2014 IGW Regular Meeting Schedule:

January 29 (4th Wednesday due to ONC Annual Meeting)
February 19
March 19
April 16
May 21
June 18
July 16
August 20
September 17
October 15
November 19
December 17

All meetings are held at 12 noon Eastern.

Conf bridge: 1-866-816-4209 (participant code: 3980879)

If you'd like to be added to the meeting calendar invitation, please email Paul Tuten: paul.tuten[at]

Attendance Tracker for Workgroup meetings

In order to streamline attendance tracking for each workgroup, there is a new form at the bottom of each workgroup page that participants should use to "sign in" at the start of each workgroup call. If you are not at a computer during the call, the workgroup lead will ask that you state your name and organization at the start of the call to be sure your attendance is recorded. Click here to access the form for the Implementation Geographies workgroup ONLY. For other workgroups' attendance forms, see the link on the respective landing pages.


When originally formed, the Implementation Geographies Workgroup (IGW) was intended to support initial pilot projects using Direct standards by assisting with implementation/operational issues through a collaborative, community-based exchange of ideas and experiences. In doing so, the IGW sought to both demonstrate the potential for Direct, as well as to provide some of the experiential knowledge required to ultimately ensure its long-term success as a means of simple, secure, and scalable health information exchange.

Having addressed this initial charter through a series of successful pilots, the Implementation Geographies workgroup has continued to exist as a community of practice, sharing and exchanging ideas, issues, and experiences in an open and collaborative environment. Participants have found these robust discussions helpful to their own projects, and the IGW believes that its collective experiences continue to positively influence the future course of the Direct standard, as well as associated policies and best practices.

At the same time, Direct has begun to enjoy more widespread adoption in HIEs at the state, regional, and local levels. In the case of many of these organizations, project leaders have reached out to IGW participants for guidance and feedback. To that end, the IGW has restructured itself to enable new Direct Project implementations to participate in our collaborative workgroup.

All documents related to the IGW's initial pilot stage remain linked and available at the IGW Pilot Stage Archive (2010-2011) wiki page, which contains a bounty of useful information and historical context on the initial 'real-world' implementations of the NwHIN Direct standards.

Purpose and Goals

Provide a powerful demonstration of cross-organizational continuity of care.

Operating Model

Meetings follow a format for topical discussions (as outlined above) and may also include special presentations from an Implementation Geography, other Direct Project / S&I Framework workgroup, governmental agency, or invited industry speaker(s), as appropriate.

Discussions will include topics such as:
  • Implementation issues / challenges
  • Establishing operational policies and procedures
  • Launching Direct to the provider community
  • Operational issues / challenges
  • Driving adoption of Direct at the provider level
  • Innovations in the use of Direct
  • Benchmarking / success metrics

IGW participants are expected to maintain a wiki page for their respective implementation(s)/project(s), which shall include at least monthly status updates

Deliverables up for Consensus

  • None at this time.

Consensus Approved Deliverables

Work in Progress / Documents

Several sub-workgroups are active as a result of the Direct Scalable Trust Forum held in November, 2012:

View 2010-2011 IGW Pilot Stage Working Documents

Active Implementation Geographies

Several Direct Project implementations are starting up or operating across the country. Each is explained below using a briefing document template (also linked below). The Implementation Geographies Workgroup uses its weekly conference call to receive updates from these implementations and collaborate in order to help each initiative achieve maximum success.

To enroll your implementation, create a new wiki page using the Implementation Brief Template as a guide and create a link to the new page below.

Pilot Project Brief - Rhode Island Quality Institute (shared documents)
Pilot Project Brief - MedAllies (Shared Documents)
Pilot Project Brief - Health Information Partnership for Tennessee/Veterans Affairs
Pilot Project Brief - Redwood MedNet
Pilot Project Brief – Cerner Corporation
Pilot Project Brief - MEDfx
Pilot Project Brief - Arizona NW-HIN Pilot
Pilot Project Brief - Gorge Health Connect Pilot
Project Brief -- Florida HIE

Our Schedule

We meet via phone from 12:00 p.m. to 1:00 p.m. ET on the 3rd Wednesday of the month.


Workgroup Lead: Paul Tuten
Implementation Geography represented (if any)
Richard Elmore

Dave Monic

Michelle Del Guercio
Atlas Medical (Atlas Development Corp.)

