Update: Read below for a synopsis and excerpts from this session. Video is also available here.
For the first time in Cerner Health Conference history, three competitors shared Cerner’s main stage at its opening Power Session on Oct. 9. Rich Elmore, VP of Strategic Initiatives – Allscripts, Arien Malec, VP of Strategy – RelayHealth, and Tom Wilson, VP of Strategic Programs – Sunquest, along with Cerner VP and session moderator Bob Robke, joined together to share their enthusiasm, insights and support of the CommonWell Health Alliance, as well as provide an inside look to what the group has been working on since it first announced the Alliance at HIMSS in March.
Read below for a synopsis and excerpts from their session:
Q: Since we announced the Alliance at HIMSS, a lot has been going on. What are your thoughts on where CommonWell is today? Can you expand on the accomplishments and challenges since our initial announcement?
Rich Elmore (RE), VP of Strategic Initiatives – Allscripts: The group of vendors who has come together here faces a series of challenges. But at the end of the day, there is this higher level interest in the greater good of the health system in the U.S. That is what is driving all of us to participate.
From the point of challenges, the big problem is patient identity. If the government were working today [Editor’s note: This conversation took place on Oct. 9, 2013, during the shutdown of the government.], they would be restricted from working on this. And we as an industry have a moment in time right now to take up the challenge that Farzad Mostashari, MD, ScM, National Coordinator for Health IT, HHS, launched over a year ago to reduce the cost and complexity for health organizations in delivering the care.
The patient identifier is really at the heart of this. Once you have that solved, then there is the not so insignificant challenge of how to know where patients’ records are, and to do that securely on a national scale. Then a doctor is in position to be able to, with a patient’s agreement and on a targeted basis, query those other locations, those other settings of care where those patients’ information is, and to have that patient unambiguously identified, so you don’t get the clutter. You get the patient’s information back to the doctor who is trying to help make the decisions that are important to you as a patient.
These are some of the challenges that the CommonWell Health Alliance faces. Now there is the challenge of making that happen. There is also the challenge of having the rights standards. We wanted open standards. In some cases, what we needed wasn’t supported by standards that currently exist, so we are working with the evolving standards that could be adopted by the health IT community broadly.
We want to pilot this process through health care organizations using our active code. And we are actually at a stage now where we have built the services, which we are starting to test even this month. So, some very exciting progress on that front.
And then we want to take all of that and make it happen in terms of a governance process that is open and transparent. We want as broad membership as possible across the country, using the health IT vendors as the facilitators for making that happen.
We are also very proud to announce that we have incorporated as a 501c6 trade associate this week, and we are making terrific progress.
Tom Wilson (TW), VP of Strategic Programs – Sunquest: The challenges of getting seven different entities together has not been an easy thing. You can imagine getting seven entities, seven competitors along with all of their representing attorneys and outside counsel together, it has been an exciting process. [Editor’s note: You can imagine the chuckles in the audience at Tom’s comment.] We have had this opportunity to really come together and hash some really difficult things out and now we are ready to make some good things happen.
It comes back to change begins with me [Cerner’s conference theme was “It Starts with Me”]. A quote by Mahatma Gandhi that we use every day at Sunquest is “You must be the change you wish to see in the world.” This is why we are involved. We want to help out the greater good. This is an altruistic group. We are not in it to make money. We all have our personal stories that we can share about helping people get home to their families. And that is what we are here for.
Bob Robke (BR), VP of the Cerner Network: I would agree that going through this process, our first few meetings were trying to figure out what we were supposed to be doing. But over the course of these last few months, I think the Alliance has become a pretty tight group. Based on the complexity and having to work through it. There is no turning back. We have to get this done. And I think that has brought our Alliance together to be really tight.
