Implementation Geographies Workgroup Adoption and Implementation Stage Archive

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The content of this page provides reference to the work of the Direct Project Implementation Geographies Workgroup during its 'Adoption and Implementation Stage' (2012-2015) as archived on 01/17/2016.


When originally formed, the Implementation Geographies Workgroup (IGW) was intended to support initial pilot projects using Direct standards by assisting with implementation/operational issues through a collaborative, community-based exchange of ideas and experiences. In doing so, the IGW sought to both demonstrate the potential for Direct, as well as to provide some of the experiential knowledge required to ultimately ensure its long-term success as a means of simple, secure, and scalable health information exchange.

Having addressed this initial charter through a series of successful pilots, the Implementation Geographies workgroup has continued to exist as a community of practice, sharing and exchanging ideas, issues, and experiences in an open and collaborative environment. Participants have found these robust discussions helpful to their own projects, and the IGW believes that its collective experiences continue to positively influence the future course of the Direct standard, as well as associated policies and best practices.

At the same time, Direct has begun to enjoy more widespread adoption in HIEs at the state, regional, and local levels. In the case of many of these organizations, project leaders have reached out to IGW participants for guidance and feedback. To that end, the IGW has restructured itself to enable new Direct Project implementations to participate in our collaborative workgroup.

All documents related to the IGW's initial pilot stage remain linked and available at the IGW Pilot Stage Archive (2010-2011) wiki page, which contains a bounty of useful information and historical context on the initial 'real-world' implementations of the NwHIN Direct standards.

Operating Model

Meetings follow a format for topical discussions (as outlined above) and may also include special presentations from an Implementation Geography, other Direct Project / S&I Framework workgroup, governmental agency, or invited industry speaker(s), as appropriate.

Discussions will include topics such as:

  • Implementation issues / challenges
  • Establishing operational policies and procedures
  • Launching Direct to the provider community
  • Operational issues / challenges
  • Driving adoption of Direct at the provider level
  • Innovations in the use of Direct
  • Benchmarking / success metrics

IGW participants are expected to maintain a wiki page for their respective implementation(s)/project(s), which shall include at least monthly status updates

Deliverables up for Consensus

None at this time.

Consensus Approved Deliverables

  • Certificate Pilot Recommendations Discussion WG Consensus Achieved
  • Implementation Guide for Direct Edge Protocols v1.0 Consensus Achieved [Word] [PDF]
  • Implementation Guide for Direct Edge Protocols v1.1 Consensus Achieved [[[file/view/Implementation%20Guide%20for%20Direct%20Edge%20Protocols%20v1.1.docx/557962569/Implementation%20Guide%20for%20Direct%20Edge%20Protocols%20v1.1.docx|Word]]] [[[file/view/Implementation%20Guide%20for%20Direct%20Edge%20Protocols%20v1.1.pdf/557962589/Implementation%20Guide%20for%20Direct%20Edge%20Protocols%20v1.1.pdf|PDF]]]

Other Works / Documents

Several sub-workgroups were created as a result of the Direct Scalable Trust Forum held in November, 2012. These workgroups concluded their work in 2013.

View 2010-2011 IGW Pilot Stage Working Documents

Active Implementation Geographies

Several Direct Project implementations are starting up or operating across the country. Each is explained below using a briefing document template (also linked below). The Implementation Geographies Workgroup uses its weekly conference call to receive updates from these implementations and collaborate in order to help each initiative achieve maximum success.

To enroll your implementation, create a new wiki page using the Implementation Brief Template as a guide and create a link to the new page below.

Pilot Project Brief - Rhode Island Quality Institute (shared documents)
Pilot Project Brief - MedAllies (Shared Documents)
Pilot Project Brief - Health Information Partnership for Tennessee/Veterans Affairs
Pilot Project Brief - Redwood MedNet
Pilot Project Brief – Cerner Corporation
Pilot Project Brief - MEDfx
Pilot Project Brief - Arizona NW-HIN Pilot
Pilot Project Brief - Gorge Health Connect Pilot
Project Brief -- Florida HIE


Workgroup Lead: Paul Tuten

Implementation Geography represented (if any)
Richard Elmore

Dave Monic

Michelle Del Guercio
Atlas Medical (Atlas Development Corp.)

