{"id":14489,"date":"2013-03-04T16:05:02","date_gmt":"2013-03-04T21:05:02","guid":{"rendered":"http:\/\/pmedicine.org\/epatients\/?p=14489"},"modified":"2013-03-24T02:20:44","modified_gmt":"2013-03-24T06:20:44","slug":"biggest-himss-news-for-e-patient-families-commonwell-health-data-alliance","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2013\/03\/biggest-himss-news-for-e-patient-families-commonwell-health-data-alliance.html","title":{"rendered":"Revised: *could have been* the biggest HIMSS news for e-patient families: CommonWell Health [data] Alliance"},"content":{"rendered":"<p><strong>Update March 24:<\/strong> I&#8217;m retitling this post, and putting it on hold, pending resolution of important concerns raised by other members of our Society for Participatory Medicine. In particular, see Adrian Gropper&#8217;s <a href=\"http:\/\/lmgtfy.com\/?q=commonwell+gropper+site%3Athehealthcareblog.com\" target=\"_blank\">posts on The Health Care \u00a0Blog<\/a>. This is\u00a0<em>almost<\/em> a retraction, pending whether CommonWell changes its position and actually becomes patient-driven. If not, I suspect they&#8217;re being disingenuous and I&#8217;m outahere.<\/p>\n<p>In a <a href=\"http:\/\/thehealthcareblog.com\/blog\/2013\/03\/18\/the-commonwell-open-discussion-forum\/comment-page-1\/#comment-344001\" target=\"_blank\">comment<\/a> on THCB on 3\/21 Gropper summarized last week&#8217;s Tweetchat (hosted by SPM) thus:<\/p>\n<blockquote><p>In last night\u2019s Tweetchat, we had participation from 3 of the 5 founding companies, including two key architects of BlueButton+, a lawyer, and many Society for Participatory Medicine members.<\/p>\n<p>Here\u2019s my summary:<br \/>\n\u2013 The people involved in CommonWell are top-notch, honorable and experienced<br \/>\n\u2013 CommonWell does not consider \u201cGimme My DaM Data\u201d or patient engagement a priority<br \/>\n\u2013 CommonWell says they will involve patients in governance but this is meaningless if it\u2019s not an open standards process<br \/>\n\u2013 CommonWell will not use an open standards process \u2013 this means there\u2019s no open forum for us<br \/>\n\u2013 CommonWell is \u201cgoing for results\u201d with provider-to-provider communications as their priority<br \/>\n\u2013 Even though they helped create BlueButton+, CommonWell is not committed to using it<\/p>\n<p>For now, the bottom line is that we need an open forum that shadows everything CommonWell does and adds the e-patient perspective for all to see. This forum therefore needs to be open to the world.<\/p>\n<p>This is how open standards evolve.<\/p><\/blockquote>\n<p>Adrian knows much more than I (as do many others) about the health IT industry, though I&#8217;ve seen similar efforts in other industries. So his remark here gives me concern, too:<\/p>\n<blockquote><p>To maintain an industry that derives 60% of revenues from interface and installation costs, CommonWell is designed to overlap and undercut the efforts of state Health information exchanges.<\/p><\/blockquote>\n<p>My view is that the\u00a0<em>entire\u00a0<\/em>reason for the\u00a0<em>existence\u00a0<\/em>of the data is to accomplish care for sick people, and I see no moral ground for in any way withholding any of the data within vendor walls. I mean, we&#8217;re talking about parents&#8217; ability to participate in care of sick kids! And comparable family situations. State health information exchanges, designed by our government to benefit citizens (not vendors), are what we need.<\/p>\n<p>I know a massive industry has been built up around processing medical data, but that industry isn&#8217;t the reason the data exists. Sick family members are the reason.<\/p>\n<p>Until this is resolved with a clear emphasis on letting patients help &#8211; a <em>priority\u00a0<\/em>on letting patients help, on creating an open ecosystem for development of truly patient-centered tools &#8211; then I withhold the approval I gave in this post.<\/p>\n<p>Now here&#8217;s the original post, when CommonWell was first announced at HIMSS. This is the potential I saw, which I still want.<\/p>\n<p>___________<\/p>\n<p><a href=\"http:\/\/www.commonwellalliance.org\/\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5656 alignleft\" title=\"Commonwell logo\" alt=\"\" src=\"http:\/\/epatientdave.com\/wp-content\/uploads\/2013\/03\/Commonwell-300x86.jpg\" width=\"300\" height=\"86\" \/><\/a><i>See important update added below about Epic, 3:45pm ET the next day.