Notes from the Implementation Geographies Meeting
Date: September 1, 2010
Time: 12pm-1pm
Attendees: Doug Arnold, Noam Arzt, Greg Chittam, Gary Christensen, Didi Davis, Karen Donovan, Hank Fanberg, Eric Heflin, Uvinie Hettiaratchy, Jack Kemery, David Kibbe, Srinivas Koka, John Moehrke, Parag More, Kate Nixon, Patrick Pyette, Will Ross, Vidit Saxena, Jas Singh, David Tao, Susan Torzewski, Paul Tuten

Current Actions

#
Date
Action
Status
Owner
Due Date
29
2010/08/11
Update Implementation Geographies Participation Guidelines - Check List
Open
Paul Tuten
2010/08/18
33
2010/08/17
Bring to Doc & Testing WG: Dispelling the mentality of "If it's going through Direct, then we can save a record"
Open
Paul Tuten and Chris Voigt
2010/08/25
37
2010/08/25
Compile list of unresolved issues from the Plan-a-thon and send to concerned bodies for review
Open
Paul Tuten
2010/09/01
39
2010/08/25
Update the Technology Providers x Pilots Crosswalk
Open
Pilot Leads: Gary Christensen, Doug Arnold, LeRoy Jones, Susan Torzewski, Frank Clark, Will Ross and Paul Tuten
2010/09/01
41
2010/08/25
Update wiki page for each individual pilot project, including the user stories being tested
Open
Remaining Pilot Leads: Doug Arnold, Susan Torzewski, Frank Clark and Paul Tuten
2010/09/01
43
2010/09/01
Update the User Story x Pilots Crosswalk
Open
Remaining Pilot Leads: Frank Clark
2010/09/08
44
2010/09/01
Update the Meaningful Use x Pilots Crosswalk
Open
Remaining Pilot Leads: Doug Arnold, LeRoy Jones, Frank Clark and Paul Tuten
2010/09/08
45
2010/09/01
Input requests into the Resource and Collaboration Needs for Pilot Projects
Open
Entire WG
2010/09/17
46
2010/09/01
Discuss off-line collaboration opportunities between the MPS and MedAllies pilot projects
Open
Doug Arnold, Parag More
2010/09/08
47
2010/09/01
Inform all pilot project leads about the agreed framework for addressing a two week plus absence in all facets of NHIN Direct by a pilot project
Open
Paul Tuten
2010/09/08
48
2010/09/01
Move the "Call for Consensus" to the front page of Documentation and Testing WG
Closed
Uvinie Hettiaratchy
2010/09/01
49
2010/09/01
Rename the "Implementation Geographies and Information Technology Providers" crosswalk to match the de facto naming conventions
Closed
Arien Malec
2010/09/01
50
2010/09/01
Vote regarding the "Call for Consensus" for the final version of the [[file/view/NHIN_Direct_Overview_ForConsensusFINAL.doc|NHIN Direct Overview document]]
Open
All participants of the WG
2010/09/08
51
2010/09/01
Edit the Deployment Models page to reflect XDR specifically
Closed
John Moehrke
2010/09/02

Actions from Last Week

#
Date
Action
Status
Owner
Due Date
29
2010/08/11
Update Implementation Geographies Participation Checklist
Open
Paul Tuten
2010/08/18
31
2010/08/11
Bring to Doc & Testing WG: Ensuring that the correct clinical message is being sent to the correct physician e-mail client, given physicians have multiple e-mail addresses at various practices
Tabled
Arien Malec
2010/08/18
33
2010/08/17
Bring to Doc & Testing WG: Dispelling the mentality of "If it's going through Direct, then we can save a record"
Open
Paul Tuten and Chris Voigt
2010/08/25
34
2010/08/17
Coordinate Reference Implementation WG update for the Geographies WG meetings
Closed
Paul Tuten and Susan Johnston
Recurring
35
2010/08/17
Compare user stories v. final rule on MU
Closed
Pilot Leads: Gary Christensen, Doug Arnold, LeRoy Jones, Susan Torzewski, Frank Clark, Will Ross and Paul Tuten
2010/09/01
37
2010/08/25
Compile list of unresolved issues from the Plan-a-thon and send to concerned bodies for review
Open
Paul Tuten
2010/09/01
38
2010/08/25
Confirm accuracy of Geographies and Reference Implementation items on the Progress Tracker and provide feedback
Closed
Brian Behlendorf, Umesh Madan, Paul Tuten
2010/09/01
39
2010/08/25
Update the Technology Providers x Pilots Crosswalk
Open
Pilot Leads: Gary Christensen, Doug Arnold, LeRoy Jones, Susan Torzewski, Frank Clark, Will Ross and Paul Tuten
2010/09/01
40
2010/08/25
Crosswalk user stories v. pilots
Closed
Pilot Leads: Gary Christensen, Doug Arnold, LeRoy Jones, Susan Torzewski, Frank Clark, Will Ross and Paul Tuten
2010/09/01
41
2010/08/25
Update wiki page for each individual pilot project, including the user stories being tested
Open
Pilot Leads: Gary Christensen, Doug Arnold, LeRoy Jones, Susan Torzewski, Frank Clark, Will Ross and Paul Tuten
2010/09/01
42
2010/08/25
Talk off-line about the State of California technology road map and compatibility issues facing NHIN Direct
Closed
Will Ross and Arien Malec
2010/09/01

