Geographies Meeting 2010-05-14

Notes from Implementation Geographies Workgroup
Status of Notes: DRAFT
Date: May 14, 2010
Time: 2pm-3pm
Attendees: Honora Burnett, Arien Malec, Adrian Groper, Umesh Madan, Frank Clark, Eric Heflin, Brian Ahier, Richard Elmore, Doug Arnold, Paul Tuten, Lee Jones, Jonah Frohlich, Jeff Cunningham, Marla Kouche, John Moehrke & David Kibbe
Actions for this Week

#	Date	Action	Status	Owner	Due Date
11	5/14/10	The NHIN Direct Team and Paul Tuten will create a checklist for the criteria for what these Implementation Geographies this will consist of how geographies represent themselves (i.e., what information should be included)	Open	NHIN Direct Team & Paul	5/21/10
12	5/14/10	Paul Tuten, Doug Arnold and Jeff Cunningham will put together a start of a framework of the Implementation Geographies so we know what it means in a real way and they can also report on what difficulties they ran into	Closed	Paul Tuten, Doug Arnold and Jeff Cunningham	5/21/10
13	5/14/10	WG members who represent certain geographies work to fill out the grid	Closed	WG	5/21/10
14	5/14/10	Jeff Cunningham will come up with a template marking the different capabilities within practices	Closed	Jeff Cunningham	5/21/10
15	5/14/10	Arien will make clear that the success metrics are outcome measures and not screening measures	Open	Arien	5/21/10
16	5/14/10	Marla Kouche’s comments about provider satisfaction will be integrated	Open	Marla Kouche	5/21/10

Actions from last 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	Closed	Arien & WG	5/14/10
8	5/7/10	Arien will put measurements of success in the operational plan	Closed	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

Key to notes:
Action Items
Conversations for next time
Suggestions for changing current documents
Agenda
1. Review of actions from prior meeting
2. Discussion based on issue framing
3. Review of actions and decisions

Issue Framing

Feedback on Implementation Plan
1. Elements – missing / unnecessary?
2. Level of specificity?
3. Relative importance (must vs. should)?
Build-out of Potential Implementation Geographies Matrix
1. Additional geographies?
2. Other key considerations / elements?
3. Complete matrix – need to fill out grid

Discussion

Conversation about Success Metrics

Comment from Umesh Madan

• Where to PHR’s fit in here?
• Patient connectivity is second to provider involvement
• Wordsmith this – if a patient asks for it, will they get it?
• Did the paper movement stop? How would we get out the

Comment from Brian Ahier

• Idea that NHIN Direct is going to be particularly useful to rural, underserved areas that are possibly unable to meet meaningful use
• All implementations must provide either/or access to rural providers small practices
• We would fail if we didn’t have access to small practices

Comment from Lee Jones

• Not many providers are served by electronic medical records
• Purpose behind putting this in a more general section is to provide flexibility for a more general group
• Focused on the components of the geography – diversity & flexibility
• Qualitative vs. quantitative

Comment from Marla Kouche
· Definition of what provider satisfaction is would be helpful
· Marla Kouche’s comments about provider satisfaction will be integrated [Marla is sending comments]

Comment from John Moehrke
· Useful to know how many unique software development projects it included
· Number of documents per transaction was to figure out if these are single document based transactions or if the multiple document case is useful
· #6 – not just provider satisfaction, but anyone who is using the system
· List the opportunities
· Arien will make clear that the success metrics are outcome measures and not screening measures
· Measure the failures

Comment from Jonah Frohlich
· Are provider’s clinicians or hospitals? Become more granular in type
· Defining the denominators of 2/3

Comment from David Kibbe
· Have a conversation about tracking the fax

Getting access to small practices and access to rural providers
· Hard to say that rural providers must be in every geography
· Key outcome: relevance to small practices
· Every geography must have a certain amount of small practices
· Everyone agrees except John Moehrke who doesn’t know

What else is missing?
· Diversity of document types or applications?
· Which of the user stories the geography will support? Or is it all of them on the first level? Isn’t this #5? This goes above and beyond – we should capture that as well. Watch for uses of priority 2, 3 or beyond.
· Different capabilities within practices?

Implementation Operational Plan
· What are our next steps?
· Comment from Jeff Cunningham
· Jeff Cunningham will come up with a template marking the different capabilities within practices
· Template that assesses the participants capabilities that we’ve implemented NHIN Direct into
o How they currently handle use cases and changes along those lines
o A how-to basis

Geographies Matrix
· List of geographies there – if there are any additional ones, add them in the near-term
· Elements that are complete
· WG members who represent certain geographies work to fill out the grid
· Level of detail?
o Mission is to think through the right operational plan so that individual operations should/can track their own progress and report back
· What is our charter?
·
Comment from Brian Ahier:
· Important to include IHS, but challenging

Comment from Paul Tuten:
· Paul Tuten, Doug Arnold and Jeff Cunningham will put together a start of a framework of the Implementation Geographies so we know what it means in a real way and they can also report on what difficulties they ran into
· Or one or two of the geographies could implement and come back with snags of things that they ran into – CT Doug Arnold TN or MT … Jeff Cunningham … Paul will work on FL
· Umesh Madan would like to assist
· Talk about all the categories – population
· The NHIN Direct Team and Paul Tuten will create a checklist for the criteria for what these Implementation Geographies this will consist of how geographies represent themselves (i.e., what information should be included)