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2014 Annual Report

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Table of Contents

COMPANIES

(OCT 4 – JAN 16)

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Table of Contents

A Letter from our Chairman . . . . . . . . . . . . . . . . . . . . . . . 2

Unveiling of CommonWell Health Alliance . . . . . . . . . . . 4

Our Formation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Launching CommonWell Health Alliance Services . . . . . 8

Our Initial Participating Providers . . . . . . . . . . . . . . . . . 10

Demonstrating Success . . . . . . . . . . . . . . . . . . . . . . . . 11

Ways to Engage with CommonWell Health Alliance . . . 12

Founding Members

Initial Service Provider

Contributing Members

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A Letter from our Chairman

You hear so many great stories of how companies and organizations first got started. Some are discovered in a classroom as part of a thesis project . Others are incubated in a home garage after work and over long weekends . Many are the result of great ideas nurtured over the course of a career .

CommonWell Health Alliance, endearingly nicknamed “Project BlueCo”, was more of a calling .

The BeginningIt began during a Bipartisan Policy Center meeting in May 2012 . Around the table sat some of our industry’s great minds, including Dr . Farzad Mostashari, then ONC National Coordinator for Health IT; Arien Malec, VP of Strategy at RelayHealth; and Dr . David McCallie, Senior VP for Medical Informatics at Cerner . During that meeting, Dr . Mostashari challenged the health IT leaders in the room to help solve one of the main challenges our U .S . health care system faces — building connections across patient health records . Soon thereafter, Arien and David each felt inclined to act and didn’t hesitate to reach across competitor lines to strengthen the cause . From this effort, CommonWell Health Alliance was born.

I wasn’t part of those initial discussions, but by the time HIMSS13 came around in New Orleans in March 2013, my company, athenahealth, became a founding member of the Alliance . It was amazing to see the reception and support the industry gave CommonWell . Since that exciting March day, it has been a whirlwind of activity, collaboration and results . While it was not always an easy process getting first five and then seven

member companies of all sizes and motivations to agree, I continue to marvel at how successful we are at keeping focused on our shared mission of data liquidity and provider accessibility, and how amicable each individual and member company is to each other to advance the greater cause .

Our Leadership in the IndustryWe broke down many more silos than just data access . The Alliance is now seen as a leader in the industry . From the Social Security Administration’s invitation to help guide its use case around electronic disability filing to ongoing conversations with fellow interoperability-focused organizations like ONC, CHIME, Carequality and eHealth Initiative, CommonWell is at the forefront of helping to improve the delivery of care for providers and the people they serve .

My favorite part of the past year was receiving an email on Jan . 24, 2014, telling me that CommonWell’s first provider went live. On day one, we had people enrolling, documents being queried…and we were celebrating as an industry, not as just one company .

Jeremy Delinsky

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I am pretty sure most people thought when we announced this Alliance that we might be all talk and little action . Less than one year later, we had 12 sites live with hundreds of people enrolled and dozens of clinicians leveraging our services daily . And we are delivering on our commitment to be transparent in our development and offerings, publishing our services and use case specifications for all to access.

It also has been gratifying to see the response we have received from organizations wanting to become a member of CommonWell . We continue to be inundated by hundreds of inbound emails, phone calls and personal outreach . It seems that organizations large and small understand the value our association can provide, not only to our industry, but also to their organization and clients .

I am sure many wonder why we have been so selective with our membership in our inaugural year . It really isn’t that complicated . We want to move fast . We want to ensure that our members and their clients received value quickly and comprehensively . We want to be thoughtful about the time and expense it takes to form a not‑for‑profit. Each of our now nine member companies brings a unique aspect to allow us to stay focused, yet visionary .

A Look ForwardIt truly feels like we have been riding a bullet train for the past 12 months, and I don’t think that is going to change in the near term . In 2014, we have a number of areas on which we are focused .

It is exciting to see what we have been able to accomplish in such a short time with our traditional EMR suppliers and are eager to broaden our services and use cases, as well as increase adoption .

We also feel like we are in a better position to more broadly open our membership to those who share our vision for interoperability . This summer, Contributor and General Memberships opportunities will be made available .

