Coalition defines EHR to HIE data sharing standards

November 8, 2011

Contact: Erin Lippincott

646-619-6560(w); 347-763-9494(m)

Support From Leadership

"I am encouraged by and excited about this type of collaboration, which has the potential to advance real-world pilots, implementation and feedback on standards for health information exchange. The results of this kind of initiative can help us advance health IT nationwide.”- Doug Fridsma, Director of the Office of Standards & Interoperability at the Office of the National Coordinator of Health Information Technology

"I applaud the work that the EHR/HIE Interoperability Workgroup is doing to move states from implementation guides to production. Their selection of Consolidated CDA and Direct is well aligned with HIT Standards Committee discussions. The EHR/HIE Interoperability Workgroup is also doing important work with NwHIN Exchange and Provider Directories that will provide the country with lessons learned, so that the HIT Standards Committee can recommend refinements to these emerging technologies. I expect that the flexibility and agility of the EHR/HIE Interoperability Workgroup will serve as an ideal laboratory for standards that are rapidly evolving."-John Halamka, Co-Chair of the HIT Standards Committee, Chief Information Officer of Beth Israel Deaconess Medical Center, Chief Information Officer at Harvard Medical School, Chairman of the New England Healthcare Exchange Network (NEHEN)

“In Colorado, providers want to use health information exchange to collaborate and ensure that there are no gaps in care as patients move between physician offices, hospitals, behavioral health or long-term care facilities. The agreed-upon standards announced today could help us move from the Wild West stage of health information exchange to a more rational world where providers can be connected more quickly and costs could go down as well.” - Phyllis Albritton, Executive Director of CORHIO

“NextGen Healthcare is pleased to be a part of this EHR/HIE Interoperability Workgroup. Successful transformation of our healthcare system requires a technology backbone that goes beyond simple information sharing. This project, along with nationwide standardization efforts by the ONC, supports a shared vision across all organizations to capture, analyze, report, and exchange the right kind of data needed to foster coordinated, higher quality patient care.” - Robert Barker, Manager of Interoperability & Standards for NextGen Healthcare

"Greenway has historically believed that a collaborative approach to standards, and putting forth a consensus to federal panels for example, is the most efficient way to advance healthcare delivery. We are very pleased this effort has proved to be successful, and as we have shown through our connectivity with the CORHIO HIE, these collaborations will show results.” - Justin Barnes, Vice President of Marketing, Industry and Government Affairs of Greenway and member of the Integrating the Healthcare Enterprise (IHE-USA) Board of Directors

“This collaborative effort has made it possible to develop a robust, standardized specification that will reduce implementation timeframes and increase adoption of EHR exchange between healthcare organizations. InterSystems is committed to ongoing support of multi-state initiatives that are aligned with national healthcare interoperability standards and ultimately improve patient care.'- Dominick Bizzarro, HealthShare Business Manager, InterSystems Corporation

"Siemens Healthcare, has maintained a leadership position in health IT for more than 40 years. Siemens helps healthcare organizations to achieve desired outcomes through its IT solutions and its commitment to standards-based interoperability. Siemens supports this workgroup’s efforts to reduce the variability among information exchange requirements in many key states and we believe these efforts will help support Meaningful Use, while improving the availability and accessibility of data for both providers and patients. " - John Glaser, PhD, CEO, Siemens Healthcare, Health Services Business Unit

“We appreciate the leadership from the NYeC work group. We believe the collaborative nature of these efforts will help accelerate EHR adoption and minimize cost and disruption for providers.” - David Henriksen, SVP and GM of McKesson Physician Practice Solutions

"We applaud the hard work of the Interoperability Workgroup, and the progress that is being made at a national level on standards. It is noteworthy that such a broad group of stakeholders have committed to working together on this important issue.” - David Horrocks, president of the Chesapeake Regional Information System for Our Patients (CRISP), Maryland’s Statewide Health Information Exchange

“Not only will these standards speed integrations with HIEs and lower their total costs, but the detailed specifications should ensure that additional common data fields are collected by EHRs, allowing for more robust population health efforts enabled by the HIE.” - Glenn Keet, President of Axolotl, now OptumInsight

"We really had no choice but to step up and do the work now in development of these reference implementations, because our RECs [Regional Extension Centers] are already out on the street implementing EHRs in thousands of physician offices, and without these specifications, our HIEs would be doing "one-off" implementations for each at a cost to the Providers and HIEs that could easily run into the hundreds of millions state-wide. - David Minch, HIE Director for John Muir Health and technical advisor to Cal eConnect, California's State Designated Entity

“The lack of standards in this industry up until now has been an impediment to industry progress. The efforts of this workgroup will go a long way in making it easier for providers to connect with others along the care continuum. We are proud to be a part of this group.” - Girish Kumar Navani, CEO and co-founder of eClinicalWorks

