On July 31, I delivered testimony to the JASON Task Force and posited that the CommonWell Health Alliance can fulfill the vision of a national “Robust Healthcare Architecture” as expounded upon in the JASON Report, discussed more below.
By way of background, members of the JASON Task Force consists of a subset of the members of the HIT Standards Committee (HITSC) and HIT Policy Committee (HITPC), organized by the Office of the National Coordinator for Health IT (ONC), and aimed at synthesizing the feedback to the JASON Report.
The JASON Report observed that health information exchange today is inadequate both in breadth of adoption and in usage towards the Triple Aim – better care, improved health of populations and lower per capita costs. The report strongly suggests that a new approach is needed, a premise that is likely to guide ONC’s agenda over the remaining tenure of the current administration. The approach primarily hinges on the replacement of “legacy” health IT/EHR systems with systems that extensively leverage APIs to enable openness and can interoperate through the seamless transmission of discrete clinical data elements. This is in stark contrast to the monolithic EHRs that dominate the health IT landscape today, and the document-centric health information exchange paradigm that pervades health care, such as the Summary of Care document specified in Meaningful Use Stage 2.
In collaboration with other thought leaders within CommonWell, specifically Arien Malec of RelayHealth, David McCallie of Cerner, and Rich Elmore of Allscripts, we delivered a point of view that laid out the premise that CommonWell is building the API-oriented architecture envisioned in the JASON report. Underscoring that ambition is the fact that the CommonWell architecture is not just concept, but (1) being used actively today across four geographies, (2) scalable nationally, and (3) solves some of the real-world implementation issues that the JASON Report overlooks. CommonWell solves these issues in a much more modular way than implied by the JASON Report, allowing a variety of systems and future innovations to be able to connect to and use CommonWell services.
The JASON Task Force’s reaction to our point of view was warm and receptive. It should be pointed out that we participated in this hearing as a panelist on the “Exchange Services Providers” panel, which also included organizations such as CRISP, Rochester RHIO, and Healtheway. Other panelists’ testimony focused largely on the implementation challenges of the JASON Report and the progress made today by each of their organizations relative to the observations made by the Report. A much engaged Q&A session followed the testimonials. There were also two other panels that were assembled in front of the JASON Task Force – a panel populated by Research organizations, and another with Standards organizations.
From my perspective, one of the most obvious actionable outcomes out of this discussion was the unanimous agreement that clearer standards for discrete data exchange are needed. In addition, ONC should foster the further development of the nascent Fast Healthcare Interoperability Resources (“FHIR”, pronounced “fire”) standard that is being utilized by CommonWell (and others).
To review CommonWell’s full testimony, visit: JASONTaskForce_Hearing_CHA_07312014_FINAL
Jitin Asnaani is the director of technology standards and policy for athenahealth and serves on the CommonWell Health Alliance’s Operating and Membership Committees.