The Interoperability Shh Storm: How Carequality, CommonWell and greed stifle innovation

February 5th, 2017 | 01:50 PM (UTC)

Nothing is more depressing than reading the FAQ's section on Carequality & CommonWell Connectivity. It tells a sad, over complicated industry story.

Let me start by saying this - Jitin Asnaani is the Executive Director and sole employee of the CommonWell Health Alliance.  He is 100% good people who is driving towards a good cause.  What's unfortunate in our industry however is that you have big dollars and egos behind the curtain that are truly controlling the strings (ehem Cern..).  When that happens, you end up with, well, ridiculousness.  The latest comes in the form of Carequality and CommonWell announcing that they are...sadly I'm trying to figure out the word to say here - partnering?  Working together?  Organizing company picnics at the same park?  It's hard to tell given their FAQs page which you can check out here:

When you start to break down the responses, you can begin to see the real story behind the scenes.  Before I do that however, let's be clear.  Carequality has one thing that CommonWell doesn't - Epic.  Epic previously complained about the multi-million dollar price tag of joining which makes zero sense given they do 1.7+ billion in revenue.  I remember when Jonathan Bush called Judy out on Twitter saying he himself would cover the bill.

I hope everyone is seeing the trend here - that while everyone talks about how important is - it's for the patient, streamlining the process, better patient care, blah blah blah - it all comes down to money with these people.  Period.  So back to the Carequality FAQ page which is hilarious now in this context.

This is one of my favorites - they proceed to talk about how these terms are NOT INTERCHANGEABLE - these organizations are essentially the same!!!!

Are terms like member, participant, connection, and implementer interchangeable? No. Below are definitions:

  • CommonWell Member: A CommonWell member is a health care organization that believes in the vision and mission of CommonWell and can participate in CommonWell committees to drive forward key initiatives.
  • CommonWell Subscriber: A CommonWell member who has subscribed to using and deploying CommonWell services, such as patient ID management, advanced record location, and query/retrieve broker services.
  • CommonWell-enabled Providers: CommonWell-enabled providers are those providers who are enabled with CommonWell services via their vendor member or providers who subscribe directly to the CommonWell services.
  • Carequality Member: A Carequality member is a health organization with an interest in a national-level common trusted exchange agreement and interoperability framework. Members are engaged in developing and expanding the framework.
  • Carequality Implementer: A Carequality implementer is a health data sharing network that has adopted and implemented the Carequality Interoperability Framework, connecting their network (and their members) to other networks that have implemented the framework.
  • Carequality Connection: A Carequality Connection is enabled to share health data under the Carequality framework via an existing Carequality implementer. An example would be a health system that is enabled to share health data via their vendor, who is an implementer.
  • Carequality-enabled Providers Carequality-enabled providers are those providers who are enabled to exchange health data under the Carequality Framework via their Carequality Implementer.
  • Directed Query: A user- or system-initiated query that is sent to a specific organization to determine whether a specific patient has a record at that location.  An organization is defined as any entry in the Carequality directory.  The query may be sent directly to the organization or through an intermediary gateway such as the CommonWell gateway.


What's funny is that they think by trying to delineate how different they are, that nobody is going to question it.  They have slightly different approaches that are all based on semantics and they make me feel like I'm taking crazy pills when they try to walk their way around it.

Here's another gem.

Does this mean that CommonWell and Carequality are merging? No. While Carequality and CommonWell have a shared interest in expanding connectivity, they will continue to have distinct missions and approaches, and will continue to provide different value to their respective communities.

The real answer?  We want to continue to charge fees and make money.  On top of that, we're all too proud to sit down and figure out a way to make it work for everyone because we all want to get our own piece of the pie.

I could go on but I think everyone gets the point.  It's all about money, vanity and greed when it comes to the best chance we have at true interoperability.  If these people really cared about the end goal, they'd be looking at finding a way to truly merge instead of detailing out 12 sentences of terms that mean absolutely nothing.

The HIS Guy has been in the C-Suite healthcare IT world for too long. As a result, he’s grown an inability to tolerate companies with poor products, organizations that make things too complicated and ridiculousness that stifles innovation. Disagree with him? We’ll give you 500 characters and let you respond (even anonymously if you choose). Email with your take.

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