Geographies Meeting 2010-10-06

Notes from Geographies Meeting
Date: October 6, 2010
Time: 12pm-1pm
Attendees: Douglas Arnold, Noam H. Arzt, Greg Chittim, Gary Christensen, Richard Elmore, Hank Fanberg, Eric Helfin, Uvinie Hettiaratchy, Kim Long, Umesh Madan, Arien Malec, Parag More, Will Ross, Jas Singh, David Tao, Paul Tuten, John Williams

Current Actions

#	Date	Action	Status	Owner	Due Date
39	2010/08/25	Update the Technology Providers x Pilots Crosswalk	Open	Pilot Leads: Susan Torzewski, Will Ross	2010/09/01
41	2010/08/25	Update wiki page for each individual pilot project, including the user stories being tested	Open	Pilot Leads: Doug Arnold, Didi Davis, Will Ross, Paul Tuten	2010/09/29
45	2010/09/01	Input requests into the Resource and Collaboration Needs for Pilot Projects	Open	Entire WG	2010/09/17
46	2010/09/01	Discuss off-line collaboration opportunities between the MPS and MedAllies pilot projects	Open	Doug Arnold, Parag More	2010/09/08

Actions from Last Week

#	Date	Action	Status	Owner	Due Date
39	2010/08/25	Update the Technology Providers x Pilots Crosswalk	Open	Pilot Leads: Susan Torzewski, Will Ross	2010/09/01
41	2010/08/25	Update wiki page for each individual pilot project, including the user stories being tested	Open	Pilot Leads: Doug Arnold, Didi Davis, Will Ross, Paul Tuten	2010/09/29
45	2010/09/01	Input requests into the Resource and Collaboration Needs for Pilot Projects	Open	Entire WG	2010/09/17
46	2010/09/01	Discuss off-line collaboration opportunities between the MPS and MedAllies pilot projects	Open	Doug Arnold, Parag More	2010/09/08
56	2010/09/29	Insert questions into the Open Questions Tracker for Pilots	CLOSED	Greg Chittim	2010/10/06

Agenda

1. Review of actions from previous meeting
2. Pilot Updates
3. Code Integration Test-a-thon - Technical Reps for October 27 & 28
4. Open Discussion

Paul Tuten

• Suggested that they proceed with their typical agenda
  • Discuss the pilot updates
  • In particular, asked pilot leads to concentrate on project needs from the group at large
    • Are there any resources that members of the workgroup can provide in-kind aside funding?

Pilot Updates

Rhode Island Quality Institute
Greg Chittim

• Indicated that Gary Christensen is on vacation
• Reported holding a successful meeting with technical integration partners
  • Achieved consensus on the overall technical architecture of their implementation
  • Resolved a number of their pilot-specific open issues
    • These had prevented them moving forward
• Stated they are now able to move forward in terms of planning
  • Technical design is being developed
    • Ex. Pat Pyette is putting together a cut of their HISP integration
  • A draft of their overall project plan will be sent to all of their pilot project partners very soon
    • Indicated that RIQI will post to the Wiki what materials they can make public
    • Have already posted a Solutions Architecture
      • [1]

Medical Professional Services (MPS)
Doug Arnold

• Indicated that MPS' pilot remains strapped for resources
  • Welcomes all support
• Reported holding a meeting with 40 of their practices
  • Presented the Direct Project to these practices
  • Continue to survey the technology needs from those practices
• Stated they held a meeting this morning with Quest
  • Outcome of the meeting is that they are still waiting for final reference implementation
• Updated workgroup on integration partners
  • Adding Emdeon as a HISP most likely
  • Adding SonicCare to achieve the criteria associated with continuity of care
• Stated they have one more meeting tonight
  • Attempting to coordinate with the REC funds
    • Their goal is to interdigitate the Direct Project

Paul Tuten

• Asked Doug Arnold if his pilot could use technical resources or other resources in-kind?
  • Suggested Doug Arnold look at the internal operations of the pilot project
• Asked if Doug Arnold has a punch list for pilot project specific tasks

Doug Arnold

• Responded that it may be difficult to task out the pilot's current needs
  • Assuming that the doctors are going to have to implement the new software developed for the Direct Project:
    • The major need is to be able to reach out and explain Direct Project implementation to their practices

Paul Tuten

• Posited that other technical vendors in Doug Arnold's implementation geography may be able to assist with that service in-kind
  • Suggested that Doug Arnold post this on the: Resource and Collaboration Needs for Pilot Projects

Doug Arnold

• Indicated he would love to talk to vendors who could help them in that regard
  • Will look into the matter

MedAllies
Parag More

• Reported that MedAllies is moving forward on their two previously identified work-streams:
  • Clinical Workflow
    • Continuing current clinical integration talks
    • Aligning timelines to achieve pilot objectives
    • Slightly delayed but still developing their project plan to this extent
  • Technical integration
    • Reported MedAllies has successfully finished conversations with individual vendors
      • These talks have proved that all vendors are in alignment with respect to the implementation
      • This may potentially change if other projected vendors come onboard
    • MedAllies next step is to convene all technical partners the following week to:
      • Hash out all potential questions/open items
      • Develop the final technical integration plan

Paul Tuten

• Asked if MedAllies had any resource needs

Parag More

• Responded that MedAllies is in good shape for now and does not have any resource or collaboration needs

