EHR Interoperability Solutions

Elizabeth Buckle discusses the interoperability questions healthcare organizations should ask before choosing a new EHR for 2019. Recently, Deloitte surveyed 624 primary care and specialty physicians on their attitudes toward EHRs and found that interoperability is their top concern with 62 percent of those surveyed saying they’d like their current system to be more interoperable.

Elizabeth Buckle currently serves as manager of interoperability solutions, product management at Greenway Health, a leading health information technology and services provider. In addition to being a subject matter expert for interoperability solutions in product management, Elizabeth has been a project coordinator and product analyst for interoperability. She also is a co-chair of the Deployment & Utilization Committee at CommonWell Health Alliance.


Neal Howard: Hello and welcome to the program. I’m your host Neal Howard here on Health Professional Radio, glad that you could join us today. Our guest today is Elizabeth Buckle, she’s manager of Interoperability Solutions product management at Greenway Health and she’s joining us here on the program today to talk about Interoperability and some of the questions that healthcare organizations should be asking before they choose a new EHR for the coming year. Welcome to the program Elizabeth, thank you for joining us today.

Elizabeth Buckle: Hi, thank you for having me.

Neal: Well first of all, interoperability – what is interoperability and what does it mean specifically to healthcare organizations?

Elizabeth: Sure. So interoperability is the ability to easily and effectively share data that is important for each individual care episode for a patient. So this means that effective interoperability isn’t just sending anything and everything under the sun, but really making sure that providers are able to send and receive exactly what is needed to make informed decisions about their patient’s care and to be able to do so within their workflow.

Neal: So are we talking about a human that actually sifts through each individual request for information or do you have a platform that can determine what is needed and what is not in each individual request?

Elizabeth: Sure. So it definitely depends on the use case or situation, but really what we’re trying to get at here is the ability to have certain configurations and settings to take that manual step out of the process and really say “in this particular scenario, this is the most important data that needs to be exchanged.”

Neal: So when it comes to I guess managing that interoperability, do you go in and manually babysit these organizations until they’re up to speed and all of their current systems are working seamlessly with whichever system you decide to implement? Is that how it works or is there something else going on?

Elizabeth: When you say manually babysit, there are certain phases that an integration will go through and with any model, with any EHR, it likely works the same. When two different systems are looking to exchange data with each other, there’s an integration period and that would be probably more of the babysitting step where there’s actual technical developers or project managers who are reviewing the transition of data back and forth to make sure that it is in fact meeting the goals set forward by the different organizations that are exchanging their data back and forth. But really, the ultimate solution is then at that point once those parties agree that the data exchange is meeting their needs that everyone can step back and allow that to take place with as little manual intervention as possible.

Neal: So I would assume that going through that transition as quickly as possible would be beneficial. What types of questions up front should an organization be asking before they choose an EHR vendor for this coming year?

Elizabeth: Yes, absolutely. So you’re right, it is important to make sure that those discussions around what the expectation is for the the practice who might be searching for a new EHR, that they ask those questions upfront. So EHR companies across the board or at different stages of interoperability maturity, so ensuring that you get a level of interoperability that works well for your practice really depends on proper discovery upfront during the EHR search. So for example, if a practice wants to exchange data, a clinic wants to exchange data with their local hospital but in the search process, they don’t discuss this upfront with the EHR vendor, they may choose an EHR vendor that doesn’t have that capability or that that has it but it’s a clunky  workflow or it doesn’t really fit within their natural workflow within the application. So it is very important to discuss this upfront and it’s not to say that the responsibility is solely on the practice. The EHR company has a responsibility here as well, so at Greenway we do place a lot of emphasis on proper discovery in those conversations with potential partners just to discover exactly what they’re going to want to achieve both within the application and also as it relates to data exchange.

Neal: Is there ever an instance where an organization, their system isn’t I guess for lack of a better term mature enough to take on say an upgrade of your level? Do you steer them in another direction or do you always try to bring their systems up to speed with the latest in EHR technology regardless of their level of technology?

Elizabeth: That’s a good question. So at Greenway, we have data exchange models with many different vendors and and those different vendors may connect to other EHR systems, they may connect to payroll organizations, labs, radiology systems, really the scope is endless. And all of those different connections can use a different maturity level I guess you could say of data exchange and so at Greenway, we’re able to support a great deal of that and then there’s new standards that are quickly coming on board and so we’re working through the best process to keep up with those standards, the new ones that come up while still maintaining some of the older, more legacy standards as well because we understand that in this environment that there’s just a large variation in what can be supported across different vendors and so we need to also be able to handle that as well.

Neal: Would you say that Greenway health is involved in defragmenting the space as far as EHR selection is concerned? And in defragmenting that space, do you focus more on larger healthcare facilities or the smaller facilities where a few doctors have gotten together and formed a practice?

Elizabeth: I would say that it’s really all of the above. We focus on from a data exchange perspective, we focus on what’s most important to meet our customers’ needs so we focus on big and small. One of the larger initiatives that we have spent a great deal of time focusing in on is the care quality pilot. So we have participated through our Commonwealth Services Agreement that we have through the Commonwealth Alliance, we have participated in a care quality pilot that’s going to open up the ability to exchange data with around 1,500 hospitals and 39,000 clinics in addition to the already around 11,000 or so organizations that are on the Commonwealth network. So those organizations can be big and can also be small, so it’s really a large variation on the spectrum of who we can exchange data with. So our focus is really on just opening up the ability and then allowing our customers to select what makes the most sense for their organization.

Neal: Give us a website where we can go and learn more about Greenway Health and a bit more about this Interoperability Solutions that you offer.

Elizabeth: Sure, so for more information you can visit us at We do have an interoperability page with a lot more information on what we offer.

Neal: Elizabeth, thank you for joining us on the program today.

Elizabeth: Sure, thank you so much for having me.

Neal: Elizabeth Buckle, manager of interoperability solutions product management at Greenway Health, thank you so much. You’ve been listening to Health Professional Radio, I’m your host Neal Howard. Transcripts and audio of this program are available at and You could also subscribe to this podcast on iTunes, listen in and download at SoundCloud and be sure and visit our Affiliate Page at and

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