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Interoperability Success Stories: The Journey Continues

June 2017

2 June 2017


InteroperabilitySuccessStories:TheJourneyContinues

TheElectronicHealthRecordAssociationwouldliketothankthefollowingorganizationsforcontributingtheirclients’interoperabilitysuccess

stories:Allscripts,Cerner,Epic,MEDITECH,andNextGenHealthcare.1 May2017

IntroductionForhealthcareprovidersandtheirpatients,interoperabilityholdsthepromisetosubstantiallyimprovequalityandreducecosts,whileenablingcoordinationofcareandengagementofpatientswiththeircaregivers.Forsome,thepromiseandtherealityofwidespreadinteroperabilityareobvious.Forothers,challengesremaininrecognizingthevaluethatinteroperabilityhasalreadyprovided.Nonetheless,allstakeholdersagreethatmoreneedstobedonetobettermeasuretheimpactofinteroperabilityvis-a-visotheradvancesinhealthITprocesses,skills,andknowledge.Becausesomanyfactorsinfluencetheimprovementsweseekinourhealthcaresystem,itisoftendifficulttodeterminetheindividualcontributionofinteroperability.

TheElectronicHealthRecordAssociation(EHRA)StandardsandInteroperabilityWorkgroupsetouttoidentifymethodstoquantifytheimpactsofinteroperability.OnemethodthatwedecidedtoaddressisthegatheringofstatisticsoninteroperabilityvolumesfromEHRAmembercompanies.Weexpecttoreportonthisdatainthenearfuture.Wealsoagreedthatvolumealonedoesnottellthefullstory,asit’simportanttounderstandboththeextentofexchangeandtheactualimpactofthedataexchangedandaccessedontherelevantstakeholders.Thiscombinedviewcanprovideamorecompletepictureofthetrueimpactofinteroperabilityinoperationalhealthcaresettings.TheEHRAisuniquelypositionedtoprovidespecificexamplesofourmembers’customers’experiencesandrelatedbenefitswhereinteroperabilityhasmadeaclearimpactonquality,cost,orcarecoordination.Todeepentheunderstandingofallstakeholders,EHRAsupportseffortsofindependentorganizationstogobeyondsuccessstoriesandaddressdeeperqualitativeassessmentoftheimpactsofinteroperabilityonhealthcaredelivery.

Thesuccessstoriessharedheresuggestthatthe‘informationexchangeglass’ishalffull–andfillingrapidly.Positiveimpactsofinteroperabilityintheusecasesthatfollowinclude:

● Reductioninduplicatetests● Up-to-dateclinicalinformation● Improvedcarecoordination● Accesstoapatient’simmunizationrecords

3 June 2017


InteroperabilitySuccessStories:TheJourneyContinues



● EDvisitprevention● Aggregateddata● Providingmoretimewithpatients● Millionsofdollarsinsharedsavings● Moreaccuratedocumentation● Lessfaxing● Morecompletedocumentationavailablebeforesurgeonsmeetwithpatients● Improvedsurgerystarttimes● Betterinformeddecisions● AcceleratedEDdischarges● ReductioninED-to-inpatientadmissions● Allergyreactionprevention● Reducedphonecalls● Eliminatinghand-writtencorrespondence

Thesestoriesclearlydemonstratethatinteroperabilityisimprovingthehealthcareexperiencesofbothpatientsandtheirclinicalsupportteams.Moresuccessstorieswillbecomeavailableasinteroperabilityallowsallhealthcarestakeholderstoconnectmorebroadlyandeffectivelywithprovidersacrosscommunitiesand,eventually,acrossthenation.AllEHRAmembersarecommittedtotheadvancementofinteroperabilityandarepleasedtosharethesesuccessstorieswithyou.

4 June 2017

Interoperability Success Stories: The Journey Continues InteroperabilitySuccessStories:TheJourneyContinues



SiteDescription AllinaHealthMinneapolis,MN

OrganizationsInvolved AllinaHealthisanonprofitsystemofhospitals,clinics,andothercareservicesinMinnesotaandwesternWisconsin.

UseCaseDescription AstudydonebytheDivisionofAppliedResearchandDepartmentofEmergencyMedicineatAllinaHealth1,conductedin2012andpublishedin2014,focusedonusingC-CDAexchangefortreatmentpurposesinemergencydepartmentsviaXCAandXDS.bIHEstandards.

