Care Everywhere

Care Everywhere
Name	Care Everywhere
Developer	Epic Systems Corporation
Initial release	2010s
Operating system	Microsoft Windows; macOS; Linux; Android; iOS
Platform	Electronic health record networks
License	Proprietary

Care Everywhere

Care Everywhere is a health information exchange (HIE) platform embedded within an electronic health record suite developed by Epic Systems Corporation. It facilitates health data sharing among hospitals, clinics, health systems, and payers across regional, national, and international networks involving institutions such as Mayo Clinic, Kaiser Permanente, Cleveland Clinic, Johns Hopkins Hospital, and Veterans Health Administration. The platform interfaces with standards and organizations including Health Level Seven International, CommonWell Health Alliance, Qualified Health Information Network, Centers for Medicare & Medicaid Services, and the Office of the National Coordinator for Health Information Technology.

Overview

Care Everywhere operates as an integrated module within Epic's electronic health record suite, enabling clinicians at institutions like Massachusetts General Hospital, UCLA Health, and Toronto General Hospital to query and retrieve patient records from participating organizations such as Intermountain Healthcare and Geisinger. It supports data exchange types recognized by HL7® FHIR®, Continuity of Care Document, and other formats endorsed by National Coordinator for Health Information Technology. The ecosystem connects stakeholders from academic medical centers to community practices, aligning with initiatives led by CommonWell Health Alliance and regulatory frameworks referenced by Health Resources and Services Administration and Centers for Medicare & Medicaid Services.

History and Development

Epic Systems Corporation, founded by Judy Faulkner, developed the platform as part of a broader roadmap that included integrations with ambulatory, inpatient, and payer systems used by organizations like Ascension (health system), Sutter Health, and Providence Health & Services. Early deployments paralleled federal incentives under the Health Information Technology for Economic and Clinical Health Act and were influenced by interoperability discussions in forums such as HIMSS and the Office of the National Coordinator for Health Information Technology. Strategic partnerships and competitive dynamics involved peers like Cerner Corporation (now part of Oracle Corporation), Allscripts, and consortia including Sequoia Project.

Technology and Interoperability

Technically, the platform implements exchange mechanisms compatible with HL7 FHIR, HL7 v2, and CCDA payloads, enabling crosswalks between disparate systems at institutions such as Stanford Health Care and NewYork-Presbyterian Hospital. It uses patient matching approaches similar to solutions promoted by Sequoia Project and identity frameworks referenced by Trusted Exchange Framework and Common Agreement participants. Connectivity options include direct peer-to-peer queries, hub-and-spoke configurations seen in regional HIEs like Indiana Health Information Exchange, and integrations with payer platforms used by UnitedHealth Group and Blue Cross Blue Shield Association affiliates.

Privacy, Security, and Compliance

Care Everywhere must comply with regulatory regimes overseen by U.S. Department of Health and Human Services, Office for Civil Rights (United States Department of Health and Human Services), and international privacy laws exemplified by General Data Protection Regulation. Security controls align with standards from National Institute of Standards and Technology and audit expectations enforced by Centers for Medicare & Medicaid Services. Implementations typically incorporate role-based access similar to practices at Johns Hopkins Hospital and consent management workflows influenced by guidance from Office of the National Coordinator for Health Information Technology and regional health authorities such as Ontario Ministry of Health.

Adoption and Use Cases

Hospitals, academic centers, large health systems, and integrated delivery networks deploy the platform for transitions of care involving organizations like Children's Hospital of Philadelphia, Dana-Farber Cancer Institute, and Mount Sinai Health System. Common use cases include emergency department encounters at institutions such as Brigham and Women's Hospital, transfer of care between Mayo Clinic campuses, longitudinal chronic disease management across Kaiser Permanente regions, and coordination with behavioral health providers and long-term care facilities affiliated with networks like CommonSpirit Health.

Criticisms and Limitations

Critiques have focused on vendor lock-in issues raised in debates involving Cerner Corporation, Allscripts, and federal policymakers, as well as concerns about incomplete data sharing highlighted by researchers at Harvard Medical School and advocacy groups including Consumers Union. Limitations cited include gaps in bi-directional flow compared to statewide HIEs such as eHealth Exchange, challenges with patient matching that echo problems reported by Sequoia Project, and variability in adoption and data quality across organizations from community hospitals to tertiary referral centers like UCSF Medical Center.

Future Directions and Innovations

Future development trajectories reference expanded support for HL7 FHIR APIs, integration with national directories promoted by Trusted Exchange Framework and Common Agreement, and tighter interoperability with payer platforms used by Centers for Medicare & Medicaid Services. Research collaborations with academic centers such as University of Washington and technology vendors including Google Health and Microsoft could drive innovations in federated query models, patient-mediated access aligned with initiatives by Apple Inc. and standards bodies like Health Level Seven International. Ongoing policy work by Office of the National Coordinator for Health Information Technology and procurement decisions by systems like Department of Veterans Affairs will shape adoption and functionality.

Category:Health information technology