The Sequoia Project recently held a series of three conferences in D.C. discussing eHealth Exchange, Carequality and The Sequoia Project overall. The recent reorganization of the three organizations was a hot topic. The other important topic was the content testing requirements for eHealth Exchange. Zen’s own John Henry Downing, Service Desk Manager and Content Testing Guru participated in an expert panel. He asked me to remind all of you:
IMPORTANT eHealth Exchange DATE REMINDER!
Keep in mind that participating organizations have eighteen (18) months to complete the content testing process. In addition, it was specifically discussed at the meeting that HIEs have a unique challenge with the overall content testing issue. The possibility of “waivers” was mentioned at the end of the initial testing window; but our interpretation is that all eHealth Exchange participating organizations must participate in a meaningful way in the content testing process and notify vendors and/or data sources of content issues (that can’t be fixed at the HIE level). Also, the VA and SSA will continue to have high content bars overall.
Zen has significant experience with the new ITP testing tool, commonly seen errors and possible mitigation approaches. Let us know if we can assist your team in planning for, or execution of, your content testing project. For more information on content testing requirements, visit the eHealth Exchange website: ehealthexchange.org.
The VA – and the VA Mission Act of 2018
Most of you are probably aware, but just a reminder. The VA Mission Act of 2018 that was passed earlier in 2018 addressed administrative issues that made it difficult to share data with providers outside the VA. At the eHealth Exchange meeting, the VA discussed their efforts to operationalize the new policy and said they are working hard to accelerate accessibility of Veterans information for all treating providers.
The Scoop on the Reorganization and the new “Hub” Model
The Sequoia Project, Carequality and eHealth Exchange are now three separate non-profit companies. This is a natural evolution of Carequality and eHealth Exchange initiatives. Also, this new structure facilitates a path for eHealth Exchange to be a Carequality Implementer and to add Carequality as a new option for eHealth Exchange participants. This “cross initiative” exchange opportunity was a key driver of the reorganization, in our opinion. The Sequoia Project will continue to nurture newer initiatives such as PULSE and RSNA Image Exchange validation, as well as provide a forum to support general interoperability discussions, emerging standards / use cases, and provide input to governmental agencies. Here is a link with more details: https://sequoiaproject.org/restructure
The other major announcement made at the D.C. meeting is that eHealth Exchange is going to be adopting new technology that will provide a “Hub – Gateway” model. The goal is to make it easier for participants to manage connections with multiple endpoints. They are finalizing vendor contract negotiations – so be on the look-out for an announcement end of year or beginning of next year.
Looking for the individual websites? Here is a quick list:
- The Sequoia Project: https://sequoiaproject.org
- eHealth Exchange: https://ehealthexchange.org
- Carequality: https://carequality.org
What’s new with Carequality?
The big news is that after talking about it since December of 2016, Commonwell (which is a Carequality Framework Adopter) and Carequality are now sharing data between certain vendors and providers who have “opted in”. They expect to be gradually increasing connections as we move into the last part of 2018. Carequality and Commonwell also jointly published a whitepaper about content issues and their recommendations. Feel free to reach out to Zen at info@consultzen.com and we can provide a copy for your review. We believe the white paper provides a glimpse into the future for clinical document exchange, since at least the larger EHR vendors are at the table for this discussion.
Zen is now officially a Carequality Framework Adopter!
The Future – and thoughts on Trust
New use cases (eg: notifications) and new data standards (eg: FHIR and Direct) are being discussed. What really stood out to us is that HIEs can expect to see these national exchange initiatives expanding use cases and supporting expanded healthcare standards support over the long term. The plan is to leverage the existing governance structure(s) to enable more exchange options such as FHIR. However, these national organizations aren’t able to move very quickly. New use cases will take a long time to be vetted, agreed to, tested and deployed, as there are so many different stakeholders involved. Also – as we have all discussed together many times – trust is paramount to HIE adoption and trust starts at the community level. A huge value of HIEs is the trusted exchange you are building at the community level. The national networks, particularly Carequality and Commonwell, offer expanded access to Ambulatory EHR Providers. But without local encouragement, many providers might just opt out. Thus, in our opinion, HIEs remain a foundational component of all national exchange initiatives.
