News Archives

Carequality Accelerates Health Data Sharing

Nationwide Patient Data Exchange Across Networks Triples in 60 Days

We are thrilled to announce that Carequality is rapidly expanding and the rate at which new providers are enabled to share health data is accelerating. In fact, since we announced live exchange in August, our Carequality implementers have brought more than 11,000 clinics and 500 hospitals online. This means that more than 150,000 clinicians nationwide are now capable of sharing patient health data across technology and networks.

This impressive scale of connectivity is possible because the Carequality Interoperability Framework was developed by volunteers from across all of healthcare who understand the value of leveraging existing technologies and investments. The Framework is dynamic and flexible to work with all types of networks, including payers and vendors, as well as welcoming service providers such as patient portals, record locator services, and others.

We also need to thank our pioneering implementers. The leading healthcare IT organizations were the earliest to adopt the framework and encourage their clients and members to connect with others under the Carequality Framework. Their leadership is paving the way for others. Since our last announcement, we’ve welcomed three more implementers: Inovalon, Mana Health, and Medicity.

ONC Coordinator Dr. Washington Visits Carequality Participants in St. Louis  

Dr. Washington visited SSM Health St. Louis

Dr. Washington (center) visits with Dr. Dr. Richard Vaughn, CMIO, (left) and Dr. Peter Schoch, Vice President of Value-Based Care & Payment (right) of SSM Health (photo credit: SSM Health)

On Tuesday, Dr. Vindell Washington, National Coordinator for Health Information Technology, visited St. Louis-area healthcare clinics and a long-term care nursing facility to see real-world health data sharing via the Carequality Interoperability Framework. The site visit allowed participants to observe patient health records being shared across different electronic health record systems and record locator services. For example, SSM Health, including the St. Louis-area SSM Health Outpatient Center that Dr. Washington visited, uses Epic to receive patient files with multiple community partners who use NextGen, athenahealth®, MatrixCare with Kno2 interoperability services, and eClinicalWorks with Surescripts’ National Record Locator Service (NRLS).


Read the complete Carequality news release.


Carequality Needs You!

Now Hiring a Program Coordinator or Program Manager

The Carequality Interoperability Framework has attracted national attention and is growing quickly. In addition to new implementers and members, we are experiencing the dynamic scale of growth in Carequality Connections for which the framework was designed. This means we’re now hiring a Program Coordinator or Program Manager to support our diverse membership of providers, vendors, payers, and other stakeholder from across the healthcare ecosystem.tsp-icons-cq-executives

This individual will assist Carequality Director Dave Cassel in all areas of Carequality’s operations, including support for health information exchange activities, planning and running committee and working group meetings, and executing on strategic priorities identified by the Carequality Steering Committee. The position is full time and is based either in the Washington, DC or Madison, WI metropolitan areas.

If you are qualified and looking to join a great group of passionate folks, please consider applying. Know someone who would be perfect? Please share the word with your friend or colleague – we can’t wait to meet them.

Learn more about the vacancy on our Carequality careers page.



Carequality Continues to Attract Implementers

Welcome New Carequality Implementers
Inovalon and Medicity






This summer, Inovalon and Medicity became the 13th and 14th Carequality implementers, respectively. Inovalon is a technology company that combines advanced cloud-based data analytics, and data-driven intervention platforms to achieve meaningful insight and impact in clinical and quality outcomes, utilization, and financial performance across the healthcare landscape. Medicity is a provider of network-enabled population health, connecting thousands of facilities in more than 100 of the nation’s leading private and public health information networks.




Carequality Steering Committee and Advisory Council Changes

New Carequality Steering Committee Members

Congratulations to Andrew Kling of Geisinger, Dr. Steven Lane of Sutter Health, and Tushar Malhotra of eClinicalWorks on their new appointment to the Carequality Steering Committee.

We are also pleased to share that the following members will return for a new term: Nancy Beavin of Humana, Hans Buitendijk of Cerner, Kevin Isbell of Kaiser Permanente, and Kathy Lewis of Surescripts. The Steering Committee is responsible for Carequality’s strategic direction, and for the development and oversight of the Carequality interoperability framework. The new two year terms begin this month.


Now Seeking Advisory Council Nominations

The Advisory Council, like Carequality itself, is unique in that is seeks to embody the entire healthcare continuum. The diverse Council members include not only provider organizations, networks, and vendors, but also patient safety organizations, behavioral health organizations, government agencies, standards development organizations, and other health care settings such as labs, pharmacies, and long term care. Strengthen your engagement with Carequality and ensure your perspective is included by applying today.