OperationalEfficienciesand/orCostSavings

ImprovementsinStaffand/orPatientSatisfaction

ImprovementsinDataAccess

● Accordingtothe2014studyof1,488EDvisitsatfourAllinahospitals,cliniciansavoided560duplicatetestsandproceduresandidentified28casesofdrug-seekingbehaviorbecausetheywereabletofirstcheckpatients’recordsfromotherorganizations.

● Fillingintheinformationgapsinapatient’srecordhelpscliniciansprovidemoreefficientcare.

AtAllinaHealth,cliniciansareusingtheirEHRintheemergencydepartmenttorequestpatients’medicalrecordselectronicallyandgetamorecompletemedicalhistorytoprovidefaster,moreeffectivecare.

5 June 2017




SiteDescription AveraHealthSiouxFalls,SD

OrganizationsInvolved AveraHealthhasmorethan330locationsin100communities,stretchingacrossfivestates:SouthDakota,NorthDakota,Iowa,Minnesota,andNebraska.

Theintegratedhealthsystemprovidesacarecontinuumthatincludes33hospitals,morethan200clinics,18long-termcarefacilities,and20homehealthandhospicecareagencies.

Averaimplementedahealthinformationexchangethatsecurelyexchangespatientinformationwith17states.

UseCaseDescription AveraultimatelychosetoestablishasingleHISP/HIEforthefive-statearea.Theydeterminedthiswouldminimizecapitalinvestmentrisk,implementationcosts,andmaintenance.

UsingoneHIEalsoenabledAveraHealthtoadoptthe“opt-out”patientconsentprocess,allowingthedefaultforhealthinformationofpatientstobeincludedautomaticallyintheexchange.

AverahasembeddedtheexchangeofC-CDAsintoclinicianworkflow,resultinginmorethan1,100providersatcloseto200facilitieshavingsentorreceivedmorethan642,000DirectmessagetransactionsacrossAvera’sHIE.




6 June 2017




● AveraHealthexceededmeaningfuluserequirementsonthisfront,withallStage2eligiblehospitalsand97%ofStage2eligibleprovidershavingattested.

● BystreamliningtheexchangeofC-CDAsintotheworkflow,providersareabletouseup-to-dateclinicalinformationtoassess,diagnose,andtreatpatients.

● Theexchangeresultsinbettercarecoordination.

● Cliniciansarenolongerwastingtimeonthetelephoneorwaitingbyfaxmachines—theinformationisnowattheirfingertips.

● Receivingprovidersappreciatethemostrecentmedicationlistandpointtoadecreaseinredundanttests(e.g.,lab,CT),savingtimeandmoney.

● AveracollaborateswithSouthDakotaCorrectionalHealthtoprovidetelehealthservicestosixcorrectionalfacilities,whichhelpedtoprevent322EDvisitsin2015.

● SouthDakotaQuitLine:AverausesDirect2exchangetosendreferralstoSouthDakotaQuitLineforsmokingcessation,replacingtheoldpaperprocess.

● AveraNowVirtualOfficeVisits:C-CDAsaretransmittedtoensureup-to-dateinformationisincludedintheEHRforAveraNowvirtualofficevisits—mobilevideovisitsviaasmartphone,tablet,orlaptop.

● AveraeLongTermCare:Point-of-careexchangeenablesgeriatriciansandpharmaciststoreviewpatients’charts,includingcareplansandordersenteredatdischarge,beforepatientsarriveatthelong-termcarefacility.

● Oneofthenation’sfewbidirectionalimmunizationinterfaces,thisexchangehascreatedenormousefficienciesforAverahospitalsandclinics.

● TheIDNismaximizingitspotentialtoshareinformation,streamlinecommunication,and,aboveall,improvepatientcare.

7 June 2017




SiteDescription ClalitHealthServicesTelAviv,Israel

OrganizationsInvolved Thedesiretoaggregatepatientinformationfromdisparatesources,todoitquickly,andtopresentitinawaythatmadesensetocaregiversgaverisetowhatisnowcalledtheOfekNetwork.ItconnectsmultiplehealthsystemsthatserveIsrael’s8.3millionresidents.

Note:ThisusecaseisthesameformanyU.S.providerorganizations,wherethesametoolsandtechnologiesarealsoavailabletosupportit.

