As my colleague Coray Tate discussed in his blog post last week, the connection between CommonWell and Carequality is not only up and running, but now generally available, creating a national framework for the sharing of patient data across the country.
This is a huge step forward. Today, all but two of the most predominant industry EMRs have made it possible for customers to connect. With over 90 percent of their customers connecting, Epic and athenahealth have led out in encouraging participation.
That said, this connection doesn’t provide inherent value in and of itself. Much like a hydroelectric dam cannot not provide electricity if there is no water in the reservoir to move the turbines, CommonWell-Carequality cannot provide patient data to healthcare organizations if industry participation is low. The real value is in the volume of data available for exchange.
All told, the organizations that have connected represent only a small portion of eligible healthcare facilities in the US. This means that for many providers, connecting to CommonWell or Carequality wouldn’t always lead to the desired result: the meaningful sharing of patient data.
So how long does it take to fill a reservoir? A very long time, if there are no significant storms to raise the water levels in surrounding rivers. Similarly, this national framework needs a flood of connections to fill the reservoir and bring immediate value to the people connecting. Unfortunately, one of the biggest issues in the industry is a tendency to move one organization at a time. If that trend holds true for the CommonWell-Carequality connection, it will take far too long for this national network to make a significant difference.
How can we as an industry overcome our current inertia? By making the choice to connect. My goal is to answer a few of the most common questions that providers may have around establishing a connection to the national framework via CommonWell or Carequality.
Is the Connection Real?
The initial announcements about CommonWell and Carequality were viewed somewhat skeptically as publicity stunts. Today, however, they are very much a reality. The connection between them was announced to be generally available after being tested by a few sites across the country.
After speaking with representatives from several of these test sites, KLAS learned that the Epic sites validated that they could access the data of connected Cerner sites, and the Cerner sites validated that they could access the data of Epic sites connected to Carequality. This is a huge deal. (For more information — or to access direct quotes — check out KLAS’ Interoperability report).
How Much Effort Will It Take to Connect?
Some vendors have removed more barriers than others. Epic and athenahealth have opt-out policies and pre-established how their customers will handle outside data. Cerner customers may have to put in the most effort, and Virence Health (GE) customers will have to pay to participate. But even these providers will have to invest much less cost and effort than they likely would have via traditional interoperability methods such as point-to-point interfaces or HIEs.
For some organizations — particularly those not with Epic or athenahealth — governance issues may be the most difficult part of connecting to the national framework. Yet, despite the possible obstacles, I believe every organization should choose to turn on the switch. Talking through governance issues and what to do with the outside data might be a process, but for organizations that have connected, it has been worth it to see their clinicians leverage outside patient data to better care for their patients.
Can I Trust Outside Data?
Through discussions with providers whose organizations have been bringing in outside data for an extended period of time, KLAS has picked up some general trends.
Initially, doctors need a while to warm up to the data. They are hesitant to access it and unsure of how to use it once they get it. But over time, their trust level increases. As they become accustomed to the outside data and the process of putting it to use, they realize that information from an outside clinic across town isn’t significantly different from information they get from their partner facility across the street. They start to ask for any data they can get.
As an added bonus, these data receivers often become better data sharers. Doctors who access outside data are likely to be clearer in their own documentation efforts. And thus, a positive cycle is created: As more providers make it easier to use their data, more outside organizations will be able to take advantage of it.
Will Bringing in Outside Data Hamper Clinician Usability?
With the push to bring in outside data, industry professionals may have flashbacks to Meaningful Use. The good news is that vendors have not just focused on checking boxes, but on making this an easy process for clinicians. Many providers using various EMRs say the patient-matching process is relatively simple (or even automatic) and that the reconciliation of outside data such as problem lists, allergies, medications, and immunizations is a straightforward process.
While each vendor’s level of automation may differ today, organizations have been overwhelmingly positive about the ease with which they are able to ingest, incorporate, and display outside patient data. And having spoken with the vendors and their customers, we at KLAS feel the vendors are truly working to make this a seamless process. KLAS will continue to watch the industry move forward in this critical area and will report on usability progress in a new report slated for the first half of 2019.
Why Should I Share My Data?
We’ve heard some organizations say that their neighbors are unwilling to share patient data, claiming it is “their” data.
As a patient, I believe the sooner we can shift away from that paradigm, the better. I want every facility I visit to have access to my health information. I don’t want the hassle of taking or paying for multiple tests, and I certainly don’t want to take my medical record with me on a CD. I want my doctors to help me get better. But to do that, they need access to my full medical history.
Let’s Create a Powerhouse
The CommonWell-Carequality connection has the potential to simplify care and save lives, but only if we all use it. We at KLAS challenge you to get involved, and learn what you’ll need to do to take advantage of this tool. Once you’ve decided to join the national network, bring others with you. Together, we can create a powerhouse that will fuel a better and brighter healthcare.