This next chapter for our Alliance is exciting . We are eager to tackle the challenges ahead and continue to break down barriers so data can flow freely . To date, we have been fortunate to have many individuals from our member companies volunteer their time and talent to our mission . To help us ensure success and continue to move forward quickly, we are kicking off the process to formally staff the Alliance, including hiring an Executive Director to lead our vision .

I hope you enjoy a look back at our first year. On behalf of the CommonWell Board, I can say we are deeply proud of all we have accomplished and look forward to what the next year has in store for us, for our members, for their provider organizations and for our industry and communities as a whole .

Best regards,

Jeremy Delinsky Chairman of the Board — CommonWell Health Alliance

Chief Technology Officer — athenahealth

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Unveiling of CommonWell Health Alliance

It started as a slow buzz leading up to HIMSS13 in New Orleans . A few headlines here and there were rumoring an alliance between Cerner and McKesson .1, 2

But it was so much more than that.

As the clock got closer to 11 am on March 4, 2013, the CEO sightings at the Hilton New Orleans Riverside began to stir the rumor mills . Taking the press conference stage alongside of McKesson and Cerner were staunch competitors Allscripts, athenahealth and Greenway. It was definitely a first for the health IT industry. Five leaders from competing companies smiling, hand shaking and congratulating each other . Together, in front of 100 press and industry leaders, as well as hundreds listening in on the webcast, they announced our industry‑defining effort around interoperability.

And CommonWell Health Alliance was born.

The next day’s HIMSS13 Daily Insider headline said it all: “A ‘Common’ Goal: …HIT heavy-hitters announce interoperability organization .” More than 70 different news articles ran over the next month highlighting the Alliance’s vision:

It seems the message resonated with many at the conference . Hundreds of people swarmed our booth, even though we were sequestered in the back of the exhibit floor. (That’s what happens when you decide to launch a new association just weeks prior to HIMSS .)

1 “Cerner alliance with McKesson is hinted .” Kansas City Star, Feb . 14, 2013 .

2 “McKesson, Cerner Talk Health IT Interoperability Alliance?” Information Week, Feb . 6, 2013

“ To break down the silos across our fragmented information system to ensure health data is available to individuals and providers regardless of where care occurs and that provider access to this data is built in health IT at a reasonable cost for use by a broad range of health care providers and the people they serve.”

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Farzad Mostashari, M.D., and e-Patient Dave even

stopped by to show their support.

We definitely were the buzz at HIMSS13.

Over the course of three days, we had more than three million impressions on Twitter and numerous industry leaders, including Janet Marchibroda, Bipartisan Policy Center; Adam Gale, KLAS; and John Moore, Chilmark Research, publically endorsing us .

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Arien Malec, VP of Strategy, RelayHealth

David McCallie, M.D. SVP of Medical Informatics, Cerner

Our Formation

What started out as five soon became seven. Our intent from the beginning was never to be the biggest association in the industry right out of the gates . In order to ensure success, we believed our membership numbers needed to be manageable and our companies needed to be agile enough to allow for the ability to make quick decisions, drive innovations forward and pilot our services within a year . They also needed to represent a wide breadth of the industry and allow for the testing our core use cases as we moved forward with building and releasing our initial specifications,

as well as piloting our services across varying geographies, provider types and venues of care .

As so, with the addition of CPSI and Sunquest in July 2013, CommonWell Health Alliance officially had seven founding members .

We are proud to be a vendor-led organization with a laser focus on embedding these interoperability services into the technology to enable seamless, trusted access to health care information across different settings of care.The idea for CommonWell Health Alliance

began with a conversation and shared vision by two industry thought leaders.

Board of Directors from left to right: Bob Robke, Cerner; Scott Schneider, CPSI; Keith Laughman, Sunquest; Jeremy Delinsky, athenahealth; Rod O’Reilly, McKesson; Justin Barnes, Greenway; Rich Elmore, Allscripts

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From the inception of CommonWell Health Alliance, we always had the aim to be a not‑for‑profit trade association, funded by membership fees, guided by bylaws and overseen by a Board of Directors . Working towards this goal started while many of us were still unpacking from HIMSS in New Orleans .

