Notes from Implementation Geographies Workgroup
Status of Notes: DRAFT
Date: May 7, 2010
Time: 2pm-3pm
Attendees: Honora Burnett, Arien Malec, Richard Elmore, David Kibbe, Douglas Arnold, Brian Ahier, Gary Christensen, Brett Peterson and Marla Kouche

Actions from This Week
#
Date
Action
Status
Owner
Due Date
6
5/7/10
WG will review the Implementation Operational Plan and edit or suggest additions in the discussion area
Open
WG
5/14/10
7
5/7/10
Arien will post draft of success criteria; WG will review these and edit or suggest additions in the discussion area
Open
Arien & WG
5/14/10
8
5/7/10
Arien will put measurements of success in the operational plan
Open
WG
5/14/10
9
5/7/10
Honora will send out 1) a list of all attendants to the group and 2) all the places we should be focusing on the website
Closed
Honora
5/14/10
10
5/7/10
Spin up the Project WG for the CT Pilot Project Team and select a Project Team Lead
Open
WG
5/14/10

Actions from Last Week
#
Date
Action
Status
Owner
Due Date
1
4/30/10
Ask VA for participation
Closed
Arien/Doug
5/7/10
2
4/30/10
Ask Indian Health Services for participation
Open
Arien/Doug
5/7/10
3
4/30/10
Publish list of potential geographies
Closed
Arien
5/7/10
4
4/30/10
Create a starter for operational plan
Closed
Arien
5/7/10
5
4/30/10
Think about forming a Communications & Outreach Workgroup
Closed
Arien
5/7/10
Decision from Last Week
#
Date
Action
1
4/30/10
Paul Tuten will be leader
2
4/30/10
Among Other stakeholders, the Action Plan will involve: Key EHR Tech vendors, HIEs/REC, Medical societies & Rural providers
3
4/30/10
The Action Plan will attempt to understand existing referral paths

Notes
Update on Action Items:
· Ask VA for participation: Honora Burnett will send Tim and Invite
· Ask Indian Health Services for participation IHS really strong leadership, but overwhelmed, best done if we can do referred to 2nd-3
· Brian – would like to set up a call with HIS to flesh out how we can move forward b
· Publish list of potential geographies Potential Implementation Geographies
· Create a starter for operational plan Implementation Operational Plan
· Think about to form a Communications & Outreach Workgroup: concerns raised by ONC about who has the communication ball
o David Kibbe has done a great job of posting
o HealthCare Blog HCB
o David meeting with QIO – Montana, Alaska, Hawaii
§ Report – people get it very quickly
§ Only trouble those pushing back on NHIN Direct – are those that are technically oriented
§ Group should look at David Kibbe’s blog post: http://kibbeandklepper.blogspot.com/2010/05/nhin-direct-getting-to-health-internet.html
David Kibbe & Doug Arnold: Discuss status of REST implementation group.
  • REST implementation in an area that is near Doug’s IPA
    • A variety of physicians and practices with a variety of approaches to ERH
      • Ex: Home Health Nurse, National Lab Company (Quest), HISP (med commons), FQHC
        • 400 Physicians in CT
        • eHealth CT
        • Close relationship with Quest and DocSite
        • A number of connectivity/interfaces that are already working
      • Need one more entity and maybe two who can serve as HISPs
      • Quest would love to participate (Marla Kouche for Tom Wagner)
  • Feedback from Arien – run with it!
Question from Brett Peterson
  • NHIN Direct concept of a “bake off”
  • Do you want to be part of this?
    • Both long term and short term

  • Consensus that the Geographies workgroup feels that this is fine
  • Spin up the Project Team for the CT Pilot Project Team and Project Team Lead
    • Different than the REST Implementation WG – but working with them
    • Elect one person to be the touch point
  • ONC Budgetary Question: HIE and Beacon build outs are on the same budget/framework
  • Make sure we keep the mission of the concrete implementation WG focused and understood
    • First iteration is not production ready code
Comment from Rich Elmore
· Appreciated the summary of the participants from the CT
· Captured the criteria of how we make these decisions
· Suggestion: other criteria to take into account – make sure we get the criteria right and then make the selection criteria
Comment from David Kibbe& Douglas Arnold
· How do we translate the “ready” into “aim”
· Posted a simple spreadsheet with some of the sub categories of user stories that we can work on already
· Issue is that there isn’t a HISP yet – need to identify and reach out to other entities
Comment from Brian Ahier
· “Aiming” will take place as we flesh out the implementation, operational plan
· Don’t want to slow anything down
Comment from Gary Christenson
· Approach question: series of more local projects that are collaborating
· Not seeing a limiting feature right now
o Arien: if there is a resource constraint that is project central, then that would be limiting (i.e. can’t guarantee that there is the right players or technology, that would be the only limiting factors)
· HISP issue – to what extent are we trying to “prove out”
o What we need to be proving out is the execution within doctors’ offices
o Connectivity/HISP/Backbone – how does this implement in doctor’s offices
§ Arien: national organizations involved in this project that can provide interesting roles as “uber-HISP”
§ An organization like Quest
§ Honora will send out a list of all attendants to the group and all the places we should be focusing on the website
§ CT not CT
Comment from Marla Kouche
· What are our measurements of success?
· Arien will put measurements of success in the operational plan
· Super set of metrics
· Define our projects to ensure that we are covering all the hypothesis that we want?
Comment from Brett Peterson
· First HISP will come out of the REST Implementation Bake Off

· Arien question RIQI is about individual involvement and diabetes management
o Laying the IT foundation for the medical home
o One implementation geography that demonstrates the individual involvement

· Anyone on the project that knows anyone on the Hampton Road’s VA project VLER
Honora Burnett, Arien Malec, Richard Elmore, David Kibbe, MD, Douglas Arnold, Brian Ahier, Gary Christensen, Brett Peterson and Marla Kouche
What, specifically, do we want to accomplish? What are the criteria that should bound our decisions/goals (e.g., is cross-state data exchange critical)? How should we flesh out the criteria in the Implementation Operational Plan beyond just Provider Mix?
  • Three operational success criteria
    • Provider mix is one criteria
    • Stakeholder engagement
    • Referral Patterns
  • WG will review the Implementation Operational Plan and review/edit or suggest additions in the discussion area
  • Arien will post draft of success criteria, WG will review these
  • Create “have to’s” and “aught tos” of implementations
Next time
  • How detailed should the operational plan become? Is this group expected to guide the execution of the plan?
  • How should we determine who the players will be?
  • Will there be one initiative or several?
· Hampton Road VA area – do we know any key players?
· RI – SHARP Proposal
· Draft of the implementation operational plan