Deadline for applications is Friday, October 28th.


Lights Turned On for Nation’s First Cross-Network Health Interoperability Framework!

The early adopters of Carequality are live!

After almost two years of planning and development, providers at select hospitals and clinics in four states are now sharing health patient data for increased care coordination and expected health outcome benefits. These providers are using athenahealth®, eClinicalWorks, Epic, HIETexas, NextGen and Surescripts to exchange data with other providers under the Carequality Interoperability Framework.

As roll-out of Carequality continues to expand across California, Minnesota, Texas, Virginia and the rest of the country, more than 3,000 clinics and 200 hospitals are now live and capable of sharing health data. Once fully implemented, this collaboration will represent healthcare’s largest ambulatory vendors, the largest e-prescribing vendor and 30% of the inpatient market.0816_CarequalityLive_Blog-03

Having a nationwide interoperability framework that unites disparate networks to enable their clients to communicate, like cell phone carriers in the telecommunications industry, marks an important step forward for healthcare. With the transient nature of patients, a single health IT network can’t address all of the needs of its patients, physicians, hospitals, pharmacies, and other healthcare organizations within that network’s reach. But when that single network joins the collective Carequality infrastructure, which is guided by a common set of rules and well-defined technical specifications, it enables individual networks to connect with other regional and national networks in the United States, despite geographic location or specific technology solution.

Carequality has an operating central participant directory and common set of rules that govern the secure exchange of data between disparate electronic health records (EHRs), record locator services (RLS) and health information exchanges (HIEs). The Carequality Interoperability Framework enables a seamless and unified process through which nationwide data exchange for patients and providers is conducted. The Carequality Interoperability Framework can help us replicate the success that other industries, such as banking, have made to allow disconnected networks, programs and platforms to inter-operate so a customer can go to any ATM machine from any bank and withdraw money.

Read the Carequality news release to learn more about the EHRs, record locator services and HIEs that are participating in today’s active exchange. We hope your organization joins Carequality and realizes the power of this united venture.

Carequality Steering Committee Application Process Now Open!

Apply to be a Carequality Leader Before July 29th.

Before you head out on your summer vacation, take a stand to support the acceleration of health data sharing by applying for the Carequality Steering Committee! We’re accepting applications to join the Steering Committee until July 29th.

The Steering Committee is responsible for Carequality’s strategic direction, and for the development and oversight of the Carequality Interoperability Framework. With input from the Carequality Advisory Council and other stakeholders, the Committee manages the work of Carequality, including adoption of new use cases and settling key decisions regarding our consensus-built Framework.

The Committee of 14 members balances continuity with fresh perspective by rotating terms so that 50% of the seats have terms expire each year. When this year’s seven open seats are filled, the committee will elect this session’s leadership. The Committee is currently led by Chair Dr. Michael Hodgkins, of the American Medical Association, and Vice Chair Hans Buitendijk, of Cerner.

The Carequality Interoperability Framework was published in December 2015 and has since been adopted by a dozen leading healthcare information networks. The implementation and production exchange of these and forthcoming members is the priority of the committee.

Learn more about the Steering Committee commitment and submit your application today.

Carequality FAQs

Carequality is a relatively new interoperability initiative of The Sequoia Project. We know you might have lots of questions, so below we have answers to the most frequently asked questions about Carequality. This is a growing list. If you have a question you don’t see below, please email us at

How is Carequality pronounced?
Care “e” quality

What is Carequality?
Carequality is a public-private initiative that enables widespread, operational connectivity between and among existing health IT data exchange programs and platforms. This connectivity is enabled by the Carequality Framework, which was developed and is maintained through a broad-stakeholder, consensus-based approach that brings together a diverse group of representatives from the private sector and government. The Carequality Framework does for health IT what the banking industry has accomplished in connecting ATM and ACH networks.

How is Carequality different?
Carequality is the only initiative implementing a common interoperability framework, driven by a public-private consensus process, to connect existing data exchange programs and platforms.
The essential elements that make up the framework to enable this widespread interoperability include:

  • Common rules of the road, based on collaboratively developed principles of trust
  • Implementation guides for each use case, defining technical, business, and policy requirements specific to that use case
  • A directory of participants across the data sharing networks

Is Carequality a data sharing network?
Carequality is not a data sharing network. It is a framework of legally binding business, policy, and technical requirements that allow the members of existing data sharing networks to communicate with the members of other networks, just as cell phone users can call other users regardless of their carrier.

