Carequality, eHealth Exchange, and The Sequoia Project (TEFCA RCE) all held their annual meetings in mid-December. Our President has returned with a number of important highlights and updates for 2023 that you should be aware of. Let’s just say there’s a lot going on in terms of nationwide data exchange!

Marilee is a member of the Carequality Advisory Council and also participated as a panelist for a discussion about the adoption of FHIR for nationwide data exchange. For meeting attendees, it was an opportunity to get updated on two important national networks (Carequality and eHealth Exchange) and understand the current state of TEFCA / QHINs (from The Sequoia Project). It really was a wonderful opportunity to reflect on what has been accomplished so far with nationwide health information exchange, and also learn about the opportunities to adopt new national network use cases. It was also great to be together in person with so many leaders focused on the mission of healthcare interoperability!

Carequality Annual Meeting Highlights

 As a Carequality Implementer, Zen really values the opportunity to come together as a community. All the panels were highly educational and vital for Implementers who seek to continuously improve success rates for national exchange via Carequality. 

During one of the panels, the Carequality Annual Meeting attendees learned that the Social Security Administration (SSA) is live on Carequality – one of the first federal partners to “opt in” to Carequality participation! This is an excellent opportunity for healthcare organizations wanting to partner with SSA to support disability claims processing. The SSA representative spoke about the coming wave of “long Covid” disability claims and how faster processing of these claims really makes a difference for patients. I hope more healthcare organizations take advantage of this great opportunity to dramatically shorten the process of processing disability claims.

Another important session was the opportunity to break into smaller groups for brainstorming work via the “Unconference Session.”There were a lot of great options, but I attended the Carequality Directory group to learn more about the new R4 Directory rollout and exchange ideas on how to improve the content available in the Directory. The new Directory will be able to provide important information, such as what permitted purposes & use cases are supported, as well as support important new use cases, such as the “on the behalf of ” use case coming in early 2023. This one is particularly important to Zen and Zen clients, as we are often filling gaps in existing workflows. The “on the behalf of” new use case, once it is adopted, will allow Zen clients to use Stargate for initiating queries, but direct participants to a different gateway (typically their EHR) for responding queries.

The Sequoia Project Annual Meeting Highlights

Sequoia Project Annual Meeting

The Sequoia Project Annual meeting was up next and included a detailed overview of the QHIN application process and status, as this meeting served primarily as the Regional Coordinating Entity (RCE) update. As of the meeting date, ten organizations had submitted applications to become a QHIN. Per the RCE, you can expect that the first group of accepted QHIN applications will be announced sometime in Q1 2023, and then the actual certification efforts will begin. That process is expected to take most of 2023, but there is a chance we will see an actual “QHIN to QHIN” exchange by the end of the year!

There was a lot of great information shared by ONC National Coordinator Micky Tripathi, including the ONC focusing on adopting FHIR “sooner” rather than later in terms of how QHIN’s share data. There are some important blockers to overcome related to FHIR – much of which is getting worked out in the Carequality FHIR workgroup. The main concern is how to best scale certificate management in a FHIR-based exchange model.

Other important news included the announcement of the publishing of the Data Usability Final Implementation Guide. This important implementation guide (IG) provides guidance to improve the usability of data received by end users to benefit patient care. Add this IG to your “must read” list heading into 2023.

eHealth Exchange Annual Meeting Highlights

We wrapped up our three days in D.C. with the eHealth Exchange Annual meeting. Did you know that there are 61 regional and state health information exchange (HIEs) that participate in the eHealth Exchange nationwide network? HIEs help improve the quality of nationwide data exchange by functioning as data aggregators or record locators.

Many people had questions about eHealth Exchange and their application to be a QHIN. The most important thing to understand is that similar to how eHealth Exchange participants can “opt in” to Carequality, eHealth Exchange participants will be able to “opt in” to the QHIN. Obviously, it’s going to take time for QHIN participation to reach critical mass. But I believe that eHealth Exchange is a great option for healthcare organizations who want to 1) Exchange data today with a large volume of healthcare organizations, including 61 HIEs! 2) Future proof their interoperability strategy by knowing that the QHIN “opt in” option will be available. With CRISP as their HIE partner, I am confident that eHealth Exchange will successfully pass through the QHIN application and vetting process.

The Annual Meeting is a great place to learn about all the eHealth exchange use cases, including the new FDA Adverse Events Reporting Use Case via FHIR.

Bonus Tip: They are waiving annual fees (first year) for the first fifteen organizations that sign up for the FDA Use Case

Wrap Up & 2023 Webinar

There was an amazing amount of content delivered in three days. I am considering pulling together a webinar in Q1 2023. That will allow Zen to provide a full update on the content shared at the Carequality and eHealth Exchange Annual Meetings, along with a deeper dive into what was presented by the Sequoia Project regarding TEFCA and QHINs. If you are interested, please email us at info@consultzen.com. If we get enough interest, we will make it happen!

My overall take away from the three days in D.C. is that we could finally see FHIR based exchange get real traction in 2023. However, as I always say, old healthcare data standards don’t die, we just create new ones. It’s going to be vital for everyone to consider how to live in an interoperability world with one foot in IHE based exchange, and one foot in FHIR based exchange. I am grateful for the Zen technical team who has seen this day coming and we are ready for it!

Marilee A Benson

President