Communications Meeting 2010-08-24

Notes from Communications WG
Date: August 24, 2010
Time: 1 - 2 PM ET
Attendees: Rich Elmore, Brian Ahier, David Kibbe, Jason Siegel, Michele Darnell, Didi Davis, Dave Juntgen, Susan Leonelli, Arien Malec, Uvinie Hettiaratchy, Caitlin Ryan

Actions

Actions from this Week

#	Date	Action	Status	Owner	Due Date
9	8/24/10	Tap into own networks to see what reservations vendors have about NHIN Direct.	Feedback to Michele Darnell	WG	8/30/10
10	8/24/10	Communicate with Implementation Geographies WG and pilot projects.	Complete	Rich	8/25/10
11	8/24/10	Brainstorm new names for NHIN Direct - please send suggested names to Rich	Underway	WG	8/30/10
12	8/24/10	Look at NHIN Direct - Communications Overview and send comments to Rich	Underway	WG	8/30/10
13	8/24/10	Finalize messages for key segments, incorporating feedback from today's discussion; create Powerpoint slides mapping out communications plan to each segment.	Underway	Ahier - HIE/StatesKibbe - Health Sytems & Individual ProvidersDarnell - HIT Vendors	8/30/10
14	8/24/10	Review Communication Channels. Determine priorities for first phase of communications and suggestions for vehicles of communication targeting each group.	Open	WG	8/30/10
15	8/24/10	Create "What is NHIN Direct" messaging across all stakeholders & ppt	Underway	Rich Elmore	8/30/10

Actions from last Week

#	Date	Action	Status	Owner	Due Date
3	8/17/10	Develop key messaging for All Stakeholders”	Open	David Kibbe, Rich Elmore, Jason Siegel (assist)	8/23/10
4	8/17/10	Develop key messaging for HIEs and RECs	Underway	Brian Ahier	8/23/10
5	8/17/10	Develop key messaging for Healthcare Delivery Systems/Providers	Open	David Kibbe	8/23/10
6	8/17/10	Develop key messaging for Vendors	Open	Michele Darnell, Jason Siegel (assist)	8/23/10
7	8/17/10	See NHIN Direct Overview Document, attempt to boil down into essential elements.	Open	WG	8/23/10
8	8/17/10	Review segments in the matrix, make necessary changes.	Open	WG	8/23/10

Agenda

Communication Priorities / Key Messages

• NHIN Direct Overview - Rich Elmore
• State HIEs / RECs- Brian Ahier
• Healthcare Delivery Systemsand Individual Providers- David Kibbe
• HIT Vendors- Michele Darnell

NHIN Direct in the Media
Communications Channels

Notes

Rich Elmore

• Proposed to review communication priorities.

Brian Ahier

• Presented State HIEs / RECs.
• Explained he is fleshing out benefits of incorporating NHIN Direct into State planning.
• Supporting providers in achieving Stage 1 of MU.
• Provided info Doug Fridsma of ONC presented in April about "What is NHIN Direct?" (State HIEs / RECs).
• Wants to create 2-3 slide deck that has bullet points and diagram explaining what NHIN Direct is and how it can help states fill the gaps.
• Should tell how RECs can use NHIN Direct source protocols to help providers meet MU.
• Info provided to the RECs will work in concert with info David Kibbe had been working on for providers and health systems.
• Very important for HIEs and RECs to know that NHIN Direct creates a baseline that states can layer additional services on top of; NHIN Direct won't replace or interfere with statewide planning, but instead will augment their efforts.

Uvinie Hettiaratchy

• Asked WG to consider any needs they might from other WGs.

Round the Room: State HIEs/Recs and Needs from other WGs

Brian Ahier	Sees NHIN Direct Overview document as good starting point, with different versions tailored for different groups. Overview document is too "beefy" for Communications WG purposes but coordinating messages with Documentation and Testing WG would be valuable.Rich Elmore Encourages WG members to refresh page to find a link to the Overview document.
David Kibbe	Thinks HIE messaging section is great. Suggested reaching out to the pilot projects and Implementation Geographies WG to better connect messaging with real world implementation findings.
Dave Juntgen	No comment.
Susan Leonelli	Likes the idea that NHIN Direct is not going to replace what states are already doing. Wonders if Communications WG will ever be in a position to get more specific on what states do need to do, in plain English, in terms of making changes to their system within the interoperability framework (i.e. If your system fits Scenario A, this is how you can take advantage of what NHIN Direct can bring to your system and the impact NHIN Direct can have.) Heard that the Policy WG that is putting together some naming guidelines about what to call NHIN Direct and how addresses will be set up. Thinks Communications WG should remain aware or even participate.
Didi Davis	Emphasized the importance of naming conventions and concise messaging. Is hearing a need from RECs for different presentations with RECs, what are the differences? from providers
Uvinie Hettiaratchy	As a to-do, this WG can help come up with a new name for NHIN Direct. Another overall goal for "Direct" would be to include in all messaging to what NHIN Direct does not do in addition to what it does do.