CareSpark

• Not present

Redwood MedNet
Will Ross

• Indicated that Redwood MedNet continues to face the same resource constraints from weeks' past
• Reported that nonetheless they had a great conversation with an EHR vendor
  • Moving forward to create a necessary EHR document with this partner for participation
• Stated that Redwood MedNet ultimately is facing a fork in the road between:
  • Hiring a dedicated project manager who can commit 20-30 hours a week to the pilot
  • Or have Will Ross continue to run the pilot project out of his own pocket and on his own spare time
• Indicated that he is looking forward to October face to face meeting
  • Will be sending a technical representative
• Raised potential outstanding questions
  • Suggested it would interesting if they could start a cross-cutting conversation on data content
    • Not a lot of time needed for that on this call
    • Can discuss at the October face to face meeting
    • Indicated he will try to start the conversation on the Direct Project Wiki
• Discussed in detail about Cal-eConnect
  • [2]
  • Cal-eConnect provides two types of resources:
    • Cash to fund proposed activities
    • Provisioning of internal out-of-kind resources
  • Redwood MedNet is exploring all funding opportunities here

Doug Arnold

• Explained situation in Connecticut
  • Majority of key officials are currently "lame-duck" (governor, senator, agency heads)
  • The Connecticut HIE is the Connecticut Department of Health
    • They oversee the all of the health information exchange duties in Connecticut
    • The head is waiting to hand this off to the next group
    • Asserted that it is difficult to move forward during this "lame-duck" period

Will Ross

• Referenced past ONC conference
  • Indicated that the ONC clarified that state-designated entities are supposed to enable the health information exchanges
    • They are not supposed to conduct the exchange themselves

Noam Arzt

• Agreed that it is up to the states to determine how to achieve statewide health information exchange
• Responded that ONC has time after time been making this distinction clear

Will Ross

• Recognized that he had been corrected
  • Regardless, the fact is that most state-designated entities do not recognize that distinction

Noam Arzt

• Agreed that the situation is as Will Ross described

VisionShare
Paul Tuten

• Announced that the state of Minnesota has been confirmed as the first state for the VisionShare pilot
  • VisionShare will likely serve as the bridge between the Direct Project and PHIN-MS software being utilized in Minnesota
    • This would avoid technical barriers to VisionShare setting up a "Direct Project" public health pilot in Minnesota
    • PHIN = The CDC's Public Health Information Network: [3]
    • PHIN-MS = The PHIN's Messaging Service: [4]
  • VisionShare would also conduct some necessary translation services
    • Translation of data protocol and same of the data content
    • May present a reasonably scalable way to bridge those two environments

Doug Arnold

• Asked if VisionShare would focus on public health user-stories

Paul Tuten

• Responded yes, that is the objective of his pilot project
• Indicated that he is hoping to bring in at least another state to the pilot

October Code-a-thon

Paul Tuten

• Suggested it may be a good idea to see if WG members can attend the October face to face Code-a-thon/Install-a-thon
  • Indicated he plans to attend the Code-a-thon/Install-a-thon

Will Ross

• Responded he plans to attend the Code-a-thon/Install-a-thon

Umesh Madan

• Announced that both he and Sean Nolan from Microsoft will be attending the Code-a-thon/Install-a-thon

Kim Long

• Responded she will not be attending the Code-a-thon/Install-a-thon
  • Someone else may be attending on her behalf

Parag More

• Responded that MedAllies principal architect will be attending the Code-a-thon/Install-a-thon
  • Personally not planning to attend, but indicated he would look into the possibility

Greg Chittim

• Responded he has been communicating with Arien about who from RIQI should attend the Code-a-thon/Install-a-thon
  • Questioned if it made sense to have their technical resources attending
    • RIQI will be knee-deep in their technical integration
      • Will have greater problems if their HISP is not up-and-running by that point
    • Hence, may not attending themselves

Doug Arnold

• Responded he may not be able to attend the Code-a-thon/Install-a-thon
  • Asked if there would be a webinar for "those on the East Coast"

Paul Tuten

• Clarified that the October Code-a-thon/Install-a-thon will primarily be a working session
  • Presence of technical leads from each pilot project would be immensely helpful
  • Asked Uvinie Hettiaratchy or Jas Singh to correct him, if wrong

Uvinie Hettiaratchy

• Responded that Paul was indeed correct
  • The Direct team really wants as many relevant technical representatives to attend
• Urged pilot technical leads to come with their questions and concerns about the reference implementations
  • Thanked Will Ross for starting an initial conversation already

Open Discussion

Doug Arnold

• Asked if there is a confirmed new nomenclature for "NHIN Direct"
  • Indicated the will keep referring to it as such until a true new name is confirmed

Paul Tuten

• Asked Rich Elmore to address this as Communications WG lead

Rich Elmore

• Responded that on a temporary basis, the NHIN Direct project is now being referred to as "the Direct Project"
• Indicated that the Communications WG solicited a comprehensive list of recommendations, and forwarded a shortlist to Arien Malec
  • Arien Malec will make a decision about this himself
    • If anyone has further suggestions/notes, they should immediately message Arien Malec
  • Not doing consensus about this to:
    • Prevent domain squatting
    • Keep the word down about it for now
  • Plan to launch the new name later this month

Paul Tuten

• Commended Rich Elmore for the good work of the Communications WG
  • Indicated that he fielded questions from three new people this week about the Direct Project
  • Was able to draw from the communications materials

Doug Arnold

• Seconded Paul Tuten's commendation to Rich Elmore for the great work of the Communications WG