Care Everywhere

Leadership: Epic Community, led by Governing Council
Date Formed:

2008 (source)

Ownership

Private

Governance

Governed by a peer-elected Governing Council and associated Rules of the Road agreements.

Geographic Reach (within US)

Global

Mission

Expand the access to health data to create a more comprehensive health record and improve the speed of care.

How does this approach facilitate exchange?

Care Everywhere is an HIE platform that is primarily a federated model that is controlled by the patient and can be used widely without the need for an intermediary.

Access Method (use cases)

Push and pull exchanges are embedded within Epic applications used by providers and consumers:

  ▪  Advanced record location

  ▪  Automated query-based exchange

  ▪  Closed loop referrals management

  ▪  PCP Event notifications

  ▪  Automated discharge follow-up alerting

  ▪  On demand Direct messaging

  ▪  Patient initiated record sharing

Primary Goals/Objectives

• Be easy to use

• Use open and inclusive standards  

• Expand the amount of content and variety of participants

• Share lessons learned

Type

Provider-centric network

Number of live connections and/or participants

100% of Epic’s U.S. customers using clinical applications, or over 1,700 hospitals and 34,000 clinics are live on Care Everywhere. Of those, 99% are connected to over 70,000 provider sites using other EHRs and HIEs. (As of October 2017)

Members

Not applicable

Primary Participants

Patients, Hospitals, Clinics, CINs, ACOs, Payers, Pharmacies, and Retail Clinics

Costs (Amount and/or Party Incurring Cost)

Care Everywhere is free to use for treatment and care coordination, regardless of the exchange partners technology platform.

Directory/MPI Details

Care Everywhere facilitates automatic distribution of exchange-ready providers and healthcare organizations regardlesss of EHR system or network that user belongs to.

Care Everywhere uses a sophisticated probabilistic patient matching algorithm and there is no centralized MPI necessary.

Standards Leveraged

Care Everywhere exchanges information using industry standard transport protocols. Query Approach: Transactions from the XCA, XCPD, PDQv3, and XDS.b integration profiles developed by Integrating the Healthcare Enterprise (IHE)

Sending/Receiving information for planned transitions of care: Direct Project standards. The types of information exchanged by Care Everywhere follow HL7's Clinical Document Architecture (CDA) standards.

Onboarding Process (Requirements to connect)

Care Everywhere is natively integrated into the Epic EHR and does not require a separate implementation process.  

Care Everywhere is also a Qualified Technology Solution with the Sequoia Project so groups can instantly go-live on Carequality or the eHealth Exchange to expand national connections to include the Veteran's Health Administration, the Social Security Administration and thousand of additional providers.

Data Persistance

Federated Model: There is no centralized hub or data storage. No data flows through Epic servers involved in the exchange and Epic does not store any protected health information (PHI) or personally identifiable information (PII).

Certification Requirements for Participation

There are no certification requirements.

Testing

Standard connectivity testing is conducted during the initial implementation. New sites are connected with no additional testing.

Future Plans

Extend the content of documents exchanged to match the needs of specialists. Each provider should find information relevant to their discipline and the patient's care being delivered.

Work with community to support novel workflows, such as telehealth & care coordination, in which CDA-based exchange will be a key component. In these scenarios, Epic is focusing not just on the information exchanged but also how it dovetails into a seamless workflow for staff who are providing care for the patient spanning across organizational boundaries.

Expand the network to support image exchange between organizations. The long-term vision is to support full DICOM exchange and integrate it natively into the provider's workflow. Non-DICOM content will also be included, such as visible light images, scanned documents, and PDF reports.

Current Collaboration across Efforts

Care Everywhere is an implementer of the Carequality Framework. (source

Care Everywhere is HISP agnostic and 82.5% of Care Everywhere participants use a DirectTrust accredited HISP. They’ve selected 45 unique HISPs across 12 different vendors.

Care Everywhere is a Qualified Technology Solution for the eHealth Exchange and have dozens of connections with Community HIEs.