After eight months, numerous edits and countless attorney hours, we formally incorporated as a trade association on Oct . 4, 2013, released our Bylaws and elected our seven-member Board of Directors .

We formalized the governing structure of the Alliance and creating working groups with charters to ensure a dedicated focus to CommonWell goals . Each committee has representatives from each of the founding member organizations .

During this time, we also held three Member Summits in Kansas City, Chicago and Denver to bring our founding members together for working sessions, networking and solidifying our organizational structure and shared initiatives . It was focused, hard work mixed with a new-found respect for our industry colleagues and a camaraderie amongst members that was unthinkable just a year earlier .

Board ofDirectors

OperatingCommittee

Membership Marketing ProgramManagement

Standards, Tech,Implementation

(STIG)

Board of Directors: Provide oversight and direction for the Alliance; review and establish final decisions, changes, and procedures that influence CommonWell’s goals and direction

Operating Committee: Maintain oversight of the CommonWell objectives and initiatives

Membership Working Group: Define objectives for new member recruitment; outreach to potential members, including prospective member cultivation, stratification and follow-up; onboard new members

Marketing Working Group: Establish the Alliance brand; influence awareness and impressions of CommonWell; support the creation, review and distribution of marketing-related materials

Program Management Working Group: Facilitate objectives as it relates to the successful and scalable launch; maintain oversight of the services expansion

Standards, Technology and Implementation Working Group: Define, develop and test pilot use cases; ensure delivery of deployable and supportable solutions

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Launching CommonWell Health Alliance Services

“We should have overcome these interoperability challenges years ago. It’s the right thing to do for the patients. The cool thing about [CommonWell is] it’s presented in the context of what the provider is used to seeing for that system.”

— William “Tripp” Jennings, M.D. system vice president, medical informatics office

Palmetto Health, Columbia, SC

At the core of everything we do, we believe that in order for health IT to work, it must be inherently interoperable . As such, we are working hard to define and promote a national infrastructure with common standards and policies, as well as offer services that are embedded natively within vendors’ own software to help solve many of the challenges associated with interoperability .

To help us build and coordinate those services, we selected RelayHealth to be our initial service provider to deliver the core services necessary to ensure the nationwide federated network of HIT suppliers can securely, efficiently and accurately share patient data .

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Identity ManagementProvide a way for health IT

suppliers to quickly and accurately identify patients as they transition through

care facilities.

Record LocatorHelp providers locate and

access their patients’ records, regardless of where the encounter

occurred, by providing a “virtual table of contents” that

documents available data from each encounter

location.

Consent ManagementDeliver a patient-authorized

means to simplify management of data sharing consents and

authorizations.

Trusted Data AccessProvide authentication and

auditing services that facilitate trusted data sharing among

member systems.

Less than eight months from when we announced CommonWell Health Alliance, our founding members and RelayHealth, CommonWell’s initial service provider, hosted our first Connect-a-thon to test and validate these services. The event, which coincided with Halloween week, was filled with many more treats than tricks, and less than three months later our services were already implemented across multiple provider sites.Shortly thereafter, we published the key concepts, services specification and use case specification that provide detailed information on the initial core services, standards and workflow that allow CommonWell members to embed the services created by RelayHealth.

CommonWell Health Alliance isn’t looking to reinvent the wheel; we want to leverage the existing standards that our members already are using to enable scalable, secure and reliable interoperability as easily as possible. To that end we’ve built our services around widely adopted IHE standards for communicating patient identity (PIX via MLLP) and locating and retrieving patient data (XCA and XDS.b over SOAP). Where our services have gone beyond IHE standards, we’ve created RESTful services based on and extending the HL7 FHIR v0.08 specification. The security for these services also leverages industry standards including PKI, OAuth, JWT and SAML. This approach allows CommonWell Health Alliance members to integrate easily, find and link patients and start exchanging CDA documents.

Our initial services include:

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Within our first month live, we had 12 provider sites in production across four different geographies ranging from large cities like Chicago to the suburban and rural communities of Elkin, NC; Henderson, NC; and Columbia, SC .