Question

• Why are we looking for a new name?

Arien Malec

• There is a trademark issue with the NHIN name.
• Over some period of time there will be a search for a new name.
• The other problem is that there is an implication that being part of NHIN will have an additional set of policy considerations.
• The NHIN Direct project is creating standards for expanded use for direct communication, but that doesn't mean everyone using those standards is formally part of the NHIN.
• Need a slightly revised name, something that makes clear the relationship between adopting standards and distinction of being formal part of NHIN.

Question

• Is the NHIN name changing, too?

Arien Malec

• NHIN will also be renamed.
• There is a process underway for NHIN governance.
• He hopes these efforts will expand NHIN governance.
• Organizations formally part of NHIN will need to adhere to a yet-to-be-determined policy framework.

Brian Ahier

• Can frame the situation as: NHIN Direct is a project that will create set of standards, services, protocols.
• Those standards, services and protocols are what we need to name.
• We need to name the product we are producing to avoid confusion when so when launched into real world implementation.

Rich Elmore

• Agrees with that WG needs to incorporate product labels.
• There also needs to be a call to action: what do we expect HIEs to do?
• At the Face to Face Gary Christensen presented a good HIE perspective.
• Gary is writing something for the Communications WG to help them gain insight into the HIE mindset.
  • HIEs are concerned about being dis-intermediated because of nature of NHIN Direct.
  • The message to them needs to be clear, that if they don't provide services to constituents, somebody else will.
  • Therefore, NHIN Direct is an important part of the portfolio state HIEs should be supporting.
  • Good to frame in politically correct way, but with clear message.

David Kibbe

• Agrees.
• Many HIEs are not getting that message that providing NHIN Direct services will be a critical business component.

David Kibbe

• Presented Healthcare Delivery Systems and Individual Providers.
• Overall, should emphasize the use of these protocols as a means to connect with particular groups of physicians to facilitate exchanges they want and need to have.
• A lot of hospital CIOs, physicians, and others are currently trying to get the most out of whatever vendor they have.
• They are all trying to connect with other physicians in their communities.
• Should stress the ease and low cost of communication through NHIN Direct protocols.
• In addition, NHIN Direct will cut out the need for a fax machine, will assist in meeting MU, and will offer physicians a choice between vendors and avoid locking into one vendor long-term.

Round the Room: Healthcare Delivery Systems and Individual Providers

Dave Juntgen	Has been in communication with the State HIE of Indiana. His organization, MIE, is trying to persuade HIE that NHIN Direct is not just a fad, and trying to encourage implementation of a pilot project. Need to tell HDS and providers about both the pros and cons of NHIN Direct.
Susan Leonelli	Was struck by last section about choice. Wants to play on the opposite side for hospitals; there might be a situation where a hospital wants to be able to reach out to everyone in their community that they want to interact with, because their competitors are already doing so. The message could be "don't keep you head in the sand about NHIN Direct" because they want to maintain their business contacts and secure their place in the community. Could first plant that fear that they are being left behind, then motivate them to act.
Brian Ahier	Likes the work that has been done on HDS and providers.Sees a pressing need to clearly define a name for the services and protocols produced by NHIN Direct.As the Communications WG, are able to form minds around the project being "NHIN Direct" but the product and services are something else.Need to step back and put a name on what we are doing.David Kibbe Coined "interhealth net" two years ago as a means of describing not just the push technology but the whole idea of using the internet for health information purposes.Brian Ahier Another option, "healthnet direct."Feels "direct" should be included to convey that it is end point to end point exchange, pushed to a known address. Also there has been buzz around NHIN Direct name, and we don't want to lose that.Jason Siegel Finds "NHIN Direct" confusing as opposed to "NHIN Secure."Some people think that because this project uses "NHIN", it is NHIN compliant.There is a need for scoping what it is and what it isn't. Agrees that the name is important; there should be clarity about what it is we are talking about at the top of any summary.
Michele Darnell	The primary message should be that in the initial stages of connectivity and accelerating adoption, NHIN Direct allows providers that might not be eligible for the first round of connectivity to connect with each other.
Arien Malec	Should further explore the relationship between Integrated Delivery Networks (IDNs) and health systems. State HIE planning efforts are already underway. Wondering if they need some very direct communication.Question How can this be done? Talked with a large system today and learned that they have to pay their vendors $2 million to do development work to meet MU standards. Will IDNs and vendors embed the NHIN Direct protocols into their applications and network systems, and at what cost?Arien Malec NHIN Direct provides a way for IDNs to meet the needs of physicians, while playing nicely with their state. This could be a key positive selling message.David Kibbe Supported idea. Can communicate with vendors that once the capabilities are available, they can act as a bridge between IDNs and HIEs. Right now IDNs are saying to vendors "we don't need you."Rich Elmore The IDNs are interested in doing their own thing due to the strength and benefits of their referral networks. We can point to the self interest of health systems, emphasizing that NHIN Direct protocols can be used by a wide spectrum of physicians--it will give access to any physician in the country, it is easy to use, and is standards-based. The protocols will strengthen referral capabilities, and will help specialists service primary care docs. All of these points should gain interest from CEO types.
Didi Davis	WG is on the right track. Can expand on how MU helps meet MU criteria at a low cost. NHIN Direct can help IDNs (they want MU incentives) in their communication back to the vendors about what they need to be questioning as they are upgrading and putting new systems in.
Jason Siegel	Agreed with emphasizing MU.

