Care Everywhere
Ownership
Private
Governance
Governed by a peer-elected Governing Council and associated Rules of the Road agreements.
Geographic Reach (within US)
Global
Mission
Expand the access to health data to create a more comprehensive health record and improve the speed of care.
How does this approach facilitate exchange?
Care Everywhere is an HIE platform that is primarily a federated model that is controlled by the patient and can be used widely without the need for an intermediary.
Access Method (Use Cases)
Push and pull exchanges are embedded within Epic applications used by providers and consumers:
▪ Advanced record location
▪ Automated query-based exchange
▪ Closed loop referrals management
▪ PCP Event notifications
▪ Automated discharge follow-up alerting
▪ On demand Direct messaging
▪ Patient initiated record sharing
Primary Goals/Objectives
• Be easy to use
• Use open and inclusive standards
• Expand the amount of content and variety of participants
• Share lessons learned
Type
Provider-centric network
Number of Live Connections and/or Participants
100% of Epic’s U.S. customers using clinical applications, or over 1,700 hospitals and 34,000 clinics are live on Care Everywhere. Of those, 99% are connected to over 70,000 provider sites using other EHRs and HIEs. (As of October 2017)
Members
Not applicable
Primary Participants
Patients, Hospitals, Clinics, CINs, ACOs, Payers, Pharmacies, and Retail Clinics
Costs (Amount and/or Party Incurring Cost)
Care Everywhere is free to use for treatment and care coordination, regardless of the exchange partners technology platform.
Directory/MPI Details
Care Everywhere facilitates automatic distribution of exchange-ready providers and healthcare organizations regardlesss of EHR system or network that user belongs to.
Care Everywhere uses a sophisticated probabilistic patient matching algorithm and there is no centralized MPI necessary.
Standards Leveraged
Care Everywhere exchanges information using industry standard transport protocols. Query Approach: Transactions from the XCA, XCPD, PDQv3, and XDS.b integration profiles developed by Integrating the Healthcare Enterprise (IHE)
Sending/Receiving information for planned transitions of care: Direct Project standards. The types of information exchanged by Care Everywhere follow HL7's Clinical Document Architecture (CDA) standards.
Onboarding Process (Requirements to connect)
Care Everywhere is natively integrated into the Epic EHR and does not require a separate implementation process.
Care Everywhere is also a Qualified Technology Solution with the Sequoia Project so groups can instantly go-live on Carequality or the eHealth Exchange to expand national connections to include the Veteran's Health Administration, the Social Security Administration and thousand of additional providers.
Data Persistance
Federated Model: There is no centralized hub or data storage. No data flows through Epic servers involved in the exchange and Epic does not store any protected health information (PHI) or personally identifiable information (PII).
Certification Requirements for Participation
There are no certification requirements.
Testing
Standard connectivity testing is conducted during the initial implementation. New sites are connected with no additional testing.
Future Plans
Extend the content of documents exchanged to match the needs of specialists. Each provider should find information relevant to their discipline and the patient's care being delivered.
Work with community to support novel workflows, such as telehealth & care coordination, in which CDA-based exchange will be a key component. In these scenarios, Epic is focusing not just on the information exchanged but also how it dovetails into a seamless workflow for staff who are providing care for the patient spanning across organizational boundaries.
Expand the network to support image exchange between organizations. The long-term vision is to support full DICOM exchange and integrate it natively into the provider's workflow. Non-DICOM content will also be included, such as visible light images, scanned documents, and PDF reports.
Current Collaboration across Efforts
Care Everywhere is an implementer of the Carequality Framework. (source)
Care Everywhere is HISP agnostic and 82.5% of Care Everywhere participants use a DirectTrust accredited HISP. They’ve selected 45 unique HISPs across 12 different vendors.
Care Everywhere is a Qualified Technology Solution for the eHealth Exchange and have dozens of connections with Community HIEs.