Making Health IT Interoperability More Concrete, Actionable

On the national level, The Sequoia Project has made considerable headway in removing technical and legal barriers to health information exchange and data sharing, most recently with several organizations (e.g., Surescripts, Epic Systems, athenahealth) agreeing to implement the Carequality framework and paying the pathway for its providers to access patient data more widely.

According to CEO Mariann Yeager, taking concrete action is necessary for advancing interoperability more widely, effectively, and quickly. “Let’s identify the hard issues that the community together can solve. Let’s start rolling up our sleeves and working on those,” she says.

In the following one-on-one interview with EHRIntelligence.com, Yeager talks about the next steps for Carequality and its implementers, the potential effect of MACRA implementation on interoperability, and future efforts to drive the use of information as part of provider workflows.

EHRIntelligence.com: Since the implementers of the Carequality framework signed, what progress has your organization made on health IT interoperability?

Mariann Yeager: Efforts are progressing very nicely to get the initial set of implementers, which are the participating networks or service providers or vendor groups that are rolling it out essentially to their customer base. If you think about the timing, it’s actually moving pretty quickly in terms of getting the implementers themselves to not just sign the Carequality agreement, which is the mechanism that binds these different partners to comply with a different set of rules for the road, technical standards, and all of that. When everyone agrees to the exact same set of rules, it eliminates the need to negotiate those terms. Really it boils down to the community focusing on getting it working. When you have the ability to just focus on the work at hand and know exactly the technical requirements, there’s common understanding and acceptance to engender a trusted exchange relationship and technical connection. The technical work is not that big a deal. It’s work, of course.

In terms of progress in adoption is there is now pent-up demand. We’re starting to see a pipeline of the customers of each of these first ten starting to sign up and be part of this — for example to connect with physician groups in their community whom they can’t get access to via their HIE — and they are able to build out readily using the same exact system they use every day for treatment purposes and it has standardized gateway and way to transmit data the very same way to all these different groups. We’ll have more to report. It’s like any rollout. We’re getting providers connected and we need to get more providers in their communities connected so they have folks to share data with, so we’re focusing on a couple geographies to build that out which is very exciting.

EHRIntelligence.com: For lack of a better expression, what providers and geographies represent low-hanging fruit for information sharing under the Carequality framework?

MY: In general, the low-hanging fruit tends to be those who have the impetus to exchange. That’s the priority right now — we know the geographies because we have worked with the different implementers to identify the cross-section where there’s high concentrations of these different groups, so we’re starting with them. They’re helping us identify those customers who tend to be on the leading edge of wanting to embark on these new endeavors and who are going to move quickly themselves and be high adopters. A great measure of it is if they have currently a high degree of connectivity through their current connections, they tend to have worked through the workflow issues and all that. It’s not so much geography as it is how well they integrated it into their own workflow, how well trained the users are in taking advantage of these things. Those tend to be the low-hanging fruit for us.

EHRIntelligence.com: What impact is MACRA implementation going to have on healthcare interoperability?

MY: It’s great to see the incentives align. We have been saying for quite some time, we have seen firsthand and there is evidence now that when you have the incentive aligned, you will see utilization as of connectivity. I say all the time and mean it sincerely: We are more wired as a country now than we have ever been in healthcare and health IT, but is that connectivity used, is there an impetus to use it? Incorporating interoperability with MACRA Alternative Payment Models is absolutely essential. We see that fueling not just the adoption of this type of activity (because we’re already seeing that, the market is driving that as well) but also getting the clinicians to use it and to rely on the information. That’s the game changer, and that’s where we really need Alternative Payment Models to fuel interoperability and the use of interoperable data sharing.

EHRIntelligence.com: How has the conversation about interoperability in healthcare changed over the past year?

MY: We have to get concrete. Interoperability over the past couple years has come out as an issue. The fact that policymakers and leaders on Capitol Hill talk about interoperability is incredible. A couple years ago did they even know what it meant? They have thought about it and they have been taking the time to learn and understand it — it’s great. What I’m hoping is that we’ll continue to see more focused discussions on the issues, instead of discussion on interoperability in general. If we’re going to solve it, we’ve got to get specific and figure out how to make it work better.

This article originally appeared here.