Chatting with IHIE Engagement Director Chuck Christian, Chapter 2

If the mark of a good leader is the ability to evolve, as many believe it is, then Chuck Christian may be one of the greatest. Throughout his career, he’s been a staunch advocate for state’s rights, and a firm believer that healthcare is provided locally, and therefore should be governed locally. But as someone who has been heavily involved in advancing data sharing (both as Director of Executive Engagement with the Indiana Health Information Exchange, as well as an active member of CHIME and HIMSS), he has seen the challenges created by the lack of an overarching consent model. And so, he believes perhaps it’s time to make some compromises.

Recently, we spoke with Christian about why he believes the patient-centered data home model could be a difference maker, the need for better education and more transparency when it comes to data access, and what he hopes to see from ONC’s proposed rule. He also provides his thoughts on CommonWell and Carequality, the obstacles still facing smaller facilities when it comes to federal regulations, and what he believes is the key to effective advocacy.

Chapter 1

Chapter 2



* Continued growth of PCDHs – “The data is following the patient wherever they seek care.”

* HIEs & the concept of “regional hubs”

* CommonWell & Carequality – “How do we support population health using that type of model?”

* Vendor adoption trends in KLAS’ Interoperability report

* Direct Messaging in rural areas – “We use the tools we have.”

* DirectTrust: “It works well, but does it work for everything?”

* Thoughts on TEFCA



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Bold Statements

The Carequality platform has been filling those gaps, but it’s going to be around a very small and defined number of use cases. I’m waiting for a deeper explanation or conversation around, how do we support population level health using that type of model?’

They’re kind of like Apple. If they can control both ends of the transaction, it works great. But it used to be if you tried to get data from a facility that doesn’t use Epic, it didn’t work well. I think that’s getting better too, because we’re getting better with the standards.

Interoperability isn’t like the Lord of the Rings. There isn’t going to be one ring that controls all. I think that it’s going to be more like Six Sigma, and it’s going to depend upon the need at the time and the market.

I’ve tried to put myself in the position of people in the federal government who are having these conversations. What they’re hearing is, ‘I don’t have a standard way to connect to the highway. I’ve got this vendor who wants to do it this way, and this vendor who wants to do it that way.’

To get to a broader community, people want one way of doing it. I understand that. Particularly if you’re a physician practice — you just want to plug it in, but the question, is what do you plug it into?

Christian:  One thing we’re seeing is that the Patient-Centered Data Home continues to grow. We continue to gain members and the transaction rates continue to increase, but it’s only going to happen based upon where people need the data. And access to that data is controlled by the patient walking into a facility that is not in their home HIE space. Basically, the data follows the patient wherever they get care.

It’s kind of simple, but it hasn’t been simple to implement, because there are a lot of questions we need to ask. Does everybody need to be connected to everybody? No. Let’s do a model that looks like the federal banks. I believe there are 13 Federal Reserve Banks that move transactions back and for...