All of this culminated with three of the provider organizations — Maria Parham Medical Center, Midlands Orthopaedics, PA, and Palmetto Health — coming together at HIMSS14 to share their initial experiences with implementing and using CommonWell services and technology .

“Within 24 hours of our ‘go live’, our team enrolled almost 200 patients in CommonWell’s services and we continue to enroll additional patients.”

— Randy Williams, director of IT Maria Parham Medical Center

Henderson, NC

Demonstrating SuccessOur Initial Participating Providers

Henderson,NCElkin,

NC

Chicago

Columbia,SC

Initial Service Launch: 4 Geographies, 12 Provider Participants

Client panel at HIMSS14 hosted by Janet Marchibroda, BPC

“One of the frustrations is that we have all this technology, and yet, we haven’t been able to truly trade that information electronically. The CommonWell pilot provides an opportunity to take the next step toward real data exchange so we’re excited to participate.”

— AnnMargaret McCraw, CEO Midlands Orthopaedics, PA

Columbia, SC

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Demonstrating Success

Just short of one year from when we announced the Alliance, we were back at HIMSS14 demonstrating how we have delivered upon the commitments we made at the previous year’s conference .

Our member companies had come together to work as one to achieve Interoperability for the Common Good . CommonWell services were live . Provider organizations were already querying and retrieving documents that previously were inaccessible . Our association was growing . And we felt the support, encouragement and excitement from the industry .

Hundreds of people stopped by our booth each day to hear live testimonials from our active provider organizations and view demonstrations of our live services in action . It was often overheard as you walked by the booth — “they did it!” and “wonderful to see how the services work across disparate systems!” We also had to have been one of the only booths where fierce competitors were encouraged to talk with one another and engage in partnership discussions around a common goal .

While at the conference, we unveiled two new and important members to the Alliance — CVS Caremark and MEDHOST, and announced that

Tenet Healthcare Corporation, with 77 hospitals in 14 states, signed a letter of intent to use the Alliance’s services .

And our industry helped rally around our shared vision #ForInterop across the health care system . Through Twitter, Facebook and onsite interactions, individuals and organizations became a Face for Interoperability, as we encouraged individuals

to share their stories for why access to health data is important to them . Photos continue to come in via our community website www .facesforinterop .org .

The shift from concept in 2013 to reality in 2014 was definitely felt throughout the conference and our industry .

And we have so much more in store for 2014…

Amazing crowds filled the booth for presentations

Demonstrations were provided by member companies throughout the conference

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A memberContributor &

General membership

A participating health care

providerAn advocate

Ways to Engage with CommonWell Health Alliance

• Applications now being accepted

• Membership officially opens in July 2014

• Membership Application, Agreement and Bylaws can be found on www .CommonWellAlliance .org

• Commercial services are scheduled to be launched in summer 2014

• Please express your interest via our website contact form www .CommonWellAlliance .org

• Contact your health IT supplier for details on how you can participate

• Join in on the conversation on our www .CommonWellCommunity .com blog

• Follow and engage with us on Twitter (@CommonWell), Facebook and LinkedIn

• Become a “Face for Interoperability” by Tweeting a picture tagged with #ForInterop

Interested in becoming…

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“We saw the lack of standards in this space that reinforces continued silos of information as untenable. Health care is in the information business, and making health data available for the benefit of the patient is very important. That is why being a part of CommonWell is so important — not only for our industry and clients but to the people our clients serve. “

— Keith Laughman, executive vice president of community care solutions — Sunquest Information Systems Board Member, CommonWell Health Alliance

From left to right: Executives from the seven founding member companies welcome new members at HIMSS14 in Orlando

From left to right:

John Hammergren, McKesson

Tee Green, Greenway

Richard Atkin, Sunquest

Craig Herrod, MEDHOST

Rich Elmore, Allscripts

Jeremy Delinsky, athenahealth

(Jonathan Bush, athenahealth)

Scott Tierney, CVS Caremark

Bob Humphrey, CPSI

Bob Robke, Cerner

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Interoperability for the Common Good