“We have enjoyed being a part of this collaborative effort to establish detailed implementation specifications for connectivity. Adoption of this and other standards between data-sharing partners is critically important to the enhancement of patient care by facilitating clinical data transport and the speed at which we can deploy it cost-effectively.” - Betty Otter-Nickerson, Sage Healthcare Division President

“If we are going to fully realize the benefits of electronic health record systems and health information exchange, it is crucial that we work effectively across state boundaries and with industry partners to break down barriers to effective information sharing. This marks a good first step in the agreement of standards that will simplify connectivity." - Carol Robinson, Administrator of OHIT and Oregon’s State Coordinator for Health IT, supports the work undertaken by this group and sees it as essential groundwork for improving patient care and health outcomes.

“We have consistently advocated for and contributed to the meaningful advancement of HIT to ease technology adoption, spur innovation and lay the foundation for accountability and transparency. It is gratifying to lend our vision and expertise to this collaborative effort as we work to improve the healthcare experience for all stakeholders.” - Ashish V. Shah, Chief Architect and Senior VP of Medicity

“By collaborating with New York and other states and EHR vendors, we’ve found a way to ensure better interoperability between EHRs and HIE. This is critical to help build a successful statewide HIE that will connect both providers and patients with more timely and accurate health care data.” - Rick Shoup, Ph.D., State HIT Coordinator and Director of the Massachusetts e-Health Institute

"We are very pleased to be part of this initiative. The efforts of this workgroup will accelerate the timelines and reduce the cost of data exchange amongst its members." - Michael Stearns, MD, president and CEO of e-MDs

“Allscripts is committed to developing a Connected Community of Health that enables the coordination of patient care among providers across entire communities, regardless of which electronic health record they use. Interoperability consortiums like this one are vital to a future in which industry stakeholders work together to apply standards that ultimately will help patients receive better care at affordable costs.” - Glen Tullman, Chief Executive Officer of Allscripts

"This is a crucial step. We started this as a New York State initiative, but we soon realized that many other states were facing the same interoperability challenges and many of the EHR and HIE vendors were also looking for clarity from the marketplace to define their product roadmaps. Collectively, the group is now looking forward to widespread adoption and market preference for the products that employ the specifications. " - David Whitlinger, Executive Director, New York e-Health Collaborative

“It is a tremendous opportunity to work collaboratively with other states on health IT. We need to continue to stretch ourselves on behalf of the patients in our own states to set up a nationwide infrastructure that will help save lives, no matter where you are. Kudos to the other states and the vendors for working so hard on this project and getting us this far. This is certainly a great model for all states to adopt.” - Colleen Woods, New Jersey Health IT Coordinator


New York, NY – A band of U.S. states and technology vendors came together to create technical specifications that enable EHRs to feed into HIEs.

The specifications, agreed upon Tuesday, “leverage existing HL7 standards, technical frameworks from IHE International, and HIE implementations,” the group explained in a prepared statement.

[Related: 4 PHI tips for HIEs. See also: The 5 roadblocks HIEs face.]

Two use cases concern “the detailed data and metadata specification for a compliant Continuity of Care Document,” the working group noted, explaining that the first, Statewide Send and Receive Patient Record Exchange, enables health records to be encrypted, then sent over the Internet, whereas the second use case, Statewide Patient Data Inquiry Service, is what allows clinicians to query an HIE for patient data. These specs, the working group added, sync with Beacon Community guidelines for purposes of reporting to ONC.

“I am encouraged by and excited about this type of collaboration, which has the potential to advance real-world pilots, implementation and feedback on standards for health information exchange,” said Doug Fridsma, MD and PhD, director of the Office of Standards & Interoperability at the Office of the National Coordinator of Health Information Technology (ONC). “The results of this kind of initiative can help us advance health IT nationwide."

Indeed, what started within the New York eHealth Collaborative (NYeC) soon grew to include California, Colorado, Maryland, Massachusetts, New Jersey, New York, and Oregon because, as NYeC executive director David Whitlinger added, “we soon realized that many other states were facing the same interoperability challenges and many of the EHR and HIE vendors were also looking for clarity from the marketplace to define their product roadmaps.”

[Q&A: On the trials and tribulations of unlocking patient data.]

In addition to the seven states, the EHR/HIE Interoperability Workgroup includes eight EHR vendors: Allscripts, eClinicalWorks, e-MDs, Greenway Medical Technologies, McKesson Physician Practice Solutions, NextGen Healthcare, Sage Healthcare Division, and Siemens Healthcare, as well as three HIE services vendors participating, those being Axolotl, InterSystems, and Medicity.