Geographies Meeting 2010-08-11

Notes from Implementation Geographies Workgroup
Date: August 11, 2010
Time: 12pm-1pm

Attendees: Douglas Arnold, Gary Christensen, Didi Davis, Mike Dentchen, Hank Fanberg, John Hall, Andy Heeren, Eric Heflin, Uvinie Hettiaratchy, Srinivas Koka, Umesh Madan, Arien Malec, John Moehrke, Parag More, Will Ross, Mark Stine, Susan Torzewski, Paul Tuten
Current Action Items

ID	Date	Action	Status	Owner	Due Date
29	8/11/2010	Update Implementation Geographies Checklist	Open	Paul Tuten	8/18/2010
30	8/11/2010	Clean Up and Refresh NHIN Direct Wiki	Open	Arien Malec	8/18/2010
31	8/11/2010	Bring up to Document and Testing WG the following Issue: 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, etc.	Open	Arien Malec	8/18/2010

Last Week’s Action Items

ID	Date	Action	Status	Owner	Due Date
29	8/4/2010	Update Implementation Geographies Checklist	Open	Paul Tuten	8/11/2010

Paul Tuten

• The geographies checklist is not complete, but will try to finish tonight
• Asked the group to first provide pilot project updates, and then participate in a “round” on the goals of the upcoming “plan-a-thon.”

Rhode Island Quality Institute Pilot Project Update
Gary Christensen

• Provided update on the Rhode Island Quality Institute pilot project
• Introduced Mike Dentchen, who will be participating in the call
• They have put together a definitive plan, however are waiting for grant approval so they have the necessary spending money
  • Planning to use funds from Beacon community grant

Medical Professional Services, Inc. (MPS) Pilot Project Update
Doug Arnold

• Provided update for the Medical Professional Services, Inc. (MPS) pilot project
• Had an excellent call with Dave, Mark Stine (MedPlus), Umesh Madan (Microsoft), Vidit Saxena (eClinicalWorks), the CIO of Middlesex Hospital, and the CEO from Bauxite regarding pilot project
• There is a logical diagram assembled by Mark Stine which is very helpful
• Umesh recommended that they try to get the pilot prepared as soon as possible
• There were questions raised about the domains by Umesh and Mark

Umesh Madan

• Identified that there are still a couple weeks remaining before completion
• Recommended that if there are those who wish to host a HISP, they should pull it down and start preparing for that
• Wants to get a test box or two up so they can begin integrating technically

Mark Stine
· Asks if the code is portioned up so that the security agent part can utilized by itself
Umesh Madan

• Yes, and the agent level code is also ready to go
• The NHIN CSharp and Java code are good to go, but the documentation is lagging

MedAllies Pilot Project Update
Parag More
· Provided MedAllies pilot project update on the behalf of LeRoy Jones
· MedAllies is still waiting to hear from certain vendors
· Looking into what are the capabilities of MedAllies pilot project
· Not much else to report, Lee might have some more information at a later point
Doug Arnold:
· Asked if the three participants in the MedAllies pilot project will be HISPs
Parag More
· Currently talking to some vendors, but have not finalized them for posting on the webpage
· Indicated additional vendors participation will primarily be an additional support
· MedAllies is providing the key HISP capabilities
Doug Arnold
· Stated that eClinicalWorks will support as a HISP
Vidit Saxena
· Did not want to make an official declaration and preferred going offline to discuss the participation of eClinicalWorks
Paul Tuten
· Posited that eClinicalWorks may have a common solution

CareSpark Pilot Project Update
Susan Torzewski

• Provided the update for the CareSpark Pilot Project
• Informed the group that the VA will participate in the planned interaction
• Stated that “we will be a HISP, they will be a HISP”

Didi Davis

• Also working with the state of Tennessee in eastern Tennessee
• Their goal is to take the lessons learned from past experiences
• Wants to connect their community based offices as well as hospitals
• Gave the example that the VA mostly outsources their mammography work to private facilities – can ask Tim Cromwell more regarding the matter
• Was asked if the state of Tennessee was going to be a HISP
  • For now CareSpark will be the HISP for the pilot project, and that the state of Tennessee is looking into escalating into a HIE by the conclusion of the pilot
  • MobileMD is responsible for securing the messaging in this pilot
  • The state of Tennessee has two recognized HISPs: Memphis (which is not ready) and CareSpark in eastern Tennessee

