- The federal Office of the National Coordinator for Health IT (ONC), the Health and Human Services Dept. agency charged with implementing Obamacare, questioned the CommonWell effort's approach and likelihood of promoting true interoperability.
- Consultant and blogger Anne Zieger referred to it as an interoperability scheme, though she admitted, "the more data sharing the better, particularly by major players with significant market share."
- Dr. Adrian Gropper, CTO of Patient Privacy Rights, called it a shame and a missed opportunity -- a shame because "another program with opaque governance by the largest incumbents in health IT is being passed off as progress" and a missed opportunity because it doesn't involve physicians or patients.
- Dan Munro, founder and CEO of iPatient, expressed concern that publicly traded companies -- with boards of directors and shareholders to please and quarterly objectives to meet -- "don't make good candidates for lean, rapid and disruptive technical innovation."
- Jon Mertz, vice president of marketing for Corepoint Health, put it simply when he asked, "What took so long?"
That's why the men behind the Cure Project -- Dr. Steven E. Waldren, a senior strategist at the American Academy of Family Physicians, and Robert L. Brown, vice president of professional services atMosaica Partners -- say interoperability will come only with what Brown describes as a "large-scale specifications development project."
Back in 2004, President George W. Bush called for widespread adoption of electronic health records. Rather than take the opportunity to recast the EHR system in the context of interacting with patients at the point of care, to make EHR less obtrusive and more efficient, the industry instead went full steam ahead, building hundreds of standalone systems the create and maintain EHRs, Brown says.
As a result, first vendors and then the federal government, through the Meaningful Use program, have defined what they want in health care IT systems -- while providers, the ones actually paying for the systems, haven't had a say. It's time for that to change.
The Cure Project approach: Define the software capabilities you need
The Cure Project began as an "academic exercise" for the Agency for Healthcare Research and Quality that examined information models in the patient-centered medical home (PCMH), one of the cost-saving initiatives included in the Obamacare health care reform. Brown and Waldren had to define that information model, as there was no standard approach, and soon discerned that the model was missing nearly everywhere else, too.
Traditionally, health care IT systems have been designed in an iterative manner that focused on business process automation -- namely, billing and documentation -- and not care delivery. Now that government incentives encourage improved care, through the adoption of the PCMH and the accountable care organization (ACO), there are financial reasons to improve clinical applications, Waldren notes.