Many, Many Services
Based on my discussions with providers and vendors prior to next week's HIMSS, it's clear we're entering a truly confusing period of not knowing which platforms and pieces will be the right ones for providers trying to achieve true interoperability. Consider that the HIMSS Interoperability Showcase will have a growing plethora of technological services and solutions for accomplishing basic health information exchange:
- Direct protocol, a kind of secure paperless fax that works much like secure email must be supported by Meaningful Use Stage 2 EHR software, like healthcare's own "Intel inside."
- Healtheway, descendent of the federal government's Nationwide Health Information Network, is a series of application program interfaces that allows all the secure transfer of Direct plus more sophisticated variants, such as query-based exchange, to provide more targeted information to support everything from coordination of care to preventing 30-day readmissions.
- Epic CareEverywhere, is used by large health systems running the industry-dominant Epic EHR to exchange health information with each other, and, due to an alliance between Epic and eClinicalWorks, with physicians running the eClinicalWorks EHR for small practices.
- CommonWell Health Alliance is a vendor-based consortium whose invitations to Epic have been rebuffed for the entire year of its existence. CommonWell technology, now in early pilot testing, will also be on display at HIMSS exchanging information. CommonWell lists these vendors in its opening lineup: Cerner, Allscripts, McKesson, athenahealth, Greenway, CPSI, Sunquest Information Systems, and HIE service provider RelayHealth.
- DirectTrust is a service for HIEs to talk to other HIEs, who must sign legal agreements and pay to establish trust relationships with each other. Not every HIE has joined DirectTrust yet, but the list is growing.
- The National Association for Trusted Exchange (NATE) is an organization trying to tie together state HIEs across the U.S., but has some distance to go to enroll all the states. The success of NATE may determine the long-term viability of some state HIEs.
- SureScripts, a new entrant, is traditionally known as the HIE limited to, but very successful in, exchanging e-prescribing health information in a trusted network. Recently, SureScripts announced a Record Locator Service, to be available this fall, built on the same provider directory that powers its e-prescribing network.