Better interoperability is the goal of an EHR vendor consortium


CommonWell Health Alliance, led by McKesson and Cerner, wants to create a private-industry-focused, neutral forum for resolving technical issues

At last week’s HIMSS (Health Information Management Systems Society) annual meeting in New Orleans, something of a stir was generated among the 35,000 attendees by the unexpected announcement of an industry alliance organized by two leading vendors in the electronic health records (EHR) market: McKesson and Cerner Corp. McKesson, besides being the biggest drug wholesaler in the world and an EHR vendor in its own right, is also the owner of Relay Health, a widely used claims-processing service (handling, for example, adjudication of pharmacy benefits). Cerner (Kansas City, KS) is one of the leading EHR vendors, managing clinical data and claims processing for 10,000 facilities worldwide.

Three other EHR vendors have joined the consortium: Allscripts (Chicago); Greenway Medical Technologies (Carrollton, GA) and athenahealth (Marlborough, MA). The members were very emphatic that, while they themselves compete with each other, they want more EHR vendors to join the effort (there are several hundred EHR vendors, in a very fragmented market—a problem for advancing healthcare IT in itself). Noticeably absent from the group was Epic Systems (Verona, WI), said to manage nearly half of the EHRs in the US currently. Carl Dvorak, COO of Epic, told Forbes magazine that the announcement caught the company “by surprise,” and that it is unlikely to join the group.

During the HIMSS press conference, the companies said that two initial goals were to develop a reliable patient-identification system (so that EHRs from different providers can be matched up for individual patients), and a method to ensure that permissions to disclose information from one provider to another are in place. “Our government is not going to deal with this problem,” asserted Neal Patterson, CEO of Cerner, saying that it was up to private industry to lead the effort.

Such interoperability issues are recognized as one of the major hurdles to overcome, both in getting healthcare systems to adopt EHRs, and to obtain value from the stored data. There are a bewildering array of HIT organizations, ad hoc work groups and public and public-private efforts at work; interoperability itself is one of the “meaningful use” measurements by which CMS scores EHR implementations, in order to justify financial incentives it is providing to healthcare systems. One of the more prominent interoperability groups formed up last fall: the Care Connectivity Consortium (Washington, DC), which has allied itself in turn with Healtheways, a group that combines several federal agencies with private health information organizations. In fact, what CCC calls “patient identity management services” and “enhanced consent management” are two of the five value-added services that the consortium is working on. Notably, however, CCC’s members are exclusively health systems such as Kaiser Permanente and Mayo Clinic (some of whom are customers of the CommonWell members, ironically).

Pharma: a place on the EHR screen

HIT is a massive, ongoing undertaking in healthcare delivery, and to a certain extent the pharma industry is on the sidelines, watching it play out with interest. But as physicians employed by health systems increasingly become excluded from direct interaction with sales reps, the need is growing to connect with these prescribers. A December report from the Centers for Disease Control found that 72% of working physicians now interact with EHR systems, and pharma is eager to be part of the EHR workflow.

For some EHR vendors, enabling a link to pharma companies becomes a competitive advantage, especially when necessary drug alerts need to be communicated, or for such patient-friendly services as copay cards, or obligatory patient education services. Quite recently, athenahealth announced the acquisition of Epocrates, an online drug-information service, and Greenway Medical announced a relationship with Physicians Interactive, which provides e-sampling and other pharma-originated services. Through Relay Health, McKesson has offered marketing research services to pharma for a number of years. And in the long run, when patient outcomes based on EHRs (appropriately de-identified) become a core part of drug development and comparative effectiveness research, the pharma industry will be eager to tap into EHR databases. CommonWell Alliance’s efforts to bring the vendor community together will be eagerly watched.

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