<\/i><\/p>\n<p>A quick note &#8211; mark my words, this is important &#8211;<\/p>\n<p>At the big HIMSS health IT conference, six vendors of electronic health records have announced that they&#8217;ll be collaborating to share data as the <a href=\"http:\/\/www.commonwellalliance.org\/\" target=\"_blank\">Commonwell Health Alliance<\/a>. That&#8217;s <em>your <\/em>data, <em>our<\/em> data, your family&#8217;s data.<\/p>\n<p>The members are Cerner, McKesson, Allscripts, athenahealth, Greenway Medical Technologies and RelayHealth.\u00a0Significantly missing is the Big Dog in the field, Epic, which is notoriously &#8220;all about us,&#8221; i.e. themselves.<\/p>\n<p>Of course all the lesser dogs have a motivation in this &#8211; to band together and try to knock Big Dog off the top of the mountain.<\/p>\n<p style=\"padding-left: 30px;\"><em><strong>Important update next day:<\/strong><\/em><strong>\u00a0<\/strong>Thanks to SPM member Brian Ahier for circulating a link to <a href=\"http:\/\/www.bloomberg.com\/news\/2013-03-05\/epic-s-faulkner-says-rivals-may-use-data-pact-as-weapon.html\" target=\"_blank\">this article<\/a> in which Epic says they weren&#8217;t invited to join CommonWell. Epic also says CommonWell is &#8220;yet another distraction,&#8221; a competitive tactic by their rivals.<\/p>\n<p>Read about CommonWell here.\u00a0<a href=\"http:\/\/ehrintelligence.com\/2013\/03\/04\/top-ehr-vendors-join-commonwell-alliance-to-boost-interoperability\/\" target=\"_blank\">Top EHR vendors join CommonWell Alliance to boost interoperability<\/a><\/p>\n<p>My take: <strong>Market forces are starting to emerge. <!--more--><!--more--><\/strong>If underdog vendors can combine offer something the dominator doesn&#8217;t, that&#8217;s free enterprise working!<\/p>\n<p>I hope they&#8217;ll also compete on usability.<\/p>\n<p style=\"padding-left: 30px;\"><em><strong>Update the next day:<\/strong><\/em><strong>\u00a0<\/strong>Someone, please, confirm or correct the data sharing item in this paragraph:<\/p>\n<p>&nbsp;<\/p>\n<p>I&#8217;ve often<em> <\/em>heard that Epic can be a royal pain to use, in addition to their policy of favoring data interchange <em>but only with other Epic systems<\/em>. (As <a href=\"http:\/\/www.metrolyrics.com\/when-youre-good-to-mama-lyrics-chicago-the-musical.html\" target=\"_blank\">Matron Mama Morton sang<\/a> in &#8220;Chicago,&#8221; &#8220;You be good to Mama, Mama&#8217;s good to you.&#8221;)<\/p>\n<p>Personally, I want the system my doctors and nurses use to be good for them to use <em>and <\/em>all about getting my frickin data to <em>my<\/em> doctors, wherever they are.<\/p>\n<p>(I spoke about the usability issue in 2009, in &#8220;Over My Dead Body: Why Usability Matters to Patients.&#8221; Slides &amp; video link <a href=\"http:\/\/epatientdave.com\/videos\/#AHRQ\" target=\"_blank\">here<\/a>.)<\/p>\n<p><strong>I&#8217;ve seen this movie play out: <\/strong>A quarter century ago(!) I gained a few tidbits of experience about overthrowing the dominator, when Microsoft and Apple (then mortal enemies) teamed up against Adobe, then the Big Dog of PostScript. Adobe, always claiming the &#8220;openness&#8221; of PostScript, steadfastly refused to release the &#8220;Type 1&#8221; format for high quality PostScript fonts. MS and Apple said &#8220;too bad you feel that way&#8221; and standardized both operating systems on Apple&#8217;s &#8220;Royal&#8221; font format &#8211; which they renamed TrueType.<\/p>\n<p>Adobe&#8217;s founder ended up in tears at an industry conference, announcing he&#8217;d release the Type 1 specs.<\/p>\n<p>We shall see how this one plays out.<\/p>\n<p><strong>Long term outlook: <\/strong>I wonder who will be the first patient to sue a vendor for failing to transfer data that they knew could have prevented a death.<\/p>\n<p>Here&#8217;s hoping CommonWell members get it done and quickly demonstrate real clinical value of moving data to the point where it&#8217;s needed. In my view, anything less is obstruction of services, obstruction of care. Give us our data!<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Update March 24: I&#8217;m retitling this post, and putting it on hold, pending resolution of important concerns raised by other members of our Society for Participatory Medicine. 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