Status of Pilot Projects


Rhode Island Quality Institute (RIQI)
Gary Christensen
  • Stated that RIQI is looking into potential HISPs for their pilot project
  • Posted the RIQI's framework for their project plan to their Shared Documents page
    • Aiming to "get their ducks in order'
  • Currently organizing their project's Gantt Chart
  • Asked if Greg Chittam had anything to add
Greg Chittam
  • Responded that he had nothing to add

Medical Professional Services (MPS)
Doug Arnold
  • Commented that MPS is waiting for final reference implementations
    • MPS wants to understand the final levels of connectivity before advancing their pilot

MedAllies
Parag More
  • Addressed group on behalf of LeRoy Jones
  • Reported that MedAllies is currently determining likely candidates for participation in their pilot project
    • Received commitment from two more vendors, raising total to four
      • Siemens (Recent)
      • Allscripts (Recent)
      • eClinicalWorks
      • Greenway Medical
    • Stressed the group should look at the "how part" in terms of implementation capabilities
    • Also asked about the clinical work plan implications
  • Clarified that MedAllies has no immediate needs at the moment

CareSpark
Susan Torzewski
  • Reported that CareSpark is concentrating on the work-flow currently
    • They have plenty of questions
    • Asked how the pilot impact the following:
      • Stakeholders
      • Staff
      • Patients
  • Added that CareSpark is working on data modeling
    • Asked how information is communicated to a patient
  • Held four two-hour sessions to work out these issues
    • There were a multitude of staff from the VA
  • Addressed their secure messaging component
    • CareSpark side is prepared
    • Waiting on the VA's components
  • Recognized that the current work-flow they are working on is not as technical
  • Expressed expectation that pilot projects will collaborate on best practices

Carolina eHealth Alliance
  • Not present

Redwood MedNet
Will Ross
  • Communicated to the WG about Redwood MedNet's current resource constraint
    • Redwood MedNet does not currently have a funded project manager
    • Currently Will Ross is coordinating the project on an ad hoc basis when time is available
    • However, there is good news for the funding front
      • In a couple weeks Redwood MedNet aims to have a dedicated resource to their NHIN Direct pilot project
  • Drew WG's attention to the Meaningful Use x Pilots Crosswalk he created
    • Added that the MU criteria is the most significant part of the NHIN Direct project for Redwood MedNet
    • Holding substantial meetings on the work-flow
      • Based the work-flow on the local clinical offices
      • Trying to find places locally that aim to use NHIN Direct to achieve either one or two MU criteria
Paul Tuten

VisionShare and Public Health
Paul Tuten
  • Reported that VisionShare is still in the same place as last week
    • Still waiting for the approval from various government different agencies
      • From the public health standpoint
    • VisionShare has communicated with many states
      • Three to four states are close to officially joining the pilot project
      • Those states have asked to not disclose their potential involvement until approved
Arien Malec
  • Commented that a number of states use a common technology platform
  • Proposed that VisionShare may be able to enable a "one-stop shop" for immunization reporting for all those states
Paul Tuten
  • Responded that VisionShare is cognizant of the common technology platform
  • However, added that VisionShare has engaged states who belong to either camp
    • Those states that share a common technology platform
    • Those states that do not have such a technology platform, and work independently instead
Will Ross
  • Added that the state of California itself has nine different immunization registries alone
    • Will Ross is working with only two of them simply due to work-flow issues
Paul Tuten
  • Shared with the group that VisionShare is not working with California
Gary Christensen
  • Added that neither Connecticut nor Massachusetts have centralized registries for immunization records
Doug Arnold
  • Raised a general question about overlap of technology providers across the pilot projects
    • MPS is also working with eClinicalWorks, Quest, etc.
    • Recognized overlap of some of their vendors with the MedAllies pilot project
    • Asked if they can create an interface to keep track of vendors that have committed
Arien Malec
  • Recognized that Doug Arnold's question is the perfect segway to the Technology Providers x Pilots Crosswalk
    • This is a possible way for vendors to support multiple pilots in one go
    • Would like to have the crosswalk updated by each pilot project
Will Ross
  • Cautioned that the pilot projects should not be too overly optimistic
    • Shared that Redwood MedNet is on a waiting list for one of the HISP vendors that are supporting another pilot project
    • Suggested to not assume that "if a vendor is on the cross walk, they have extra resources"
Arien Malec
  • Stated that the pilot projects are hence incentivized to act early in contacting technology providers
Parag More
  • Expressed belied that this is a great opportunity
    • From the technical perspective there is a great benefit for collaborating
  • Recognized that the starting point is filling up the Technology Providers x Pilots Crosswalk
  • Decided to have an off-line discussion about collaboration with Doug Arnold
Jack Kemery
  • Identified that Jack Kemery from Labcorp joined the call after roll
  • Informed the WG that Labcorp would be willing to help out as a technology provider
Paul Tuten
Arien Malec
  • Thanked Labcorp for their participation and offer to assist the pilot projects
    • Recognized that the two largest reference labs involved
  • Suggested that if you have access to that lab information
    • You are helping your providers meeting the MU criteria from a transport perspective
    • There are still problems regarding implementation from the HL7 perspective

