News | November 09, 2011

Multiple States and Vendors Agree on Standard Health Data Connectivity Specifications

November 9, 2011 – A group of states and vendors focused on eliminating the barriers to sharing electronic health records (EHRs) issued a set of technical specifications to standardize connections between healthcare providers, health information exchanges (HIEs) and other data-sharing partners.

The objective of the EHR/HIE Interoperability Workgroup is to define a single set of standardized, easy-to-implement connections to increase the adoption of EHRs and HIE services. The effort leveraged existing published standards for interoperability from the Office of the National Coordinator (ONC). Ultimately, the specifications aim to remove impediments that make it difficult for EHRs to connect to HIEs, including technical specification differences, wait times for interface development and high costs.

The workgroup was originally formed by the New York eHealth Collaborative (NYeC) and comprises its federally designated counterparts in seven states (California, Colorado, Maryland, Massachusetts, New Jersey, New York and Oregon), representing approximately 30 percent of the country's population.  The eight EHR vendor members include 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, including Axolotl, InterSystems and Medicity.

Doug Fridsma, M.D. and Ph.D., director of the office of standards and interoperability at the Office of the National Coordinator of Health Information Technology, commented, "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. The results of this kind of initiative can help us advance health IT nationwide."

"This is a crucial step," said David Whitlinger, executive director of NYeC. "We started this as a New York State initiative, but we soon realized that many other states were facing the same interoperability challenges and many of the EHR and HIE vendors were also looking for clarity from the marketplace to define their product roadmaps. Collectively, the group is now looking forward to widespread adoption and market preference for the products that employ the specifications."

The first set of specifications focuses on two use cases and the detailed data and metadata specification for a compliant Continuity of Care Document. The first use case, Statewide Send and Receive Patient Record Exchange, describes how encrypted health information can be transmitted over the Internet. The second, the Statewide Patient Data Inquiry Service Use Case, describes the clinician's ability to query an HIE for relevant data on a specific patient.

The workgroup members collaborated to leverage existing HL7 standards, technical frameworks from IHE International and HIE implementations to provide a fully detailed implementation specification. The implementation specifications were also aligned with Beacon community guidelines to be capable of gathering information required for reporting to the ONC.

"I applaud the work that the EHR/HIE Interoperability Workgroup is doing to move states from implementation guides to production. I expect that the flexibility and agility of the EHR/HIE Interoperability Workgroup will serve as an ideal laboratory for standards that are rapidly evolving," said John Halamka, M.D., co-chair of the HIT Standards Committee, chief information officer of Beth Israel Deaconess Medical Center, chief information officer at Harvard Medical School, chairman of the New England Healthcare Exchange Network.

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