Presentation:
Notes from Implementation Group
Date: October 12, 2010
Time: 3:00 – 3:40pm EST
Attendees: American Academy of Family Physicians, Anakam, Axolotl, CareSpark/Anakam HIE Tech, Cerner, Christus Health, eClinicalWorks, Emdeon, Gartner, GE, Google, Harris Corporation, High Pine Associates, HLN Consulting, LLC, IBM, Inpriva, Massachusetts eHealth Collaborative, MedAllies, Medicity, MedNet, MedPlus/Quest Diagnostics, Microsoft, Mirth Corporation, Misys Open Source Solutions (MOSS), NoMoreClipboard.com, NYC Dept. of Health and Mental Hygiene’s PCIP, Redwood MedNet, RelayHealth, Siemens, South Carolina Health Information Exchange, Surescripts, Techsant Technologies, VisionShare

Actions

Actions for This Week

Date
Action
Status
Owner
Due Date
10/12/10
Contact Arien Malec if interested in posting on the Direct Project blog on behalf of your WG
Open
IG members
10/19/10
10/12/10
E-mail nhindirect@nhindirect.org or sign up at http://nhindirect.org/Direct+Project+October+Face-to-Face+Meeting to attend the October face to face meeting
Open
IG members
10/19/10
10/12/10
Leave any unanswered questions in the FAQ drop-box page
Open
IG members
10/19/10
10/12/10
Look at the final draft of the Direct Project Overview document, provide comments
Open
IG members
10/19/10


Actions from Last Week

Date
Action
Status
Owner
Due Date
10/5/10
Submit input on NHIN rebranding by writing to nhindirect@nhindirect.org.
Open
IG members
10/12/10
10/5/10
Write to nhindierect@nhindirect.org if you plan to attend the October face to face meeting in San Francisco.
Open
Coders and Implementation Geography Team Members
10/12/10
10/5/10
Provide opinions and guidance on Direct Project (NHIN Direct) renaming efforts by writing to Rich Elmore.
Open
IG members
10/12/10
10/5/10
Submit details about available communications vehicles on the Communications Launch page.
Ongoing
IG members
10/12/10
10/5/10
Communicate best practice needs as they arise in pilot project planning by writing to David McCallie.
Ongoing
IG members
Ongoing
Agenda:
  • Reminders
  • Workgroup Updates
  • Calendar &Participation
  • Recap

Notes:

Announcements
Arien Malec
Changes to the Direct Project Blog
  • Would like to turn the Direct Project blog over to the workgroups, because there is so much more going on that he would like to showcase
  • If you are on a WG and want to promote some of the work going on, let Arien Malec know
October Face to Face Meeting
  • At the end of October there is a face to face Code-a-thon meeting for members of the Reference Implementation WG, Implementation Geographies WG, and technically-minded folks who want to take the code out of the box and get prepared to do the work in the real world
  • Likely to have another face to face meeting sometime thereafter, focusing on operations and policy, best practices
  • Will let the implementation geographies take the lead in determining when an appropriate time for that second face to face meeting will be
Project Timeline
  • At this point it seems implementation geographies will launch in December or early January
  • Noam Arzt pointed out that the calendar invites end at the end of October
  • This project will go strong until the work is complete, when there is real world operation, which will likely be in January
  • After January there is a whole set of activities going on internal to ONC
  • He expects activity of Direct Project to take place under the wider scale activities in the Standards and Interoperability framework

Brian Behlendorf
October Code-a-thon
  • Host: CollabNet
  • When: October 27th(12pm –5pm PDT); October 28th(9am –5pm PDT)
  • Where: 8000 Marina Blvd, 6th floor, Brisbane, CA 94005-1865
  • Closest Airport: One mile from SFO
  • Purpose: Finalize code, create solid plan for pilot testing in November, and familiarize pilot technical leads and partners with reference implementation
  • Pilot technical teams can also use this time to share common challenges and issues
  • Who should attend?
  • Technical leads/partners from Pilot projects (especially pilots who are aiming to start testing in November)
  • Coders
  • If you would like to attend, please email nhindirect@nhindirect.org or sign up at http://nhindirect.org/Direct+Project+October+Face-to-Face+Meeting
  • So far 9 people have registered
  • You can visit the page on the wiki to get more details about it, see what is going on
  • Looking forward to finishing remaining functional development and test integration between the references and any privately built HISPs
  • Besides those already involved, participation is welcome from developers who want to get involved in health IT

Wes Rishel
  • Asked for a definition of success at the end of the Code-a-thon

Arien Malec
  • Success would be that all of the participants have been able to
  • Take and use either their implementation that they’ve written, or one of the two reference implementations written by the Direct Project Reference Implementation WG
  • To understand the reference implementation and have it tested and configured
  • And to run end to end with interoperable HISP technology and understand how to integrate into the work that is already done, whether part of an HIO or not

Workgroup Updates

Reference Implementation WG
Brian Behlendorf
  • Tremendous amount of progress on CSharp and Java
  • Some work remaining on XD* on both sides
  • Need equivalently implemented on both platforms
  • People seem confident that at the Code-a-thon, the code will be feature-complete
  • “70% of the work is in the last 30% of development”
  • Both teams are feeling confident

Arien Malec
  • At the stage with both implementations are in a state where you can take the SMTP implementation and set up and integrate into the technology to do end to end direct messaging
  • A lot of the work going on right now is finishing off the XD* side of the imp for XDR and XDM, as well as a lot of ongoing work in configuration, configuration facilities, UIs and certificate validation and chain building
  • Except for the security stuff, we are really in a place where both implementations can take off and run
  • Amount and quality of code written is commendable

