3 Reasons for Optimism on Healthcare Data Interoperability

The ability to share data among providers has been hobbled by obstacles large and small. But as technologies mature, real-world models of workable interoperability are emerging.

As the summer doldrums wind down, there are some reasons to be optimistic about the state of data interoperability in healthcare.

While no one development signals that we've turned the corner on this predominant technology shortcoming standing between healthcare providers and data-driven value-based care, when taken as a group, they are encouraging signposts.

1. The Argonaut Project's progress means more rapid interop development.

Launched in late 2014, the Argonaut Project was the unprecedented collaboration of traditional healthcare rivals Epic and Cerner, as well as many others, to develop a set of implementation guides for HL7 Fast Healthcare Interoperability Resources (FHIR), basically a series of shortcuts to allowing EHRs and other apps to interoperate between providers.

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While a handful of healthcare organizations have managed to implement some FHIR technology, Argonaut was launched to provide a "code sprint" so developers from EHR companies to healthcare organizations could more quickly implement key interop use cases ranging from sharing problem lists, immunizations, medication list, allergies and other key meaningful use requirements.

After some initial consensus work last year, next month Argonaut will finalize a set of core implementation guides, says Micky Tripathi, head of the Massachusetts eHealth Collaborative, whose organization is managing Argonaut.

The better news is that a growing number of healthcare organizations will base their own standards and interop direction on these completed Argonaut guides, Tripathi says.

Intermountain Healthcare's EHR-neutral Healthcare Services Platform Consortium (HSPC) app store and NIH's precision medicine initiative, Sync for Science, are just two examples.

Another sign of Argonaut's maturity is that the group, which includes a number of healthcare organizations such as Beth Israel Deaconess Medical Center, Intermountain, Mayo Clinic, and Partners HealthCare, is now working on how its implementation guides will be governed and by whom, perhaps without disappearing into HL7's often lengthy upgrade processes, Tripathi says.

2. The most recent FHIR demos by providers show promise.

Harvard Medical School hosted two days of FHIR app demos in late July, showcasing such innovative projects as UCSF's ClinicalTrialsMatch (CTMatch), a patient-centric technology platform that matches a patient to clinical trials, and InterSystems' CCDA Shredder, a way of taking difficult-to-read CCDA documents and storing them as individual data values, unlocking clinicians' ability to use shared data.

These apps and others will find their way into the annual releases and app stores of EHR software vendors such as Epic and Cerner, further extending that software's interoperability and utility.

3. Carequality is up and running and providers are exchanging data on it.

Earlier this month, the Carequality interoperability framework announced that more than 3,000 clinics and 200 hospitals are live on the Carequality network and capable of sharing health data.

While there is still work to do to interconnect Carequality with the network built by the CommonWell Health Alliance, the good news is that between the two networks, every major EHR is represented, leaving much less work to do to connect the two networks, which looks more and more likely to happen.

Among those healthcare systems now live on Carequality is SSM Health.

"Carequality Framework adoption was important in expanding the number of providers with which we are automatically connected so we can better coordinate care in our communities," said Richard Vaughn MD, chief medical information officer for SSM Health, in a statement released by Carequality.

"The Framework really creates a win-win for patients and providers by helping us make faster and better decisions, avoid reordering expensive tests, and ensure that our patients receive the best care possible. We look forward to the additional benefits that will be realized when other vendors go live on the Framework as well."

Other providers now live on Carequality include Sutter Health, which like SSM, is running the Epic EHR; as well as Midwest Nephrology, a St. Peters, Missouri organization which runs the eClinicalWorks EHR. Also on board is Signature Medical Group in St. Louis, which runs the NextGen EHR.

As summer turns to fall, the network effect of all these interoperability developments still remains a bit hazy, but the cumulative effect of all these efforts will be to focus the attention of ever-more providers on jumping on the interoperability bandwagon.