UseCaseDescription ClalitHealthServicesexecutivesdeterminedthataninformationaggregationsystemshouldprovideamedicalrecordthatfollowsthepatientthroughthesystem–regardlessoflocation–tocreateacontinuumofcare.Thiscapabilitywouldreturnrelevant,completeinformationtocaregiversinrealtimeatthepointofcare,subjecttopermissionsandprivacyregulations.

Theultimategoalwastoimprovethequalityofcarethroughareductionofmedicalerrorsandtoprovideproactivecarebygivingclinicianseverythingtheyneedtobeeffective.ClalitusesCCOWforpoint-of-careintegrationwithEHRs,XDRWSandCCD/CCDAtoloaddatafromsourcesystems,SMARTonFHIRtointegrateotherapplications(e.g.,messaging,medicationreconciliation)andSAMLtointegratewithPACS.




PhysiciansinatypicalClalitHealthServices AnexecutivefromClalitHealthServicessaid, Anintegratedrecordalsopromotesproactive

8 June 2017




primarycarepracticehavejust7to9minuteswitheachpatient.Thequickaggregationofdatagivesphysiciansmorequalitytimewithpatients,whichleadstobetteroutcomes.

“Thesystemdoesnotrequireanychangeinworkfloworthewayproviderswork.Itpresentsallinformationinoneview,whichisuser-friendly.Itonlytakesaminimumofguidance,10to15minutes,totrainanewdoctoronthesystem.”

andpreventivecarethatlogicallyreducestheinherentcoststothehealthcaresystem.

SiteDescription HolstonMedicalGroup(HMG)Kingsport,TN

OrganizationsInvolved HMGisamulti-specialtyphysiciangroup,seeinganaverageof40,000patientspermonthacrossits41officesinNortheastTennesseeandSouthwestVirginia.Physician-ownedandphysician-led,HMGmanagesadiversifiedgroupofmorethan150primarycarephysicians,specialistsandmid-levelproviders.Itsmissionistoprovidequalitymedicalcarethatexceedspatientexpectationsandbuildslastingrelationships.

HMGhelpedformaphysician-ledaccountablecareorganization(ACO),QualuableMedicalProfessionals;andahealthcaretransformationcompany,OnePartner,whichincludesaprivatehealthinformationexchange(HIE).Together,theseorganizationsareimprovingtheoverallhealthofthecommunitiesHMGservesbychampioningapatient-centered,data-drivenapproachtocare.

UseCaseDescription HMGconsistentlycapturesdataforindividualpatients,andacrosspatientpopulations,toassessprogresstowardachievingbetteroutcomes.HMGusesdataandanalyticstoidentifypatientswithhighprobabilityforanadverseevent,suchasahospitaladmission,readmission,

9 June 2017




multipleemergencyroomvisits,ormedicinecomplications.

HMGusesdatafromitsEHRtostratifypatientpopulationsaccordingtothecomplexityoftheirconditions.Theinformationhelpscliniciansaddressvariousconditions,includingthetopfourdiseasestatesofHMG’spatientpopulation:hypertension,diabetes,depressionandasthma.




● Earned$7.2millioninvalue-basedpaymentsin2015.

● Generated$40millioninsharedsavings,earningnetpaymentof$19million(forperformanceyears2013,2014and2015).

● 91.67%ofprimarycarephysiciansmetmeaningfuluserequirementsin2015,betterthanthenationalmeanof76.22%.

AnexecutivefromHMGsaid,“We’reseeingmoreunityamongthephysiciansintheACO.Moreaccesstopatientdatameansasagroupwemakemoreintelligentandtimelydecisionstokeepcostsdownandqualityup.”

WithbetteraccesstopatientrecordsthroughtheEHR,HMGisbetterabletoeffectivelytreatpatients,avoidingunnecessaryandcostlytripstotheemergencyroom.

HMGphysiciansfindtremendousclinicalvalueinbeingabletoviewpatientinformationthroughtheHIE.Thiscapabilityalsoenablesphysicianstocodetheirvisitsatahigher,moreaccuratelevel.Forexample,ifaphysicianisabletoreviewadiagnosticexamordocumentpatientswithmultiplechronicconditions,itiscodeddifferentlythanaregularofficevisit.Appropriatelycodedvisitsincreaseriskscoresandpaymentrates.

