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Interoperability 2018

Interoperability 2018
Plug-and-Play Patient-Record Sharing via CommonWell and Carequality

Authored by: Coray Tate & Kent Gale March 2, 2018 | Read Time: 3  minutes

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In a major announcement at HIMSS 2013, CEOs from Cerner, McKesson, Allscripts, athenahealth, and Greenway formed CommonWell Health Alliance to expedite low/no-cost sharing of patient records locally and nationally. In 2016 athenahealth, Epic, eClinicalWorks, and NextGen Healthcare announced they would use the Carequality interoperability framework to accelerate the sharing. At this point these major vendors have set expectations of patient record sharing with one of these options. This report clarifies the progress major EMR vendors have made in sharing via these publicly touted plug-and-play approaches and how that impacts you as the leader of a healthcare organization.  

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Proven Scenario:  Today’s successful plug-and-play scenario (as described by providers like you) is for each EMR vendor to integrate their EMR product with a single network and then get their EMR clients to participate en masse. Examples of these networks include athenahealth network, Epic Care Everywhere, and a multi-vendor network offered by CommonWell Health Alliance. Once established, these networks can connect with one another based on a common standards framework from the Carequality collaborative.

march emr vendor impact on plug and play patient record sharing

How Do athenahealth's & Epic's Jump Starts Impact You? When Will Others Catch Up?

For nearly all of athenahealth and Epic clients, plug-and-play sharing is a normal, everyday occurrence. 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.

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.

CommonWell must connect with other networks immediately if CommonWell participants are to be part of the big sharing going on through Carequality.

march commonwell and carequality adoption

Barriers to Sharing Go Away When CommonWell Connects to Carequality

The major hurdle impacting the value of CommonWell is lack of adoption—there likely is not a critical mass of participating providers in your area to drive value. Most CommonWell EMR vendors require their customers to onboard one at a time, and only athenahealth has driven adoption en masse. 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.

access to epic sharing en masse drives more exchange

CommonWell will likely see a significant adoption increase with a solid Carequality connection. The tendency by some to overmarket the level of adoption of CommonWell has created apprehension and a lack of trust among some potential participants and prompted this report clarifying today’s reality and offering a snapshot of providers’ success.


Your Vendor's Level of Sharing, Including Custom Connection Considerations

Proactive vendors like athenahealth and Epic gave their customers a head start by enabling automatic, plug-and-play sharing between all customers. athenahealth has been the most proactive in pursuing all reasonable channels for sharing. The value of same-EMR interoperability has been discounted, but in Epic’s case it has been a factor in large portions of the country adopting Epic. Epic’s accelerated adoption of Carequality in 2017 opened patient-record sharing to a much larger provider community. All EMR users may see access to patient records rapidly accelerate as CommonWell and other vendors also implement Carequality to connect their networks.

Even if plug-and-play sharing were pervasive, a major barrier to deep interoperability remains: the usability of patient records. Vendors have yet to resolve data-formatting issues that prevent clinicians and their EMRs from easily digesting the information they retrieved.

deep interoperability rate same vs different emr vendor sharing

While it is not the focus of this report, it should be noted that KLAS has validated that all major EMR vendors build successful custom (i.e., not plug-and-play) connections to share patient records.


What Is It Like for Your Team to Work with Your EMR Vendor?

Knowing your EMR vendor is looking over your team’s shoulder makes it easier to sleep at night. Surprisingly, some vendors vary greatly in client satisfaction based upon the size of the client.

Vendors whose clients’ experiences vary significantly by size are Allscripts, athenahealth, and GE Healthcare.

Your organization has a unique relationship and experience with your EMR vendor. This chart offers some context into how your peers see their EMR vendor experience.

overall client satisfaction today by organization size
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2020 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.