Discussion on Repercussions for Inactive Pilot Projects

Paul Tuten
  • Highlighted that there have been pilots that have not been the most active
  • Suggested action be taken if a pilot effectively goes radio silent for two full weeks - this includes:
    • No updates on the wiki
    • Not on the calls
    • Not reaching out to anyone on the WG
  • If that is the case, suggested that then the pilot project should fall off the "list of active pilot projects"
  • Recognized the need for him to update the Implementation Geographies Participation Guidelines - Check List
    • Will reflect Paul Tuten's expectations for each pilot project
  • Asked for any objections to his proposal
    • Expressed willingness to have "Round the Room" on the issue
Doug Arnold
  • Expressed agreement with Paul Tuten's proposal
  • Suggested informing all the groups who have not been on the calls of recent
    • Does not wish blind side someone
    • Ex: Someone may have potentially been on vacation, etc.
Paul Tuten
  • Clarified that his proposal is more of a policy perspective moving forward
    • Doe not aim to retroactively punish anyone
    • Ultimately, pilot projects need to have a reason why they are not active
  • Recognized there were no further objections
    • Reached agreement around Paul Tuten's proposal
    • Paul Tuten will update the guidelines (ACTION ITEM)
    • Paul Tuten will contact the pilot leads
Noam Arzt
  • Questioned about when a pilot project does qualify as no longer active
    • Do you label the pilot project as "suspended?"
    • Do you delete the pilot project from the Wiki?
Paul Tuten
  • Believes there is a benefit to keep the pilot project's Wiki page over time
    • Does not believe it is worth deleting
    • Suggested removing from the Geographies WG main page, and place somewhere else less visible
Gary Christensen
  • Asked if there was a compelling reason why this matters so much
    • Asked if it cost the WG anything
Arien Malec
  • Responded that the NHIN Direct Implementation Geographies WG is a very visible and public area
    • Arien Malec constantly has people asking him for updates on the various pilots
    • If a pilot project is listed there, then they need to have a highly likelihood of going live
Gary Christensen
  • Satisfied with Arien Malec's explanation
Paul Tuten
  • Expressed his agreement with Arien Malec as well
  • Explained that delinquent pilot projects misrepresent the hard work that other pilot projects are putting in

Question and Answer Session

Paul Tuten
  • Recognized that there are more documents to review next week
Doug Arnold
  • Asked the WG to look at the documentation precisely on the Communications WG Wiki page
  • Highlighted how their material enabled Doug Arnold to explain NHIN Direct to CT state technocrats
David Tao
Uvinie Hettiaratchy
Arien Malec
Hank Fanberg
  • Admitted that he is not the most tech-versed
  • Highlighted one of their technology providers with respect to messaging
    • Asked: If they have a proprietary methodology, do we need to substitute that with the NHIN Direct code?
Arien Malec
  • Pointed Hank Fanberg in direction of the Consensus overview
    • The Consensus overview does note that it is permissible if:
      • You know the endpoints
      • Satisfy the listed requirements
    • So you can use an proprietary API
      • Need to be open to sharing and sending to those without a proprietary API
    • Long way of saying that somebody who just uses a propriety address is not good
      • If you can send and receive from others then you are good
David Tao
Arien Malec
  • Stated that anyone who can take the issue is free to edit said pages
John Moehrke
Arien Malec
  • Wrapped up the Geographies WG meeting
    • Gets energized during these meetings
    • Recently had walked out of an internal ONC meeting about State HIEs
    • Can see general excitement across the board about health information exchange
    • Thanked everyone for the progress they had made
Doug Arnold
  • Thanked Arien Malec for his continued leadership
Paul Tuten
  • Thanked everyone and told them to enjoy the holiday weekend

Agenda

  1. Status Updates and Needs from Pilot Projects
  2. Discuss Repercussions for Inactive Pilot Projects
  3. Question and Answer Session