David McCallie, Jr., MD, SVP of medical informatics for Cerner and co-founder of CommonWell Health Alliance, invited HIStalk readers to submit their questions about CommonWell. He obtained answers from the most appropriate CommonWell resource. These replies were provided by David along with Dan Schipfer (VP/GM of government for Cerner and CommonWell operating committee chair); Nick Knowlton (VP of business development for Brightree and CommonWell membership chair); Bob Robke (VP for Cerner and CommonWell treasurer); and Jitin Asnaani (director for Athenahealth and CommonWell operating committee co-chair).

How do organizations like CommonWell promote interoperable transfer of health information to non-members? If our goal is a national infrastructure for transfer of PHI, don’t these aggregations of health partners create barriers to a national solution?

From a strategic point of view, CommonWell’s founders created the network because they did not believe that any of the existing approaches met the need for national-scale federated query based on robust identity management and record locator services. CommonWell’s founders believe that regional and vendor-proprietary networks won’t meet the demand for universal query connectivity. In contrast, CommonWell membership is open to all HIT suppliers and their customers, nationwide. However, if other networks emerge that cover substantial portions of consumers, CommonWell is open to creation of bridging services that could interconnect with other networks.

More tactically today, we feel that CommonWell has already promoted interoperable transfer of health information by publicly calling out the important issue of the lack of a common patient identifier in US health care. Second, to advance the state of the art, CommonWell members have designed and published specifications that address the problem of the missing patient identifier. These specifications are available for any and all (i.e. members and non-members) to evaluate, improve, implement, and use under common open source licensing.

Does CommonWell have any plans for taking the initiative outside of the US?

We’re taking it one step at a time. Currently, CommonWell’s focus is to deliver real-world interoperability services across the US.

Why did some folks refer to CommonWell (in its early days) as the “HIE killer” and is that still a valid point? Accordingly, do entities like Aetna (who has invested in Medicity) and Optum (with their Axolotl acquisition) consider CommonWell to be a threat?

It is difficult to speculate on behalf of “some folks,” but CommonWell is not attempting to “kill” any type of exchange. CommonWell is designed to offer a national-scale service because we believe that a patient’s provider should have access to that patient’s information regardless of where the information lives. Through this approach to “universal plumbing,” members can expect an increase in the access to health information for …read more