New eHealth Exchange Health Information Network Infrastructure

Network Participants Adopting Nationwide Gateway Service, Now Finalizing Carequality Implementation

The eHealth Exchange (@eHealthExchange), the oldest and largest nationwide health information network connecting the public and private sectors, announced the go-live of its new gateway technology that simplifies connectivity for its participants via a single connection to the nation. The benefits to members will include reduced information sharing expense, further expansion of its national footprint, and faster implementation of innovative capabilities such as real-time content quality validation and a national record locator service.

When the eHealth Exchange was formed more than a decade ago by the Office of the National Coordinator for Health IT (ONC), the government opted for a federated exchange approach, stopping short of creating a required gateway. As the proposed national network for health information exchange, the government favored an open-market and decentralized approach that would support further innovation, much like the internet.

Today, the landscape has changed. Though the eHealth Exchange remains the largest network of its kind, there are multiple large and thriving networks. The eHealth Exchange can now adopt a more centralized health information network approach by providing a common gateway for all participants. This is also a step toward supporting additional exchange methods beyond query and a breadth of new use cases.

“The Veterans Health Information Exchange [VHIE], AdventHealth, InterCommunity CCO, and OCHIN were our pioneer partners,” said Jay Nakashima, executive director of eHealth Exchange. “Their unwavering commitment to query-based connectivity to improve patient care drove us from implementation kick-off to live, bi-directional exchange using the new eHealth Exchange technology in just four months. This is a remarkable achievement for any health technology initiative, and unheard of when you think of implementing visions to support nationwide scale.”

The eHealth Exchange leverages the InterSystems platform integrated with the eHealth Exchange’s Fast Healthcare Interoperability Resources (FHIR) healthcare directory as the basis for the hub model. The hub will make it dramatically easier for organizations to connect to each other using a “connect once” model to reach any other member of the network. This approach leads to faster access to correct patient records at a lower implementation cost. The eHealth Exchange network’s modernized approach will also help organizations to prepare for pending regulatory changes, such as information blocking and the Centers for Medicare and Medicaid Services (CMS) interoperability rule, as well as meeting expectations in the ONC’s pending Trusted Exchange Framework and Common Agreement (TEFCA).

“This eHealth Exchange architecture will help decrease complexity, cost, and security risk of our connections to our community partners.” said Jonathan Nebeker, MS MD, Acting Chief Medical Information Officer at the Department of Veterans Affairs. “It improves appropriate access to Veteran’s health data and will help VA and community providers provide better care.”

With more than 75 percent of all hospitals in America and 61 regional and state health information exchanges (HIEs) participating in the nationwide eHealth Exchange, the evolution from point-to-point connections to a one-gateway solution will dramatically increase connectivity for the entire country while saving millions of dollars in IT infrastructure and effort for network participants and their future exchange partners.

As the network’s participants continue to transition to the gateway-approach, early adopters of the new architecture are expanding their focus to complete implementation of the Carequality Interoperability Framework. The nationwide trusted exchange framework is already leveraged by an estimated 600,000 physicians to share more than 36 million clinical documents a month across and among disparate networks.

About the eHealth Exchange
The eHealth Exchange, a 501(c)3 non-profit, is among the oldest and largest health information networks in America and is most well-known as the principle way the federal government shares data between agencies and with the private sector. The eHealth Exchange network, which is working in 75 percent of all US hospitals, is leveraged by more than 30 electronic health record (EHR) technologies and 61 regional or state health information exchanges (HIEs). Four federal agencies (Centers for Medicaid and Medicare, Department of Defense, Department of Veteran Affairs, and Social Security Administration) participate in the network to share patient information with private sector partners as well as other agencies. In all, the eHealth Exchange supports secure exchange of the records of more than 120 million patients.