Carolina eHealth Alliance Pilot Project Update
Not Represented

Redwood MedNet Pilot Project Update
Will Ross

• Provided the update for the Redwood MedNet pilot project
• Currently in the second week of planning a three-way crosswalk of the 12 priority user stories checked against the final rule for Meaningful use
• This cross-walking is against four specific actor classes
• Developing the standards for messaging
• Currently talking to the California Department of Health and Human Services, focusing on the posting immunizations
• Welcomed all volunteers who want to help

VisionShare and Public Health Pilot Project Update
Paul Tuten

• Provided the update for the VisionShare and Public Health pilot project
• Currently talking to a number of states and near completion in preparation
• In partnering with Public Health, the pilot project will concentrate on the transfer of immunization data
• Indicated that once it is clear which states will participate, then the pilot project can reveal more information
• Currently the project is in its approval process in various different state agencies
• Any providers in those states are welcome to join this use-case – waiting for next week or the following week for a firm commitment

Doug Arnold

• Asked Arien about the cross-walking which Will Ross is engaged in

Arien Malec

• Arien will update and refresh the Wiki for NHIN Direct

New: Texas Pilot Project Update
Hank Fanberg

• The final team is being assembled
• Has confirmation from their core tech provider - Medicity (wants to be a HISP by itself)
• Currently talking to EMR vendors in the area, focusing on physician to physician referrals
• Corpus Christi participating
• Christus is here as a part of group collaborative

Round the Room – Suggestions/feedback on how the time for the plan-a-thon should be utilized

Susan Torzewski and Didi Davis	Nothing to add beyond their comments during the CareSpark pilot project update
Andy Heeran	Was curious about the percent completion on their reference code Umesh Madan CSHARP is pretty far along Most of the agent code should be good Needs to fix up some bugs The gateways also works Running at light speed - “running at Umesh speed”
Hank Fanberg	No comment
Doug Arnold	Asked about what will be communicated to providers - what will be expected of physicians in terms of new applications and software required for NHIN Direct pilots Umesh Madan Documentation team will help out for the step-by-step instructions Susan Torzewski Can Physicians use multiple e-mail address? Umesh Madan It’s pretty much up to the physician since it’s the same way normal SMPP works Arien Malec A risk assessment is necessary on their part – do they want to use ordinary e-mail client or custom Works with different configurations, if you store or don’t store certificates or S/MIME, etc. Policy considerations need to be included Will Ross Since many doctors work in multiple practices, it is necessary to configure such that the capability to send the correct clinical message to the correct client e-mail Arien Malec Will bring this to the documentation group “Things are getting real” John Hall Addressed metadata
John Moehrke	Participating in the document-a-thon
Parag More	No suggestions
Eric Heflin	No suggestions
Mark Stine	Domain name recommendations NHIN com/log – general recommendations in the pilots Asked about “trust anchors” in the pilots – will they be developed across the group or through general agreement How far does the group go in terms of circle of trust? Wiki template for pilot domains, etc?
Umesh Madan	Nothing to report, jokingly mentioned he hopes to get some sleep in the near future
John Hall	Nothing to add
Will Ross	Likely to be sprinting back and forth between the document-a-thon and plan-a-thon Wants to do a cross-walk that compares the user-stories to the new final rule
Gary Christensen	Wants to discuss testing strategies All of the pieces need to know what the resources are and where to find them What will these dependencies look like? Will these resources become visible?
Sri Koka	Curious how one will switch back and forth the breakout “thons” if they are interested in more than one? Arien Malec Believes it is “better to pick one and stick with it” If someone can productively participate in multiple “thons,” then they will try to accommodate What user stories are connecting to the reference documents – will the mapping be there?
Paul Tuten	Believes this was helpful May reach out to people over the course of the week
Arien Malec	Although he suggested otherwise for participants, he made it clear he is likely to be a floater Uvinie might stick with the plan-a-thon and he will float between the document-a-thon and code-a-thon
Uvinie Hettiaratchy	Will divide the main conference room between the plan-a-thon and document-a-thon, and have coders elsewhere
Arien Malec	Having been a vendor, we should fill up that matrix Add up the number of providers – this should be one exercise during the plan-a-thon
Uvinie Hettiaratchy	Hopes to have one representative from each pilot group to present Arien – just presenting before the implementation group Uvinie – Will be sending out the agenda, make sure to send in your own information