States, Health Care Companies Offer EHR, HIE Standards

States and vendors in the EHR/HIE Interoperability Workgroup have issued specifications to allow multiple electronic health record systems and exchanges to connect.

The EHR/HIE Interoperability Workgroup, a coalition of states and health care IT software producers, has issued specifications that will allow health care professionals to share data among multiple electronic health records (EHR) and health information exchanges (HIEs).

The standards are based on those established by the Office of the National Coordinator (ONC) for Health Information Technology within the U.S. Department of Health and Human Services (HHS).

A main goal of the workgroup's specifications is "plug and play," in which the EHR applications communicate with each other without the need for a custom interface, David Whitlinger, executive director of the New York eHealth Collaborative (NYeC), told eWEEK. NYeC is a nonprofit organization that develops policies and standards for health care IT in New York State and facilitates development of the state's HIE.

These interoperability specifications could reduce the differences among technology specifications, as well as address high costs and long wait times for interfaces to be developed, according to the workgroup.

EHR databases and HIEs, which store records from multiple systems, need to be compatible to allow doctors to offer better care to patients and stay informed about medical histories.

"Doctors and hospitals are very keenly interested in standards, as that reduces the cost and reduces the variability," Whitlinger said.

NYeC formed the workgroup, and then counterparts in California, Colorado, Maryland, Massachusetts, New Jersey and Oregon joined the effort.

EHR vendors in the workgroup include Allscripts, eClinicalWorks, e-MDs, Greenway Medical Technologies, McKesson and NextGen Healthcare, which will store health records in a cloud infrastructure hosted by Dell.

"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 and Standards for NextGen, said in a statement.

Other EHR vendors participating include Vitera (formerly Sage Healthcare) and Siemens Healthcare.

Meanwhile, companies in the HIE business such as InterSystems, Medicity and OptumInsight also participate in the workgroup. InterSystems announced the launch of Rhode Island's HIE Sept. 6.

Released Nov. 8, the specifications are accessible at the workgroup's Website,

The workgroup's collaboration on health record standards could advance development of real-world pilots, increase implementation and bring more open feedback on HIE standards, Dr. Doug Fridsma, director of the Office of Standards & Interoperability at ONC, said in a statement.

"The results of this kind of initiative can help us advance health IT nationwide," he said.

Health care IT vendors are looking for clarity on how to design their "road maps" for EHRs and HIEs, according to Whitlinger.

The workgroup formed the specifications around two use cases. The document "Statewide Send and Receive Patient Record Exchange" explains how encrypted health information can be transmitted over the Internet from one EHR database to another.

"A hospital or a practice that is sending a patient from their care setting to another care setting can package up the records on a given patient and send them directly to their receiving clinician," Whitlinger said.

In the second use case, "Statewide Patient Data Inquiry Service Use Case" explains how a clinician can query an HIE for a specific patient's data.

"Any records that would exist on that patient from the community of practitioners that are connected to the HIE will be returned to that query and right into the EHR," Whitlinger said. "It allows for an unbroken workflow."

The system would allow physicians to access records from other databases within their own EHR application without having to switch to another portal, he said.

The workgroup also designed the specifications using standards from Health Level Seven (HL7) International, a global authority on compatibility of health care IT standards.

In addition, the standards align with the framework of IHE International, a health care industry organization focused on finding ways to share data, as well as federal Beacon community guidelines, which describe how data must be reported to ONC.

EHR and HIE vendors will start implementing the workgroup's specifications in the first quarter of 2012, according to Whitlinger.

With states and vendors working together on standards, additional collaboration in health care IT will be possible going forward to improve efficiency and quality of care, he noted.