Experts view move as giant step for interoperability

WASHINGTON  -  Marking a bridge's beginning, ONC has made it official: eHealth Exchange is standing on its own as a non-federal, nonprofit entity. ONC announced the new status on Oct. 11. 

The mammoth project formerly known as NwHIN-Exchange created enough buzz throughout the year, in certain circles at least, that the news might be seen as anticlimactic. In terms of demonstrable progress that the healthcare industry is advancing information interoperability while furthering the business case for exchange, however, the fact that ONC delivered eHealth Exchange is anything but.

Today, 28 partners share health information across eHealth Exchange, a mix of private and public organizations that includes CMS, DoD, SSA and VA as well as industry heavyweights Kaiser Permanente, Marshfield Clinic, MedVirginia. And Idaho Health Data Exchange, in late September, became the newest member.

"What we realized is that six months ago, 500 hospitals were already connected, 30,000 clinical users, 3,000 providers, and a patient population coverage area of 65 million people, and 1 million shared records, Mariann Yeager, interim executive director of NwHIN-Exchange, said last March. "It became pretty clear this wasn't a pilot anymore  -  and it's time for it to stand on its own." Yeager said then the Exchange would stand on its own in October 2012.

Shortly after ONC rechristened NwHIN-Exchange as eHealth Exchange, health IT evangelist and prominent blogger Brian Ahier wrote of the already-evident benefits.

"The VA is sharing patient records among not only numerous VA hospitals but also non-military and private providers. There is also work under way to use Exchange to enable smoother transitions of care between the DoD, VA and the private counterparts that provide more than 50 percent of a military veteran's care," Ahier wrote in Nationwide Health Information Network Comes of Age. "At the Social Security Administration sharing data via NwHIN-Exchange has dramatically cut disability determination with 10 percent of claims filled in one to two days." 

Indeed, those two use cases  -  the VA and SSA  -  have not only resulted in smoother transitions of care but also in cost-savings. One participant eliminated $2 million annually in uncompensated care by being able to recognize dual-eligibles who qualify for both Medicare and Medicaid but did not previously understand that.

"I think that more people need to recognize just how big this is," John Moehrke, principal engineer specializing in standards architecture and interoperability at GE, put it simply on his Healthcare Security/Privacy blog at the time.

To put that in a bit of perspective: eHealth Exchange is the biggest bridge built to date between public and private health entities.

"Ultimately the value of this infrastructure is huge for all patients," Ahier wrote. "We are truly entering a new era."