With the bipartisan legislation known as the 21st Century Cures Bill being drafted in the U.S. House of Representatives, which includes mandates that systems be interoperable by the end of 2017 or face reimbursement penalties, the conversation continues around how we can push interoperability forward even faster.

And, that’s the right conversation. Person-centered interoperability is essential to our industry’s health reform transformation because data is driving value-based arrangements for care. As information becomes readily available when and where it’s needed, organizations can facilitate care coordination, drive physician alignment, reduce administrative complexity and engage patients in their care to ultimately accomplish population health.

To make the conversation meaningful and productive, I think it’s instructive to define what true interoperability is and what it is not.

Interoperability is not intra-operability that shares data only within the same vendor platform.  Point-to-point sharing between IT platforms was a good start, but it’s insufficient to get to our end game. True interoperability should not be IT-system based but rather patient-ecosystem based.

Additionally, technically or theoretically being able to connect is not interoperability. True interoperability requires that you actually connect and do so without considerable barriers or expense.

So how do we define true person-centered interoperability? It’s the frictionless flow of patient information between all systems, regardless of technology or platform.  The information follows the person, all of us, regardless of where care is delivered, so that the right data is electronically available for the right patient at the right time for the patient’s provider or care team. And, the entire healthcare system is securely connected electronically, with the patient’s permission, without any special effort on behalf of the user.

The good news is that healthcare has made a lot of progress with many more EHRs and automation of certain kinds of clinical transactions in EHR workflow. These transactions include electronic prescribing as well as delivery of lab results, discharge summaries or text-based radiology reports. These capabilities are on a trajectory to match what our industry has done relative to financial and administrative transactions.

While there is still work to be done in driving toward true person-centered interoperability, we don’t have as far to go as some might think.

  • CommonWell Health Alliance® is growing by leaps and bounds. When we helped launch CommonWell at HIMSS13 two years ago to develop the infrastructure needed for interoperability and person-centered care, we had five health IT vendors and 12 pilot sites live by HIMSS14. For HIMSS2015, CommonWell has 25 member organizations representing 70% of acute-care EHR vendors, and our services have been rolled out to more than 60 provider locations nationwide. At this rate, we could expect our services to be in all 50 states and across more than 5,000 provider locations in the next 12 months.
  • As the service provider for CommonWell, RelayHealth is are using FHIR in our CommonWell services to make patient identification and linking, record location and retrieval, and trusted data access possible nationwide, all foundational needs of a connected healthcare system.
  • The recently announced Project Argonaut by Health Level Seven® International (HL7®) is focused on accelerating the development of the necessary standards and data services needed for health IT interoperability. These standards include the use of open APIs to support full vendor neutrality.
  • Part of Project Argonaut includes working with HL7® to establish the HL7® Fast Healthcare Interoperability Resources® (FHIR®) standard. FHIR represents a significant step forward in the ability to access and deliver healthcare data. As a vendor-neutral platform, FHIR holds the promise to do for healthcare what Apple and Android platforms have done for smartphones, tablets and apps.

If we’re really going to revolutionize the quality and delivery of care, interoperability must be advanced in a way that it serves the needs of patients and their care teams, not the needs of IT platforms or business models. By making interoperability person-centric and vendor-neutral, we can help patients and providers gain secure, safe and easy access to all relevant patient data, regardless of care setting, system or technology.


Arien Malec is vice president, Data Platform Solutions, RelayHealth, and one of the thought-leaders and co-founders of CommonWell Health Alliance. He has a more than 20-year career in healthcare and life sciences. In his current role, Arien addresses improved care and health as well as cost containment through the use of clinical data. Prior to this role, he was a staffer at the Office of the National Coordinator (ONC) as the coordinator for the standards and interoperability framework. Arien currently sits on the Health IT Standards Committee, a Federal Advisory Committee that advises the National Coordinator for Health IT.

HL7 and FHIR are the registered trademarks of Health Level Seven International.

CommonWell Health Alliance and the CommonWell logo are registered trademarks of CommonWell Health Alliance in the U.S. and other jurisdictions.