Implementation Geographies WG
Uvinie Hettiaratchy
  • Met this week
  • Visionshare announced a pilot project in Minnesota
  • Will serve as the bridge between the Direct Project and PHIN
  • RIQI posted a solutions architecture: http://nhindirect.org/file/view/RIQI+-+NHIN+Direct+-+Solution+Architecture+v1.0.pdf
  • Pilot project technical teams invited to participate in next Code-a-thon/Install-a-thon
  • More progress on the planning front, looking to get the technical teams together for Code-a-thon in October, preparing questions to address with coders from the Reference Implementation team
  • Compiling questions

David Tao
  • Asked about the definition of success
  • One pilot group talked about user work flow and whether the message would be automatically or would not be automatically filed
  • Do we have a commonly understood definition for the success of the pilots?
  • So that if the message is delivered securely and then the actual handling of the documents (how it is displayed and filed) is left up to the receiver, to what degree is the end user acceptance of “I like this workflow” a factor in the success measurement?

Arien Malec
  • There is an existing set of metrics to track in the implementations
  • Provider satisfaction, number of messages, number of providers covered
  • Thinks they have a reasonably good set of metrics for success
  • For project as a whole, have a set of outcomes driving toward, as David McCallie says, “universal secure messaging for providers all over the country”
  • Good topic for Best Practices WG: what are the best practices for integration of workflow?
  • Would encourage people to look at the set of metrics established, cross-linked off of the WG page
  • Implementation Operational Plan—describes essentially what kind of they are geographies looking for, organization types, and success metrics
  • Covers well established objective metrics
  • Implementation Geographies could section out its own chunk

David Tao
  • Might be good if provider satisfaction plays into metrics

Janet Campbell
  • Would be a way to distinguish ourselves competitively

Wes Rishel
  • Critical question: now that we can get the data, how can we make it useful?
  • While he agrees that there is a competitive aspect, he expects we can balance with some general statement of what we would expect another vendor to do if our system was sending info to their system
  • Would like to see some consciousness rising about this issue

Arien Malec
  • Thinks it is a good topic for the Best Practices WG


Communications WG
Uvinie Hettiaratchy
  • Decided on a new name: The Direct Project
  • Was voted as a good name by the Communications WG
  • Will keep continuity with the Nationwide Health Information Network, and then go through a renaming effort after the NHIN is officially renamed, if we want to
  • Communications WG discussed planning around a Communications Launch
  • Plan to give presentations at HIMSS
  • Communications plan also includes press releases, vignettes, presenting about the progress of implementation geographies and what they’ve learned
  • Planning around key target events:
  • Wrapping up reference implementation (end of October) and HIT Standards Committee meeting (November)
  • Start of real world operations (January)
  • Continuing to coordinate with ONC around HIMSS, will update the IG next week

Documentation and Testing WG
Janet Campbell
  • Finally completed the Overview document
  • Trying to coordinate better around FAQs
  • Did answer the implementation questions from the Implementation Geographies WG
  • Added an FAQ drop-box page, which Arien Malec has blogged about
  • Documentation and Testing WG will make it their responsibility to take those questions and add to the FAQ
  • Security Overview document is ready for the Security and Trust WG to review
  • Deployment Models document is almost ready for wider review
  • This document is very relevant for wider use in terms of how will the standards actually be implemented?
  • How to connect to HIEs using other standards?

Arien Malec
  • Tons of stuff happening
  • Good to see a final draft of the Overview
  • Encouraged IG members to look at the document, provide any comments
  • Hard work and labor went into that document

Wes Rishel
  • When people drop questions in the drop box, if it doesn’t go into the FAQ, what happens to it?

Janet Campbell
  • If there is a question in the drop box that we don’t know the answer to, we’d still put in the FAQs unless it duplicates another FAQ entry word for word

Wes Rishel
  • Asked if they were expecting the Direct Project community to answer the FAQs, or just the Documentation and Testing WG members
  • Likes open source communities, relatively self-help communities, not all answers are official, but still helpful

Janet Campbell
  • Documentation and Testing WG provides net for catching questions and answers
  • The WG will then take responsibility for answer the question, unless someone else can better answer the question


Best Practices WG
Arien Malec
  • We have a “big P” Policy set of activities that are being coordinated with the HIT Policy Committee, with dedicated and strong focus from the Security and Trust Tiger Team, as well as other HIT Policy Committee workgroups
  • “Big P” Policy level questions need to be taken up at a national level in the form of recommendations to HHS for consideration and rulemaking
  • There is a separate set of truly operational “small p” policy decisions made at the level of individual organizations, HIOs, HISPs
  • The intermediate level “medium p” policy questions, what we are calling “best practices” are below the level of the HIT Policy Committee and Tiger Team, but it is important to have standard best practices that are relatively uniformly followed
  • Put together a set of best practices for cert management, which is currently up for WG Consensus
  • Best Practices WG members will vote and comment by COB, 10/12/10 http://nhindirect.org/Certificate+Pilot+Recommendations+Call+for+Consensus
  • There is a link off of the Best Practices WG page for incoming best practices ideas
  • Actively coordinating activities with the Tiger Team
  • Some work will be reflected back to the Tiger Team for a session on Friday of this week


Security and Trust WG
  • Currently on hiatus

Calendar &Participation
Arien Malec
  • Introduced calendar of weekly meetings:
WG
Meeting Time
Reference Implementation WG
Tuesdays, 12pm-1pm EST
Communications WG
Tuesdays, 1pm-2pm EST
Implementation Geographies WG
Wednesdays 12pm-1pm EST
Documentation and Testing WG
Wednesdays, 2pm-3pm EST
Best Practices WG
Thursdays, 1pm-2pm EST
Security and Trust WG
Thursdays, 2pm-3pm EST

  • All the hard work and energy from participating organizations has been amazing