Multi-State Initiative
The EHR | HIE Interoperability Workgroup is a New York eHealth Collaborative-led coalition of 19 States (representing 52% of the U.S. population), 20 EHR vendors, and 22 HIE vendors. The workgroup was launched in February 2011 to leverage existing standards and develop consistent implementation guides for interoperability between HIE software platforms, and the applications that interface with them. The goal of the EHR/HIE Interoperability Workgroup is to create an integrated marketplace of EHR capabilities, in which the interfaces between EHRs and HIEs will be compatible more easily across and between states.
Currently, because there is no single set of standards to connect various information exchanges, custom interfaces must be developed with virtually every new effort in the field. The development of these interfaces drastically increases cost and time spent by physicians, HIEs, and vendors alike. This has limited both adoption of EHRs, and usage of HIE services.
Realizing that merging efforts with other states would create economies of scale and provide the vendor community with a single, consistent set of specifications, NYeC created the EHR/HIE Interoperability Workgroup last year. Commitment to common standards creates a larger potential market and a clearer development roadmap for vendors. Vendor collaboration and commitment to common APIs, and certification of a common HIE platform, creates a potentially larger opportunity for all of them by guaranteeing interoperability.
This effort builds on and accelerates consensus on national standards, adopting EHR certification criteria and testing procedures as relevant and finalized for Stage 2 of meaningful use. Members of the Workgroup provide feedback from real-world implementations to the national health IT standard setting initiatives established by the U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC).
The workgroup has developed a set of specifications that will ultimately allow for “out-of-the-box” EHR connectivity, to simplify and align the process of EHR and HIE development. The first set of functional, technical, and test specifications developed by the workgroup focus on two use-cases. The technical specifications include:
- Statewide Send and Receive Patient Record Exchange allows encrypted health information to be transmitted over the internet (Direct Exchange)
- Statewide Patient Data Inquiry Service allows clinician to query an HIE for relevant data on a specific patient (Patient Record Lookup)
- Continuity of Care Document (CCD): Complements and constrains ONC specifications (C32/C83) to reduce variances and state-specific customization
Compliance Program Launched
The coalition selected the Certification Commission for Health Information Technology (CCHIT), the most experienced HIT certification organization in the U.S., to carry out the testing. As the compliance testing body, CCHIT will certify that the interfaces between the HIT and HIEs are consistent across multiple states and systems. CCHIT is also an Office of the National Coordinator (ONC) authorized certification body and is an accredited testing laboratory for EHRs.
The testing program will be piloted and quickly followed with an initial wave of testing of the first set of systems and HIE implementations in late 2012. The program is targeted to be available on a wide-scale basis in early 2013.
The coalition designed the compliance testing program to align with and compliment the national strategy established by ONC. To that end, the Compliance Testing Program:
- Includes a technology certification component, building upon the EHR certification program established by ONC to support meaningful use
- Utilizes an accredited and authorized testing laboratory and certification body, leveraging the strategy implemented for the EHR certification program
- Verifies conformance with national standards
- Leverages national standards and work from the ONC Standards & Interoperability (S&I) Framework Initiatives
To learn more about the workgroup, download the specifications, or to become a member, check out the website: interopwg.org or e-mail admin@interopwg.org
Current members of the workgroup include:
| STATES | EHRs | HIEs |
|---|---|---|
| Arkansas | Alere Wellogic | 1MEDiX |
| California | Allscripts | Alere Wellogic |
| Florida | CareVoyant | ApeniMED |
| Georgia | Cerner | dbMotion |
| Illinois | Data Strategies | GE |
| Kansas | De Fran Systems | GSI Health |
| Kentucky | Dr. First | Harris |
| Maryland | eClinicalWorks | HealthUnity |
| Michigan | eMDs | ICA |
| Missouri | Epic | InterSystems |
| Nebraska | GE | Med3000 |
| New Jersey | Greenway | MedAllies |
| New York | McKesson | MedFx |
| Oregon | MDClick | Medicity |
| Rhode Island | MTBC | Mirth |
| Utah | Nextgen | Misys Open Source |
| Vermont | Nortec Software | NextGate |
| Virginia | Siemens | OmniMD |
| West Virginia | Vitera Health | OmniXchange |
| Optum | ||
| Orion Health | ||
| RelayHealth |