10 June 2017




SiteDescription LewisandClarkInformationExchange(LACIE)KansasCity,MO

OrganizationsInvolved LACIEincludes20+hospitals,300+clinics,7,000+providers,andKansasCityHeadStart,KansasCity,MO.TheusecasediscussedherefocusesonKansasCityHeadStart.

UseCaseDescription KansasCityHeadStart’sstaffusedtheLACIEHIEtoidentifytrendsinmedicalinformationfor

somechildrenwhofrequenttheemergencyroom.TheHIEhelpedcentralizethedatainthechildren’shealthdocumentsfrommultipleproviders.Theseexchangesarequery-based,anduseHL7C-CDAdocuments,HL7V2messages,andIHEXDS.b,XCA/XCPDfordocumentexchangetransportmethods.




● HavingasignificantamountoftheinformationthatHeadStartisrequiredtoreportintheHIEhashelpedthestaffspendlesstimecallingproviderstogethealthdocumentationandmoretimecheckinguponthechildrenandprovidingtheirguardianswithadditionaleducation.

● UsingtheHIEhasalsohelpedstreamline

TheburdenforthestafftocallprovidersandrequesttherequiredhealthinformationbyfaxhasbeenreducedbecausetheycannowqueryforthisinformationintheHIE.

Thestaffcanqueryforvariousinformationregardingchildren’simmunizationstatus,wellnesschecks,medications,height,andweight.

11 June 2017




theabilitytoproducedocumentationtoreceivefederalfunding.

SiteDescription LowellGeneralHospital

Lowell,MA

OrganizationsInvolved ● PrecisionSurgicalSpecialistsofLowellinChelmsford,MA● LowellSurgicalAssociates–NorthChelmsford,MA● MassachusettsEar,NoseandThroatAssociatesinChelmsford,MA● RiversideSurgicalAssociatesinLowell,MAAllsitesusetheHISPnetwork.

UseCaseDescription LowellGeneralHospitalwantedtofocusonimprovingtheefficiencyoftheoperatingroomandstayingonschedulewiththeirsurgeries.Thefirstsurgeryoftendidn’tstartontimeandwouldpostponecasesfortherestofthedaybyupto1to2hours.Patientinformationandlabresultsweregettinglostinthesystem,whichcauseddelays.LowellGeneralHospitaldeterminedwhattheywantedtheiroptimalworkflowtolooklikeandincorporatedDirectmessaging(usingtheXDRstandard)tohelpthemgetmoretimelysurgeryschedules.




● WithDirect2messaging,staffhassetupstandarddataexchangeworkflowstoensurethepatientdataandsurgery

Datadoesnotgetlostinthesystemasitdidwithfaxing.

12 June 2017




informationgodirectlytotheproviderswhoneedthem.

● Ahighrateofhistories,physicalsandconsentformsgetintopatients’chartsbeforethesurgeonsentertheirrooms.

● Becausetheinformationiseasiertofind,surgeonsandnursescanreviewtheinformationandgetintotheoperatingroomwithbetterfirststarttimesandhittheirbenchmarks.

SiteDescription MetroHealth

Cleveland,OH

OrganizationsInvolved MetroHealthisanintegratedhealthsystemwithanacutecarehospitalhousingaLevelIAdultTraumaandBurnCenter,askillednursingfacility,andmorethan25locations(mostlyambulatoryclinics)throughoutCuyahogaCounty,OH.

UseCaseDescription Astudy3publishedinAmericanJournalofManagedCarein2013analyzedsurveyresponsesfromallprovidersthathadusedtheHIEatleastoncewithinthefirst5to7monthsafteritsimplementation.ThestudyfocusedonusingC-CDAexchangefortreatmentpurposesinemergencydepartmentsviaXCAIHEstandards.

13 June 2017







● 85%ofproviderssurveyedsaidthattheHIEsavestime,while84%saiditreducesunnecessarylabandimagingtests.

● TheHIEimprovespatientcareinotherwaysaccordingto82%ofproviders,with15%reportingthatitpreventsunnecessaryadmissions.

● Inasurveyoftheirprimarycare,inpatientcare,specialtycare,andemergencydepartmentclinicians,MetroHealthfoundthat93%ofprovidersfoundvalueinusingtheHIEtoexchangepatientrecordselectronically.

SiteDescription MichiganMedicineAnnArbor,MI

OrganizationsInvolved MichiganMedicineishometooneofthelargesthealthcarecomplexesintheworld.

