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Source: InformationWeek

Progress On Health Data Exchange Specs

Seven states, eight e-health records vendors, and three health information exchange providers agree to support interoperability standards that also could make health data exchange easier nationally.

By Marianne Kolbasuk McGee InformationWeek
November 08, 2011 05:14 PM

Seven states and 11 health IT vendors have banded together to support a set of technical specifications to standardize health data sharing among healthcare providers, health information exchanges, and other parties.

A bigger vision being eyed by the group is for the set of technical standards to gain support from other states and EHR and HIE product vendors so that the specs help in the country's loftier goal of health data exchange among healthcare providers nationwide.

The specifications, available at www.interopwg.org, are the result of a workgroup originally launched in April by the New York eHealth Collaborative (NYeC). Besides New York, the other members of the group include federally designated entities or HIEs in six other states--California, Colorado, Maryland, Massachusetts, New Jersey, and Oregon.

Together, those seven states represent about 30% of the U.S. population. That chunk of the population, along with the several big-name health IT vendors pledging to support the standards, could help motivate compliance from other states, EHR vendors, and HIEs in also implementing the defacto specifications, potentially easing barriers of nationwide health data exchange.

"We were careful not to allow the group to get too big. It's the right size to move forward without having too many cooks in the kitchen," said Dave Whitlinger, executive director of NYeC.

[The healthcare industry and IT together face challenges on many standards fronts. See IT Executives Reject Meaningful Use Metadata Standards.]

Still, with the workgroup of states representing almost a third of the U.S. population, the effort should have enough clout for other states, as well as other health IT vendors, to also consider supporting the specifications, said Whitlinger in an interview with InformationWeek Healthcare.

The group's specifications also leverage existing interoperability standards from the Office of National Coordinator, which should also help promote support by others, said Whitlinger.

Among the vendors supporting the standards are EHR providers including Allscripts, eClinicalWorks, e-MDs, Greenway Medical Technologies, McKesson Physician Practice Solutions, NextGen Healthcare, Sage Healthcare Division, and Siemens Healthcare.

In addition, there are three HIE services vendors participating: Axolotl, InterSystems, and Medicity.

"I am encouraged by and excited about this type of collaboration, which has the potential to advance real-world pilots, implementation and feedback on standards for health information exchange," said Dr. Doug Fridsma, director of the office of standards and interoperability at the Office of the National Coordinator of Health Information Technology in a statement. "The results of this kind of initiative can help us advance health IT nationwide."

The specifications make it easier for clinicians to have two important basic health-data-exchange capabilities: patient record look-up and point-to-point, or direct, data sharing, said Whitlinger.

The standard for patient record look-up--or more specifically, Statewide Patient Data Inquiry Service Use Case--describes clinicians' ability to query an HIE for relevant data on a specific patient.

The second capability, enabled by the Statewide Send and Receive Patient Record Exchange specification, describes how encrypted health information can be transmitted point-to-point over the Internet. This could allow a doctor in Florida, for instance, to exchange data about a patient being treated for injuries by a doctor in California while the patient is on vacation, Whitlinger said.

As interoperability standards evolve and more capabilities are layered, increasingly complex data exchange, such as information that needs to be shared for coordinated patient care plans, can become possible, Whitlinger said. "Care plans are a next step," he said.

Currently, EHR vendors---and healthcare providers using home-grown software--often need to develop individual interfaces for their products in order to exchange health data with systems used by other healthcare providers or any of the hundreds of state and local HIEs that currently operate in the U.S.

The development of those interfaces can cost many thousands of dollars, and is one of the many big hurdles for healthcare providers, HIEs, and EHR vendors to support data exchange efforts.

The workgroup members collaborated to leverage existing HL7 standards, technical frameworks from IHE International, and HIE implementations to provide a fully detailed implementation specification, according to the NYeC.

The implementation specifications were also aligned with Beacon community guidelines to be capable of gathering information required for reporting to the ONC.