Michele Darnell

• Presented HIT Vendors.
• In communicating with HIT vendors, should start with the general definition of NHIN Direct.
• Next, there are 4-5 key points as an HIT vendor about why important NHIN Direct is important.
  • 1) Allows me to deliver additional connectivity to my clients.
  • 2) Creates services for current clients, creates a pathway (detailing what services could be).
  • 3) Opens doors by extending reach to a set of new clients that I'm not already touching but could through NHIN Direct standards/approaches.
  • 4) Will help my clients and potential clients meet MU Stage 1.
  • 5) Competitiveness: if I don't do it, someone else will.
• The role of this WG to promote these messages, sooner rather than later.
• WG should talk with pilot vendors and why they are interested, then use this input in our messaging.
• Finally, WG should explain how NHIN Direct compares to everything else going on.

David Kibbe	Great points. Learned from a family physician that her vendor is asking her to pay $500/doctor/month to be able to communicate with her patient population by providing clinical summaries and adding a module for registry. This means she would have to pay additional money meet three MU objectives. Should emphasize that NHIN Direct=lower cost. Some vendors are already adopting NHIN Direct, others are not. Shared idea to give statements right up front about those vendors.
Dave Juntgen	His vendor organization is taking the opportunity to provide NHIN Direct services because it is easy to use, relying on technologies that already exist. WG should show vendors why they should consider using NHIN Direct.
Susan Leonelli	Important to consider why vendors might not go with NHIN Direct? What are we missing? What might NHIN Direct not solve? After we've learned this we can develop counter messaging. -->Should all tap into our networks to see what reservations vendors have about NHIN Direct.
Brian Ahier	First WG should spell out how vendors will have a comparative advantage by using NHIN D protocols. Indicate that it will be difficult as time goes on for vendors to not be compliant with NHIN Direct services and protocols. Can use those already involved in pilot projects as ambassadors.
Didi Davis	What are we going to do to fold into existing protocols?
Jason Siegel	Some vendors are already using protocols. At the IHE Connectathon people were set up to be using protocols. Questions from vendors will be: how is that different from NHIN Direct protocols? if different, why have they spent all this money? They need to know that NHIN Direct is person to person versus EHR to EHR. Also, there are a number of web-based "free EHRs" that claim they are using secure health information exchange based on HIPAA regulations. They are getting a lot of press for guaranteeing MU incentive payments to providers that use their product. They are our competitors. We need to watch them and distinguish ourselves (NHIN Direct) from their approach.

David Kibbe

• American Academy of Family Physicians is already in contact about offering HISPs.
• If NHIN Direct is able to get physician organizations to understand the value of offering the service of basic, "healthnetdirect" email addresses so that any physician can communicate with any other physician who has an address through a HISP, those powerful organizations could move the vendors very quickly.

Arien Malec

• Agrees.
• As former vendor, RFPs and clients asking for the implementation of services are what moves vendors fastest.
• The vendor sees, "I have a critical mass of customers who will buy my product if I implement these services or won't buy if I don't implement these services."
• -->WG needs a piece highlighting all of the great progress we are making.
• People in all of the different WGs are doing all the hard work on the ground.
• Talking up the progress that is being made creates a sense of inevitability that these protocols will be adopted in the future, and that vendors should act now.

Brian Ahier

• Recap on new name suggestions for NHIN Direct:
  • Health Message Direct
  • HealthNet Direct
• Would like to move toward consensus.

Arien Malec

• Will need to coordinate with ONC.
• -->Let's all come up with a bunch of names.

Rich Elmore

• Look at NHIN Direct Communications Overview ([1])
  • -->get comments to Rich.
• Also look at NHIN Direct in the Media.
  • -->please add to.

Meeting Takeaways/Next Steps

• Incorporate examples of what is happening with pilots, relevant to stakeholders, in future messaging.
• Add in a call to action (what is it the stakeholders should be thinking about now?).
• Collect possibilities of new names for NHIN Direct and coordinate with ONC.
• Finalize messages for key segments, incorporating feedback from today's discussion.
  • Next step will be to include messages into a PowerPoint deck.
• Rich will do the overview messaging.

Uvinie Hettiaratchy

• Presented Communications Channels.
• Asked group to -->Review, determine priorities for first phase of communications and suggestions for vehicles of communication targeting each group.