Arien Malec (AM), VP of Strategy – RelayHealth: I was just thinking the last project that David McCallie (SVP, Medical Informatics – Cerner) and I organized and kicked off was the Direct Project. I was very proud to have coordinated that effort for ONC. And it was 10 months from launching at HIMSS to having the first production use out in the community and having all the services available. And CommonWell is now 8 months in and currently we are going through a certification process to get 7 EHR vendors connected to live nationwide services. So in many ways, we are exceeding what was already a pretty rapid timescale.
I mean look at this. We are on the Cerner stage – Allscripts, Sunquest and RelayHealth. Could you have imagined this five years ago? [Editor’s note: A huge round of applause is heard throughout the conference center ballroom!] I mean it is kind of unbelievable. What has changed in the world is that we used to be preoccupied … rightly so … with improving the efficiency of care delivery at single points of care. And we have done a great job at that individually and at our organizations, working with you guys (health care organizations).
And now we recognize that we have another great challenge. We need to be patient centered. We need to follow the patient around and provide care for individuals and provide care for populations.
Very few organizations have just one HIT vendor who powers their organization. Patients need to work with pharmacies, with long term care, with home health. If we are serious about enabling population health and delivering patient-centered care across a system of care, this system has to work. We have to ensure that no matter where the patient receives care, their data can flow to improve the patient care and can flow to do all the hard work downstream to enable population health, better analytics and better care improvement.
And right now, it’s just too hard to get the data to flow. And CommonWell really is an opportunity for us to step up and say “we have got to make this happen” so that you guys can do your job in that next stage of transformation.
Q. How does CommonWell fit into the state of the ecosystem of health care and what is coming up next in our industry?
AM: The next thing that people are thinking about is “how does this play into Stage 3 Meaningful Use”. As you may know, across the CommonWell Health Alliance we have three members who sit on the HIT Standards committee advising the national coordinator – David McCallie, Cerner; Jeremy Delinsky, athenahealth; and myself-Arien Malec, RelayHealth, and one of the big topics right now is how to make sure that we at least have the ability for directed query and have the ability to look up a patient’s information in any single setting of care.
In many ways, what CommonWell is doing is going above and beyond Stage 3 by making sure that it works not just from setting of care to setting of care, but we can also ask the question “where else has this patient been seen” and “where might their data be”. I very strongly believe that the work we are doing here at CommonWell is going to lever well for the next turn for Population Health, the next turn for Accountable Care and also serve us well for Stage 3 Meaningful Use.
Q: How does CommonWell work with established HIEs?
RE: Think of CommonWell as a patient ID router – it’s not doing data transformation. It’s not doing data normalization. It’s not providing population health analytics or a patient record across settings of care. It’s not doing a range of services needed to solve problems that are important for Population Health, for Accountable Care and for the move to value-based care. HIEs, in general, should benefit from CommonWell since they won’t have to worry so much about plumbing and connectivity in the future, given CommonWell is successful.
Q. How does one become a member of CommonWell? When is CommonWell going to fully open up membership beyond just health IT suppliers?
TW: Sunquest and CPSI joined after the initial announcement. And we are very excited to be a part of this and we want everyone to be a part of it. So, if you have connections with any HIT vendors who you want us to partner with, let us know because eventually we want everyone to be a part of this. That is when we are successful. When we have everyone nationwide involved. We have a list of over 450 different entities who have contacted us wanting to be a part of this thing. This is big and it is gaining momentum and it will continue to gain momentum as we get this pilot out and as we continue to show the value of being involved in this.
Q. What is the patient experience for the CommonWell enrollment process?
AM: The HIT Policy Committee made recommendations to the ONC around the concept of “meaningful choice”. Meaningful choice is the simple proposition that you are doing something for the patient that goes above and beyond what they need to do to receive care. You need to let patients know what is going on and why, and give the patient the choice to participate. That could mean “opt-in” or “opt-out” — we are not asking for any additional formal agreements above and beyond what is required by federal, state and local law and custom. The key obligation that needs to be done is to talk to your patients about what it is we are doing, why we are doing it and how it will help them receive better care.