The Story Behind the CommonWell Story

Arguably, the biggest news story coming out of HIMSS last month was the announcement of the CommonWell Health Alliance – a vendor-led initiative to enable query-based, clinical data sharing. So much has been written about CommonWell that there is little need to rehash what has been said before.

What has not been said, or at least has been sensationalized nearly to the point of irrelevance is the whole controversy surrounding Epic and how they were not invited to join the CommonWell Alliance until after the announcement. None other than Epic’s own founder and CEO, Judy Faulkner, has gone on record stating the Epic was unaware of CommonWell prior to the announcement. Faulkner has gone on to question the motives of CommonWell, in an effort to subvert it, in her highly influential role on the Dept of Health & Human Services HIT workgroup committee.

That was the last straw.

It is one thing to moan and groan at the HIT love fest that is HIMSS, where vendors commonly discount the announcements of competitors. But it is quite another thing to be a part of a highly influential body that is defining nationwide HIT policy and make the same claims over again, especially when they are frankly not true.

Is there some truth to Faulkner’s claims that the vendors who have created CommonWell may have had an additional motive, stopping the steamroller that is Epic? More than likely.

But it is also true that founding members of the CommonWell Alliance do wish to lay down the swords of hoarding data to allow higher order services to be developed on top of the CommonWell platform. They all see the market changing rapidly. They know that they, on their own, cannot move fast enough to meet all the needs of the market. They understand that the next iteration in HIT is to move to a platform-based services model – that is where the value will be. As to whether or not CommonWell will ultimately be successful, that is far from certain as there are many rivers to cross before we see the query-based health information sharing that these alliance members envision take hold, if at all, in this industry.

From our vantage point, Epic, with its monolithic strategy that is more akin to Wang Laboratories than it is to Apple’s iOS, is operating on a model that while providing a seamless environment from ambulatory to acute (something other EHR vendors have totally messed up on), will ultimately hinder healthcare organizations’ ability to rapidly innovate and respond to market changes. Epic simply will not be able to move fast enough and their customers will struggle as a result.

As to whether or not Epic was invited to the CommonWell party; we have received confirmation from several sources that indeed Epic was invited to join a couple of weeks prior to the announcement. What likely occurred is that Epic saw that CommonWell’s goals, objectives, and operating structure were already formalized when the invite arrived. Thus, Epic would not have an ability to make substantive contributions to this initiative and rejected the invitation.

It is disingenuous for Epic to state otherwise and if they were a public company, they may have been subjected to an SEC inquiry. But alas, Epic is not a public company and Faulkner can say what she wishes with few, if any, repercussions. Her quite vocal denouncements of CommonWell though do show that she clearly does feel threatened by this alliance.

But a core mission of Chilmark is to cut through the BS to ensure that this industry is informed. In keeping with that mission, we felt it important to let you know what is really happening behind the scenes at CommonWell. Hopefully, we have set the story straight on the CommonWell Health Alliance and Epic saga.

John Moore is an IT Analyst at Chilmark Research, where this post was first published.

5 replies »

  1. Speaking of transparency, does Chilmark have a business relationship with any CommonWell vendors? Normally Chilmark is one of the best analysts out there in HIT-land but I wonder motives in this situation.

  2. I’m with you on this, Dr. Gropper. Sadly, though, the entrenched Big Players seem to continue to dominate. To the extent that patients will benefit marginally, fine, but that is not the point. Patients are a necessary evil who provide the grist for billing.

  3. Chilmark is not cutting through the BS this time around. The saga of when was Epic invited and speculation over their motives hardly matters a month after HIMSS.

    The CommonWell Alliance with and without Epic would still be a closed EHR vendor challenge to standards-based state health information exchanges (HIE) and to policies and processes based on the amazing work being done in Blue Button+.

    Epic and the CommonWell allies benefit equally from connection fees and rent-seeking behavior more appropriate as applied to airport landing fees than information interfaces in the Internet era. Not surprisingly, Epic and CommonWell members also benefit disproportionately from the $Billions in Meaningful Use incentives.

    Can Chilmark tell us how much Epic charges for messages in and out of the Epic information exchange? CommonWell refuses to say how it will price messaging in and out of members’ EHRs but their desire to control and charge for interfaces is a major impediment to interoperability today.

    State HIEs and patient-directed automated exchange via Blue Button+ are both based on Stage 2 Meaningful Use standards and not subject to the EHR vendor lock-in business model. This is the most important aspect of the CommonWell / Epic saga.

    It’s time for all of us, especially ONC and HHS as well as the VA / DoD / Medicaid purchasing behemoth to demand transparency and mobility of health information as a condition for the $20+ Billions of incentives to the EHR vendors.