UseCaseDescription MichiganMedicineconductedayear-longstudy4,usinginformationfrom2,163adultandpediatricemergencydepartmentvisitstotheirhealthsystem.ThisstudyfocusedonusingC-CDAexchangefortreatmentpurposesinemergencydepartmentsviaXCAIHEstandards.




● Providersorderfewerduplicate Patientsleavetheemergencydepartment

14 June 2017




diagnostictests–reducingthenumberofMRIs,X-rays,andCTscansby1.6–2.5%–resultinginaveragereducedcarecostsof$1,187.

● Whenclinicianshaveelectronicaccesstopatients’healthrecords,cliniciansareabletomakeinformeddecisionsfaster,andpatientcareisimproved.

nearly53minutesfaster,andthelikelihoodofhospitaladmissionis2.4%lower.

SiteDescription NewYorkPresbyterian(NYP)NewYork,NY

OrganizationsInvolved NewYorkPresbyterian(NYP),anonprofituniversityhospital,startedusingopenAPIstoachieveinteroperabilityin2014.

UseCaseDescription AccordingtoanNYPexecutive,“Basedonthecontinuingsuccessofearlyprojects,APIshavebecomeago-totechnologyfornewprojectsbecausetheyareeasytouse,welldocumentedandcapableofgrowingquickly.”

NYPusesopenapplicationprogramminginterfaces(APIs)toaccessorsharepatientdataacrossapplications/devicesfromvariousvendorstoimprovepatientcare.




15 June 2017




In2014,doctorspracticinginthehospitalweredocumentingintheinpatientEHR,buthadtogobacktotheirofficesanddocumentagaintobill.Thissituationrequireddoubledataentry,wastingvaluabletimeandcreatingtheopportunityforerror.Tolinkinpatientdocumentationwithoutpatientbilling,theteamusedin-housestaffwithexpertiseusingopenAPIstobuildacustomapplication,whichstreamlinedthebillingprocessandlinkednotestobills,eliminatingtheneedfordoubleentry.

TraditionalinterfacesbetweenEHRsanddevicescapturingvitalsignswereslowandrequiredextrasteps.NursessometimesenteredtheresultsintheEHRdirectlyandcircumventedtheinterface,writingdownnotestokeeptrackofdata,orstandinginfrontoftheEHRwaitingforvitalsigninformationtoappear.AnAPIsolutionnowimmediatelysendsresultsfromthevitalsdevicetotheEHRandeliminatesadditionalstepstoassociatethedatawiththepatient’smedicalrecord.Increasedaccuracyofdataandreducedomissionsofdatahavefreedclinicianstospendmorequalitytimewithpatientsandhavealsoimprovedcliniciansatisfaction.

UsersinNYP’sburnunitwereconcernedaboutthetimespentuploadingpatientpictures,whichhelpclinicianstrackprogress.ClinicianswantedthepicturestoautomaticallyuploadintotheEHR.NYPturnedtoasmallcompanythatwasapartnerintheirEHRsupplier’sdeveloperprogram.Thesolutionisnowlive,andexistingusersidentifythattheyaresaving5to10minutesperpatientuploadingthepictures.Theinitialrolloutto30usershasrapidlyexpandedtohundredsofusersthatcantakeadvantageofthisapplication.

SiteDescription RockyMountainCareSaltLakeCity,UT

OrganizationsInvolved Manageseightskillednursingfacilities

UseCaseDescription RockyMountainCareusesCommonWellHealthAlliance5toaccessandsharepatientinformationwithotherhealthcareprofessionalstoprovidebetterpatientcare.Anexecutivefromtheorganizationstated,“Aresidentwasadmittedtooneofourskillednursingfacilitiesfromahospital.Thepaperdocumentfromthehospitalsaidthepatientwasallergictocodeine,butwhentheCommonWellrecordcameup,itshowedthatnotonlywasthepatientallergicto

16 June 2017




codeine,butallopiates.So,welookatitasare-hospitalizationaverted,andanallergyaverted,becauseimmediatelyanydrugthatpatientwasonthatwasanopiatewasdiscontinued.”TheexchangeisbasedontheIHEDocumentExchangeprofilesandHL7C-CDAdocumentsstandards.




Providerscanviewamorecompletepatientmedicalrecordfromvariousorganizations.