As a physician, how do I join Carequality?
Carequality works by connecting what we call Implementers, who might be HIEs, EHR vendors, payers, clearinghouses, or other types of organizations. What these different groups have in common is that they can provide connectivity into data from many different sources. From a physician perspective, it’s analogous to using your cell phone; you have to sign up with a carrier, but once you do, you can call anyone, regardless of who they’ve chosen as their carrier. Just as you might get cell service through Verizon or AT&T, you might get Carequality connectivity through a local HIE, your EHR vendor, or some other service provider. Visit our Provider page for more information.

Who is involved in Carequality?
Carequality was founded by 35 members who supported the launch and continue to contribute to our ongoing success. Since the launch, many more organizations have joined as members or supporters, and volunteers from over 80 organizations across a diverse spectrum of government and the private sector have participated in Carequality’s work:

  • Physicians
  • Consumers
  • Government agencies
  • Data sharing networks
  • Payers
  • Emergency medical services
  • Behavioral health
  • Acute care
  • Long term care
  • Hospice & home care
  • Research
  • Public health
  • Vendors
  • Standards Development Organizations (SDOs)
  • Pharmacies








How does Carequality ensure broad stakeholder representation?
Carequality ensures broad stakeholder representation by providing a forum that is platform neutral, technology neutral, and inclusive of the viewpoints of stakeholders from across the care continuum. Each of Carequality’s constituent bodies – the Steering Committee, the Advisory Council, and the Work Groups – is chartered to ensure membership across a variety of stakeholders. In particular, the Advisory Council is specifically designed to be a larger body that will provide a voice for a wide set of stakeholders.

Who has signed to be a Carequality Implementer?
Organizations from across the healthcare industry have begun adopting this legally-binding Framework.
Organizations began adopting the Framework in January 2016, many are now live and enabling cross-network exchange for their customers.

  • athenahealth
  • Coordinated Care Oklahoma
  • eClinicalWorks
  • Epic
  • GE Healthcare
  • Inovalon
  • Integrated Data Services
  • Kno2
  • Medicity
  • Netsmart
  • NextGen Healthcare
  • OneRecord
  • Surescripts
  • Texas Health Services Authority/ HIETexas

What is the Carequality Interoperability Framework?
The comprehensive Framework consists of multiple elements, including legal terms, policy requirements, technical specifications, and governance processes, which operationalize data sharing under the previously approved Principles of Trust. All of these elements were developed under Carequality’s broad-stakeholder, inclusive process. The Framework is now available for health information exchange networks, vendors, payers, and others across the healthcare ecosystem to adopt, providing a practical approach to unlocking previously unseen levels of connectivity.

Organizations that adopt the Carequality Interoperability Framework can establish data sharing partnerships more quickly and uniformly than ever before, by leveraging existing networks and business relationships. Many physicians already are members of a health information exchange (HIE), or have access to connectivity through a vendor or service provider. The Framework allows these existing operations to access one another, with the potential to dramatically increase connectivity across healthcare, including provider organizations, payers, government agencies, and more.

How can my organization get involved in Carequality?
Organizations interested in participating in Carequality have multiple options. Interested parties can formally join the initiative as a member, or they can participate as a supporter or a volunteer. Organizations that can provide connectivity into data from a number of different organizations and sources can consider becoming an Implementer of the Carequality Framework. Contact us at for more information and to discuss the best fit for your organization.

How does Carequality relate to the eHealth Exchange?
Carequality and the eHealth Exchange are both managed by The Sequoia Project, but the initiatives are separate and distinct, each with its own mission, charter and governance.

Simply put, the eHealth Exchange is a nationwide data sharing network. Carequality aims to connect the eHealth Exchange with all other data sharing networks throughout the country, forming a nationwide, interconnected web of networks.

Learn more about the differences between Carequality and eHealth Exchange

Does Carequality include a Record Locator Service (RLS)?
Carequality is a common framework for health data sharing between existing data networks. We are not and do not offer a record locator service. We know that each network has individual needs – some have no need for an RLS, some need an RLS partner, and still others are an RLS themselves. Unlike other interoperability initiatives that require all members to purchase the same RLS, our flexible framework allows each member the freedom to choose the right RLS for them, if necessary at all.

