- Besides making public the cost of enabling interoperability and data exchange charged by Epic Systems, this week's hearing on EHR and health IT adoption held by Committee on Health, Education, Labor, and Pensions also revealed the reasons the EHR company has refused to join CommonWell Health Alliance.
First and foremost is the matter of cost. Peter DeVault, Epic's Director of Interoperability, told members of the committee that CommonWell approached the EHR company to join its group of EHR vendors at the cost of "multiple millions of dollars."
Next was the matter of signing a non-disclosure agreement, which did not sit well with Epic. The lack of transparency was one of manner deal breakers.
"To us, the only reasons to have an NDA are if they are going to tell you something that otherwise they wouldn't want people to know — for example, the possibility that they might sell data down the stream — or that they want to make sure that their intellectual property doesn't conflict with ours," DeVault explained.
Another reason was the maturity and service area of CommonWell as a network of health information exchange. Compared to Epic's Care Everywhere network, DeVault described that of CommonWell's to be "aspiring."
"They aspire to be a nationwide network with a record locator service that will tell you where every part of a patient's record is," he stated. "They are not that today. According to their latest report that I have seen, they have four different sites live on their network, fewer than a 1000 physicians compared to a 100,000 thousand in Care Everywhere and almost 10 million records exchanged a month now."
To bridge the gap between the two networks, Epic proposed forging connections through Carequality, a network of networks.
"Carequality is meant to be that fabric that connects all of the networks together," he continued, "so you have health information exchanges, you've got the Care Everywhere network, you will eventually have CommonWell. Carequality then will be the fabric that stitches all of that together. So we hope that they will join Carequality."
Unsurprisingly, DeVault's comments were not well received by two of its competitors which are also members of CommonWell, athenahealth and Cerner Corporation.
Taking to twitter, athenahealth CEO Jonathan Bush questioned the revelation that the cost of joining CommonWell was more than Epic was willing to pay, even offering to foot the bill for one its competitors in the EHR space:
Cerner rejoined that it would should half the financial burden and likewise did the math on what Epic was bringing in by charging $2.35 per-patient annually for enabling interoperability and data exchange for its customers:
Additionally, Cerner was highly critical DeVault and Epic's statements on interoperability in a public statement issued after the hearing:
Today’s rhetoric is a slap in the face to many parties working to advance interoperability. It was discouraging to hear more potshots and false statements when it’s clear there is real work to be done. We’re committed to CommonWell as a practical, market-led way to achieve meaningful interoperability.
As it stands, the competition between EHR companies is likely shifting (if it hasn't done so already) to a new arena where interoperability and data will be the difference makers.