PatientinformationfromtheCommonWellrecordcanalertprovidersofallergiesnotcapturedinpaperdocuments,whichcanhelpthepatientavoidapotentialre-hospitalizationfromnewlyprescribedmedication.

SiteDescription Tucson,AZCommunity-BasedDataSharingCollaboration

OrganizationsInvolved ● ArizonaCommunitySurgeons● TucsonMedicalCenter● Carondelet–SaintJoseph’sHospital● NorthwestMedicalCenter

ThreedifferentEHRsfromdifferentcompaniesareusedbythesefourunaffiliatedorganizations.

17 June 2017




UseCaseDescription ArizonaCommunitySurgeonsisageneralandorthopedicsurgerypracticewhosephysiciansperformsurgicalproceduresatmanylocalhospitalsintheTucsonarea.Thesesitesarecurrentlyinproductionusingstandards-basedprotocolsandconnectivityviaDirectmessagingtocommunicate,coordinate,andexchangeclinicaldatawitheachotherinpreparationforapatient’ssurgery.

IncludedinthisDirectmessagearedocuments,images,andacurrentC-CDAonthepatient.Documentsandimagessenttypicallycontainarecenthistoryandphysical,recentX-ray,andlabresultsneededforthesurgery.Allofthisinformationisreceivedandconsumedbythelocalhospitalsystem’sEHRinpreparationforsurgery.Oncethesurgeryiscompletedbythelocalhospital,theycreateadischargesummaryandsendaC-CDAbacktoArizonaCommunitySurgeonsviaDirectmessaging.ThisC-CDAcontainsnewinformationfromtherecentsurgeryvisitthatcanbediscretelyimportedbackintotheArizonaCommunityPhysicians’EHR.




Usingthisfullyelectronicmethodofcommunicationdrasticallyincreasesstaffefficiencybyeliminatingphonecalls,handwrittencorrespondence,chartpulling,andthemanualscanningandfaxingofpatientdocuments.

Themostcurrentpatientinformationisavailableonlinetoallcareprovidersatallsites,improvingboththequalityandefficiencyofcare.

NotesandReferences

18 June 2017




1T.J.Winden(1),L.L.Boland(1),N.G.Frey(1),P.A.Satterlee(2),J.S.Hokanson(2),(1)DivisionofAppliedResearch,AllinaHealth,Minneapolis,MinnesotaUSA;(2)DepartmentofEmergencyMedicine,AbbottNorthwesternHospital,AllinaHealth,Minneapolis,MinnesotaUSA,ApplClinInform201452:388-401,https://doi.org/10.4338/ACI-2013-12-RA-0100

2LaunchedinMarch2010asapartoftheNationwideHealthInformationNetwork,theDirectProjectwascreatedtospecifyasimple,secure,scalable,standards-basedwayforparticipantstosendauthenticated,encryptedhealthinformationdirectlytoknown,trustedrecipientsovertheinternet.TheDirectProjecthasmorethan200participantsfromover50differentorganizations.TheseparticipantsincludeEHRandPHRvendors,medicalorganizations,systemsintegrators,integrateddeliverynetworks,federalorganizations,stateandregionalhealthinformationorganizations,organizationsthatprovidehealthinformationexchangecapabilities,andhealthinformationtechnologyconsultants.Moreinformationisavailableathttps://www.healthit.gov/policy-researchers-implementers/direct-project.

3Kaelber,D.C.,Waheed,R.,Einstadter,D.,Love,T.E.,Cebul,R.(2013).UseandPerceivedValueofHealthInformationExchange:OnePublicHealthcareSystem’sExperience.AmericanJournalofManagedCare,19(11SpecNo.10),337-343.4Everson,J.,Kocher,K.E.,&Adler-Milstein,J.(2016).Healthinformationexchangeassociatedwithimprovedemergencydepartmentcarethroughfasteraccessingofpatientinformationfromoutsideorganizations.JournaloftheAmericanMedicalInformaticsAssociation,2016ocw116.doi:10.1093/jamia/ocw116

5CommonWellHealthAllianceisanot-for-profittradeassociationdedicatedtoachievingcross-vendorinteroperabilitythatassuresprovideraccesstohealthdataregardlessofwherecareoccurs.MembersbelievethatprovideraccesstothisdatamustbebuiltintohealthITatareasonablecostforusebyabroadrangeofhealthcareprovidersandthepeopletheyserve.Moreinformationisavailableathttp://www.commonwellalliance.org.