CommonWell Health Alliance was founded on the shared belief that to drive better patient care and improve health outcomes, we need to connect as many care locations as possible across all care settings. Our vision was to unlock the full potential of healthcare IT by connecting as many other participants as possible who are committed to interoperability. Last year, we made great strides towards that vision, and in 2019, we will see the rise of national networks truly talking to one another. With that in mind, in November, CommonWell formally announced the connection of the CommonWell network to the Carequality Framework, actualizing a series of conversations and agreements which started years ago.

The goal behind connecting networks like CommonWell to those which are accessible through Carequality is to create a broad highway to securely allow information to travel freely and efficiently between all the participants involved in the delivery of a single patient’s care – from the post-acute setting in the home to the primary care physicians quarterbacking care in the value-based reimbursement world, and all points in between. This interoperable connection extends the power of the network enabling providers involved to connect with the various groups who participate and directly deliver patient care, enhancing the power of the interoperable ecosystem.

Since the Carequality connection went live in July 2018, CommonWell-enabled providers have bilaterally exchanged more than 750,000 documents with providers locally and nationwide. While our initial traction is strong, it is always about growing to the next milestone in the vision. We must be cognizant of why interoperability is such an urgent mission and that we need to go even further in the coming months.

Solving the Shoebox Effect

In the post-acute setting, a typical patient interacts with several different providers during their care journey, and it is a tremendous challenge to update, process and store their increasingly complex care history. Often when a care provider drives out to the patient’s home intending to treat them for one specific issue, they might find is a shoebox full of medications for a variety of unrelated conditions that may or may not be active. These medications may have been prescribed by different providers and the home health nurse will not know which medications the patient should or should not be taking. This dynamic is known in the industry as ‘the shoebox effect.’ In a more perfect world, through CommonWell, the care providers could access the other relevant care settings in the patient’s medical history before they drive long distances for their encounters with the patient. This would allow them to better interact with the patient, feel confident in understanding the complexity of a visit, and provide better care to the patient from day one.

Beyond the Black Hole

When I joined Brightree in 2014, I needed an education on the specific problems faced in post-acute care, as my prior experience was in ambulatory physician practice and health system interoperability. As such, I reached out to a few colleagues in leadership roles at enterprise health systems, ACOs, and physicians who referred patients into post-acute settings. One major challenge that surprisingly came up in every conversation was the black hole phenomenon. Simply put, providers referring patients into post-acute care settings all experienced the frustration of losing track of patients under their care. In a value-based reimbursement world, this is unacceptable to those providers; they are increasingly responsible for their covered lives, and they could not gain visibility to the patient’s care journey in the home. By enabling healthcare information to follow the patient through interoperability not just into the post-acute settings, but back to referral sources and to other care providers the patient encounters down the road, we supply those care providers with the information that they need to do their job better and more effectively to take care of the patient and feel comfortable with the post-acute care providers they are partnering with. This is a big deal to post-acute care settings. Patients are increasingly being directed to care settings that not just provide the highest quality of care, but who can supply information back to referral sources to prove it.

This week, I hope you can join us in Orlando at HIMSS19, where CommonWell is demonstrating an important use case in the Interoperability Showcase™ (Hall F, Booth 9100) developed with seven CommonWell members, including Brightree. Over the last two years, the Showcase has been the one of the highest-trafficked section of the exhibit floor at HIMSS. This year, we are excited to demonstrate how a patient can better coordinate their care across multiple care settings thousands of miles apart. Attendees will see CommonWell services embedded in participating members’ EHRs, PHRs and other software, and see how a patient’s care is seamlessly handed off across the disparate facilities, vendors and technologies – all illustrating the power of nationally scalable interoperability and how it will benefit patients and providers alike across the health care continuum. I hope to see you there, so we can show you the power of CommonWell interoperability solutions and the collaboration between our members in action!

Nick Knowlton, vice president, Strategic Initiatives– Brightree, serves as the CommonWell Membership Committee chair as well as the CommonWell Board of Directors Vice Chairman.