Amber Broadwater-Martinez

Francois Andry

Jonah Frohlich
California Health and Human Service Agency

Chris Voigt
CareSpark/MobileMD (HIE Tech)
Susan Torzewski
Douglas Arnold
Clinical Groupware Collaborative

David C. Kibbe, MD
Clinical Groupware Collaborative

Douglas McLeod
Community Choice PHCO

Bhawna Batra

Vidit Saxena

Julie Maas
EMR Direct

Luis Maas
EMR Direct

John Williams
Garden State Health Systems

Michael Firriolo
Garden State Health Systems

Susan Johnston
GSI Health

Noam Arzt
HLN Consulting, LLC

Jeff Cunningham

Pat Pyette
Rhode Island Quality Institute
Bruce Schreiber

Lee Jones

Parag More
MedAllies - Hudson Valley - NY
Mark Bamberg
MEDfx - MedVirginia - Verizon - Dominion
Frank Clark
Medical University of SC, South Carolina Research Authority

Eric Heflin

Mark Stine
MedPlus, Inc./Quest Diagnostics

Tom Wagner
MedPlus, Inc./Quest Diagnostics

Marla Kouche

Umesh Madan

Chris Voigt
MobileMD - CareSpark HIE Tech

Robert Barker
NextGen Healthcare Information Systems, Inc.

Yvan Charpentier
NextGen Healthcare Information Systems, Inc.

Chris Harris
NextGen Healthcare Information Systems, Inc.

Brian Ahier
Gorge Health Connect
Gorge Health Connect/Medicity
Will Ross
Redwood MedNet
Northern California
Gary Christensen
Rhode Island Quality Institute
Rhode Island Quality Institute
Greg Chittim
Arcadia Solutions
Rhode Island Quality Institute
Didi Davis
Serendipity Health, LLC
Health Information Partnership for Tennessee
David Tao
MedAllies - Hudson Valley - NY (Albany Med Ctr)
Sri Koka
Techsant Technologies

Paul Tuten
Consultant, State HIE Program ONC

Bob DeAnna
Recursion Software

Vaibhav Bhandari

Meeting Notes / Agenda

Geographies Meeting 2013-12-18
Geographies Meeting 2013-11-13 -- Did not hold due to logistical problems
Geographies Meeting 2013-10-16 -- Did not hold due to govt. shutdown
Geographies Meeting 2013-09-18
Geographies Meeting 2013-08-21
Geographies Meeting 2013-07-17
Geographies Meeting 2013-05-29
Geographies Meeting 2013-04-17
Geographies Meeting 2013-03-20
Geographies Meeting 2013-02-20
Geographies Meeting 2013-02-06
Geographies Meeting 2012-12-05
Geographies Meeting 2012-11-14
Geographies Meeting 2012-10-17
Geographies Meeting 2012-10-02
Geographies Meeting 2012-09-19
Geographies Meeting 2012-08-22
Geographies Meeting 2012-08-08 -- Did not hold due to logistical problems
Geographies Meeting 2012-08-01 -- Cancelled due to recombining Pre- and Post-Implementation Tracks (next meeting on 8/8/12)
Geographies Meeting 2012-07-25 -- Post-Implementation Track
Geographies Meeting 2012-07-18 -- Pre-Implementation Track
Geographies Meeting 2012-07-11 -- Post-Implementation Track
Geogrpahies Meeting 2012-07-04 -- Cancelled due to Independence Day holiday
Geographies Meeting 2012-06-27 -- Post-Implementation Track (Note: this meeting was cancelled)
Geographies Meeting 2012-06-20 -- Pre-Implementation Track
Geographies Meeting 2012-06-13 -- Post-Implementation Track
Geographies Meeting 2012-06-06 -- Pre-Implementation Track
Geographies Meeting 2012-05-23 -- Pre-Implementation Track
Geographies Meeting 2012-05-16 -- Post-Implementation Track
Geographies Meeting 2012-04-25 -- Pre-Implementation Track
No Meeting on 2012-04-11 due to S&I F2F
Geographies Meeting 2012-04-04 -- Post-Implementation Track
Geographies Meeting 2012-03-28 -- Pre-Implementation Track
Geographies Meeting 2012-03-21 -- Post-Implementation Track (Note: this meeting was cancelled)
Geographies Meeting 2012-03-14 -- Pre-Implementation Track
Geographies Meeting 2012-03-07 -- Post-Implementation Track
Geographies Meeting 2012-02-29 -- Pre-Implementation Track
Geographies Meeting 2012-02-15 -- Pre-Implementation Track
Geographies Meeting 2012-02-08 -- Post-Implementation Track
Geographies Meeting 2012-02-01 -- Pre-Implementation Track
Geographies Meeting 2012-01-25

View 2010-2011 IGW Meeting Agendas / Notes

Google Group (for mailing purposes only):

Implementation Geographies WG Google Group

What We’re Part Of

Implementation Group