How do I learn more about Carequality or express my organization’s interest in participating?
If you’re ready to get engaged with Carequality email Still not sure? We’re always ready to answer your questions as well.


Help Us Develop Patient Authorization Policy & Standards

Family on Map

Support Patients by Volunteering!

We hope you’re recovered from HIMSS16 and ready to roll-up your sleeves to join us in refining the Carequality Framework.

In many cases, healthcare providers may release the patient’s records without any specific consent or authorization. In some states, however, or for patients seen in certain facilities, authorization from the patient is needed in order to release the records. Today, there is no method via the Carequality Framework to communicate that records could be released if authorization has been given, or to assert that specific authorization has, in fact, been obtained.

Carequality is seeking volunteers for two new workgroups that will address this need.

The Technical Workgroup will focus on transactions and messaging approaches, and is best suited for those with knowledge of the standards and technologies used in the Query-Based Document Exchange Use Case.

The Policy Workgroup will focus on applying Carequality’s trust principles to the patient authorization approach, and is best suited for those with knowledge of medical records practices, Carequality’s trust principles, or both.

How to Volunteer for Carequality’s Patient Authorization Workgroups

If you or someone from your organization is interested in participating, please send an email to indicating which workgroup(s) (technical or policy) you are interested in, and briefly describe your qualifications. We’re soliciting applications until 5:00pm PDT on April 29, 2016.

To learn more about our Patient Authorization work, visit the Carequality Wiki (free registration required).

Coordinated Care Oklahoma, GE Healthcare, Kno2, Netsmart and OneRecord Adopt Carequality Framework

Just in time for HIMSS16, we are thrilled to announce the new round of Carequality Interoperability Framework adopters.

This month Coordinated Care Oklahoma, GE Healthcare, Kno2, Netsmart, and OneRecord became the latest to commit to nationwide health IT interoperability through the creation of network-to-network connections.

They join previous adopters athenahealth®, eClinicalWorks, Epic, NextGen Healthcare and Surescripts in committing to implement the novel approach to health data sharing.

The new adopters broaden the scope of Carequality implementation, highlighting the versatility of the Carequality Framework.  The inclusion of an HIE, a PHR, and a behavioral health vendor, along with a greatly expanded set of EHR users, brings Carequality connectivity into new parts of the healthcare ecosystem.

Read the Carequality News Release to learn more about the latest Carequality Interoperability Framework adopters and why they choose Carequality.

If you are going to HIMSS, plan on watching a live demonstration of health data sharing among and between Carequality members at The Sequoia Project booth (#454) at HIMSS16. This is a great opportunity to learn more about the Carequality Framework and chat with current adopters.

We look forward to seeing you!

Carequality Demonstration Planned for HIMSS16

We’re looking forward to seeing all our healthcare colleagues at the HIMSS16 annual conference, the healthcare IT event of the year.

Please plan on stopping by The Sequoia Project and Care Connectivity Consortium booth, #454, to catch-up on our latest activities. You can also pick up a free packet of Giant Sequoia Tree seeds—which we think are really cool—so you too can grow your participation in The Sequoia Project!

At The Sequoia Project booth, you can watch a Carequality demonstration with athenahealth, eCinicalWorks, Epic, NextGen Healthcare, and Surescripts, our first pioneering adopters of the Carequality Interoperability Framework.

The demonstration will run at Noon on Tuesday, March 1st, and Wednesday, March 2nd. The demonstration will run at 1 p.m. on Thursday, March 3rd.

An overview of Carequality and our latest activities will also be presented each day by Dave Cassel, Director of Carequality. See a complete listing of our HIMSS events.

In addition to the diverse presentations schedule at The Sequoia Project booth, you can catch these additional HIMSS events with The Sequoia Project staff and members:
• Tuesday, March 1 @ 7 a.m. – HIMSS16 Interoperability & Standards Breakfast Panel (featuring Eric Heflin, CTO of The Sequoia Project)
• Thursday, March 3 @ 8:30 a.m. – Report from the Frontline: A Panel of Carequality Members (moderated by Dave Cassel, Director of Carequality)
• Thursday, March 3 @ Noon – The Sequoia Project & Spreading Interoperability (presented by Mariann Yeager, CEO of The Sequoia Project)

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