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Interoperability End of Year Progress 2018
Real Progress with Patient-Record Sharing via CommonWell and Carequality

author - Coray Tate
Coray Tate
author - Jonathan Christensen
Jonathan Christensen
December 4, 2018 | Read Time: 4  minutes

Since the last KLAS report on interoperability was published in March 2018, the acute care/ambulatory EMR market has taken critical steps forward in sharing data via national networks. The most notable advancements include the establishment of the CommonWell-Carequality link, MEDITECH’s initial connection to CommonWell, and notable Carequality adoption among NextGen Healthcare customers. At this point, all of the most prevalent acute care/ambulatory EMR vendors except Allscripts and MEDHOST are connected to the national framework, putting the ability to exchange patient records within the reach of most acute care or clinic-based provider organizations, regardless of size or financial situation.

current state of plug and play patient record sharing

CommonWell to Carequality: The Connection Heard Round the US

As announced in August 2018, a few pioneering organizations have tested the initial CommonWell-Carequality connection, which was announced in November 2018 to be generally available. Two CommonWell-connected Cerner organizations tested and validated the ability to connect with Epic sites via Carequality. Their initial reports are that the connection enables data sharing with critical partners otherwise out of their reach and adds tremendous value to their existing CommonWell exchange. The Epic sites involved indicate that they also are able to see and consume data via the new connection. This connection should be key in driving value and opening the floodgates so that any provider organization that desires to can exchange patient records with relative ease and little cost. While this connection is just getting started, KLAS plans to measure the impact of this sharing in a 2020 interoperability report.

“We were connected to CommonWell [with Cerner] but only had a handful of exchange partners in our area. Our major referral partners were running Epic, so we volunteered to be first. With the CommonWell connection to Carequality, we saw record matches on 55% of our patient population via the Carequality connection.” —IT Director

“The data coming from the Cerner sites via Carequality and CommonWell came [into the Epic EMR] just like any other data we were used to seeing.” —IT Analyst

december emr vendor impact on plug and play patient record sharing

NextGen, eClinicalWorks Show Most Notable Progress; MEDITECH Makes Initial Connection

Since NextGen Healthcare made their bidirectional connection available in Q1 2018, customers have rapidly taken up connections to Carequality. With 80 customers connected, there is still much room for additional uptake—though NextGen has removed both financial and technical barriers to make this a reality. eClinicalWorks customers have also rapidly taken up connections, with nearly triple the number participating today (~2,500) compared to March 2018. MEDITECH also made their first connection to CommonWell. The connection is currently available only for Expanse customers, and MEDITECH is working to make it available for customers using C/S 5.x. The plan for those on 6.x or MAGIC is still undetermined. CPSI (not covered in KLAS’ previous report) has also made notable progress this year. Customers report that CPSI has built functionality into Evident and made it easy to connect to CommonWell. Cerner continues to actively push for customer participation and has added 35 hospital customers. While Cerner is passionate about customer participation, customers still face the most technical barriers (e.g., installing Resonance and the mapping in the background), which typically take three to six months to resolve. Epic and athenahealth have near complete uptake among their customers, allowing them to work on the next steps for interoperability, such as fine-tuning usability and increasing value for clinicians.

Virence Health (GE Healthcare) has been slower to get out of the gate despite good feedback from early adopters. Greenway Health also doesn’t have much momentum, and overall, interviewed Greenway organizations are the least excited about their CommonWell connection. Greenway is working on expanding support for the CommonWell connection to Intergy; beta customers validate that this is underway but not complete. Allscripts recently announced more solidified plans to have their Carequality connection ready in Q1 2019 and to then roll it out in product updates throughout the year. MEDHOST has been aligned with CommonWell since 2014 but has yet to have any live connections.

december commonwell and carequality adoption

Biggest Remaining Obstacle Is Local Community Adoption

With CommonWell and Carequality linked, the biggest technical obstacle to widespread patient-record sharing has been removed. The healthcare industry is rapidly approaching the point where an organization using any of the major acute care/ambulatory EMRs should be able to easily connect to other provider organizations with minimal cost and effort. Many vendors have eliminated obstacles on the path to data exchange—all but Virence offer connections to customers at no cost, and all but Cerner have made this plug and play by removing technical barriers. Epic’s and athenahealth’s approach to facilitating participation (via an opt-out approach) and removing governance barriers (via predetermined handling of outside data) shows that regardless of customer size, vendors can facilitate widespread adoption if they choose.

Today, the biggest barriers preventing widespread participation are governance and the need for organizations to decide to participate. Even Epic and athenahealth customers report diminished value from their connection when local exchange partners opt not to connect to the national networks. Until other vendors take an opt-out approach, you as an organization will have to be proactive in promoting local connections to these networks to ensure high value from your connection.

obstacles to plug and play interoperability
author - Jonathan Christensen
Jonathan Christensen
author - Jess Wallace-Simpson
Jess Wallace-Simpson
author - Robert Ellis
Project Manager
Robert Ellis
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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. © 2024 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.