Solving Today's Adoption Problem

• Currently, because there is not one single set of standards consistently implemented, a custom connection has to be developed from each electronic health record (EHR) to each health information exchange (HIE). The development of the interface represents a significant expenditure of cost and time for all stakeholders (physicians, HIEs, and vendors) which has been limiting both adoption of EHR and the usage of HIE services.
• States are struggling to create the best strategy to promote uptake of HIE services while minimizing costs. EHR and HIE vendors are using their limited resources to ensure their products meet meaningful use capabilities and to promote adoption of their products.
• The workgroup builds on current standards, to simplify and align EHR and HIE development processes, and will ultimately form a strong marketplace for integrated, "out-of-the-box" EHR connectability. The intended result is a set of more robust EHR products with integrated capabilities so that providers can connect to HIE services with minimal effort across multiple states.
• Following the development of functional and technical requirements, each state will promote vendors that comply with the defined specifications. The workgroup will coordinate its efforts with other multi-state workgroups as well as emerging national standards.

Initial Functional and Technical Specifications Issued

• The first set of specifications the EHR/HIE Interoperability Workgroup has issued are focused on two use cases and the detailed data and metadata specification for a compliant Continuity of Care Document.
• The first use case, Statewide Send and Receive Patient Record Exchange, describes how encrypted health information can be sent and received over the internet. The second, the Statewide Patient Data Inquiry Service Use Case, describes the clinician’s ability to query one or more HIEs for relevant data on a specific patient.
• The workgroup members collaborated to leverage ONC standards for meaningful use, existing HL7 standards, technical frameworks from IHE International, and HIE implementations to provide a fully detailed implementation specification. The implementation specifications were also aligned with Beacon community guidelines to be capable of gathering information it requires for reporting to the ONC.  
• These documents are available to all stakeholders to download and implement.

Next Steps

• The workgroup members are evaluating potential reference implementations of the specifications across states and with different vendors.

• Members of the workgroup will begin work on additional capabilities in the future.