in order to achieve true interoperability in healthcare.

CommonWell first announced its formation at HIMSS13; its founding members have been supporters and active participants of HIMSS long before CommonWell was launched.

Our vision that “health data should be available to individuals and providers regardless of where care occurs” seamlessly aligns with HIMSS’ vision of “better health through information technology.”

CommonWell has continued to grow since 2013, and has leveraged the HIMSS Annual Conference as a platform in which to demonstrate its growth and share its learnings—most recently by being a first-time participant in the HIMSS Interoperability Showcase at HIMSS17 in Orlando, FL.

In February 2016, CommonWell became a HIMSS Member, as a Non-Profit Partner, and we have enjoyed the additional opportunities to work with the HIMSS to best leverage our shared vision around access to health data and furthering standards-based interoperability.

In May 2012 the concept for CommonWell Health Alliance was born during a Bipartisan Policy Center meeting hosted by Dr. Farzad Mostashari, then the National Coordinator for Health IT. This meeting was attended by Arien Malec, VP of Strategy at RelayHealth (a division of McKesson at the time), and Dr. David McCallie, Senior VP for Medical Informatics at Cerner, among other industry leaders. Less than a year later, Cerner, McKesson, Allscripts athenahealth and Greenway Health formally announced the launch of CommonWell on March 4, 2013 at HIMSS13.

Within its first six months, CommonWell and its service provider, RelayHealth, had developed its initial four core service specifications. By the end of 2013, CommonWell had already identified the first four geographic areas it would use to trial its initial services, which went live in January of 2014. Later that year, members went live with nationwide expansion of services.

In August 2016, CommonWell announced a first for the industry: the commitment to give patients access to their health data through the CommonWell network, which would empower patients to become more involved in their care decisions.

Today, we are excited to report that more than 5,000 provider sites in all 50 states, D.C. and Puerto Rico have gone live with CommonWell services and have generated millions of transactions on the network.

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, has significantly spurred the adoption and use of IT. The sheer volume and growth of the health IT market since HITECH is noteworthy, and is what makes CommonWell so much stronger, given its reliance on the collective experience of members to continue driving the organizations forward.

Additionally, innovations, including HL7 FHIR®, blockchain and the use of application programming interfaces (APIs) to improve data exchange, reinforce just how fluid and awe-inspiring the changes in the health IT landscape can be.

CommonWell is on a journey in which its service offerings are continually adapting to provide even more value to its members and to the industry. This was most recently illustrated by our commitment to building new APIs that will enhance existing services and make data exchange even more efficient, specifically for needs across the “health and care” ecosystem, including individuals seeking coverage for disability insurance, organizations investing in more effective care coordination and communities seeking to drive public health programs.

We also recently completed building the first set of the Argonaut Project’s latest FHIR® specifications into our core services—making CommonWell the first national network to enable comprehensive FHIR®-based-exchange at scale. This is a game-changer for the industry, since FHIR® will enable non-traditional EHR and health IT vendors across the care continuum to plug into and access CommonWell services.

As organizations and initiatives similar to CommonWell continue to drive forward services that more easily enable data exchange among disparate systems, interoperability will become more of a utility.

This will improve a provider’s ability to deliver quality, person-centered health care. The focus will continue to be on ensuring the data exchanged is consumable and useful for those providers.

Equally as important, as consumers increasingly bear the burden of their health care costs, they will demand the opportunity to be more engaged in their care, including the ability to access directly their longitudinal health records, their family members and even their community members (coaches, teachers, etc.). We believe we are well positioned to empower this reality for the patient.

In February 2017, fourteen (14) CommonWell members committed to building new APIs that will enhance existing services and make data exchange even more efficient. As mentioned above, the new APIs are anticipated to be utilized for a variety of needs across the “health and care” ecosystem, including for individuals seeking coverage for disability insurance, organizations investing in more effective care coordination and communities seeking to drive public health programs.

We see the use of these types of APIs as a stepping stone to exchanging health data more widely throughout the industry-at-large, bringing us even closer to experiencing interoperability among disparate systems as a common utility.

Since day one, CommonWell has been committed to working with all industry stakeholders to achieve true interoperability to ensure consistent and complementary results.

Currently, four HIE organizations contribute to the collective experience of the Alliance: Michigan Health Information Network Shared Services (MiHIN), Delaware Health Information Network (DHIN), One Health Record (Alabama’s HIE) , and Texas Health Service Authority (HIETexas).

In the past, a handful of executives from our member companies and I have served on multiple government-sponsored task forces, including many of ONC’s Health IT Policy Committee workgroups.

Additionally, many representatives from CommonWell member companies work closely with other interoperability initiatives such as The Sequoia Project, The Argonaut Project, HL7 International and more.

Most recently, CommonWell and Carequality announced an agreement to collaborate to increase health IT connectivity nationwide – this includes providing Carequality members access to the CommonWell national record locator service.

CommonWell services aim to solve the patient linking and identity problem at scale nationwide. Additionally, we have created a functioning record locator service (RLS), which allows providers to find all records associated with a patient, no matter where the care is delivered.

The founding members of CommonWell put aside their differences to come together and solve two critical industry challenges for the common good. We have a long way to go to make interoperability a national utility, but we have also made huge progress in a very short amount of time, and that is something we will always be proud of.

At the end of the day, the biggest challenge is overcoming the status quo. The way things have always been done (hoarding data in silos and perpetuating a world where care is based on a fee-for-service model) is not going to improve health care for all. While the journey to change may be long and arduous, it will always be worth it in the end to ensure the person is truly at the center of their care and feels empowered to participate in critical decisions.

The best piece of advice that I have received is probably also one of the most common pieces of advice I have received from providers which is, the utilization of health care data is directly impacted by the availability of the data in the workflow, no matter what the exchange mechanism behind it. Research has shown this to be true repeatedly. CommonWell has taken this to heart; our vision spells out the need for such data access to be built into our members’ products.

However, this workflow is not just about software. As the digital tools and devices that clinicians utilize increase, and as patients visit an ever-expanding array of health and care settings, “workflow” means that the data is virtually “attached to the patient” so that it is accessible whenever and wherever they present themselves across the continuum of care. CommonWell will continue its pursuit to ensure that there are no gaps in access and availability of a person’s data and that it practically becomes an extension of the person.