Amber Broadwater-Martinez

Francois Andry

Jonah Frohlich
California Health and Human Service Agency

Chris Voigt
CareSpark/MobileMD (HIE Tech)
Susan Torzewski
Douglas Arnold
Clinical Groupware Collaborative

David C. Kibbe, MD
Clinical Groupware Collaborative

Douglas McLeod
Community Choice PHCO

Bhawna Batra

Vidit Saxena

Julie Maas
EMR Direct

Luis Maas
EMR Direct

John Williams
Garden State Health Systems

Michael Firriolo
Garden State Health Systems

Susan Johnston
GSI Health

Noam Arzt
HLN Consulting, LLC

Jeff Cunningham

Pat Pyette
Rhode Island Quality Institute
Bruce Schreiber

Lee Jones

Parag More
MedAllies - Hudson Valley - NY
Mark Bamberg
MEDfx - MedVirginia - Verizon - Dominion
Frank Clark
Medical University of SC, South Carolina Research Authority

Eric Heflin

Mark Stine
MedPlus, Inc./Quest Diagnostics

Tom Wagner
MedPlus, Inc./Quest Diagnostics

Marla Kouche

Umesh Madan

Chris Voigt
MobileMD - CareSpark HIE Tech

Robert Barker
NextGen Healthcare Information Systems, Inc.

Yvan Charpentier
NextGen Healthcare Information Systems, Inc.

Chris Harris
NextGen Healthcare Information Systems, Inc.

Brian Ahier
Gorge Health Connect
Gorge Health Connect/Medicity
Will Ross
Redwood MedNet
Northern California
Gary Christensen
Rhode Island Quality Institute
Rhode Island Quality Institute
Greg Chittim
Arcadia Solutions
Rhode Island Quality Institute
Didi Davis
Serendipity Health, LLC
Health Information Partnership for Tennessee
David Tao
MedAllies - Hudson Valley - NY (Albany Med Ctr)
Sri Koka
Techsant Technologies

Paul Tuten
Consultant, State HIE Program ONC

Bob DeAnna
Recursion Software

Vaibhav Bhandari

Meeting Agendas / Notes

Geographies Meeting 2015-08-19
Geographies Meeting 2015-07-15 -- Not held. See 2015 Meeting Schedule above for details.
Geographies Meeting 2015-06-17 -- Canceled
Geographies Meeting 2015-05-20
Geographies Meeting 2015-03-18
Geographies Meeting 2014-11-19
Geographies Meeting 2014-08-20 -- Canceled
Geographies Meeting 2014-07-16 -- Not held (summer break)
Geographies Meeting 2014-06-18
Geographies Meeting 2013-12-18
Geographies Meeting 2013-11-13 -- Did not hold due to logistical problems
Geographies Meeting 2013-10-16 -- Did not hold due to govt. shutdown
Geographies Meeting 2013-09-18
Geographies Meeting 2013-08-21
Geographies Meeting 2013-07-17
Geographies Meeting 2013-05-29
Geographies Meeting 2013-04-17
Geographies Meeting 2013-03-20
Geographies Meeting 2013-02-20
Geographies Meeting 2013-02-06
Geographies Meeting 2012-12-05
Geographies Meeting 2012-11-14
Geographies Meeting 2012-10-17
Geographies Meeting 2012-10-02
Geographies Meeting 2012-09-19
Geographies Meeting 2012-08-22
Geographies Meeting 2012-08-08 -- Did not hold due to logistical problems
Geographies Meeting 2012-08-01 -- Cancelled due to recombining Pre- and Post-Implementation Tracks (next meeting on 8/8/12)
Geographies Meeting 2012-07-25 -- Post-Implementation Track
Geographies Meeting 2012-07-18 -- Pre-Implementation Track
Geographies Meeting 2012-07-11 -- Post-Implementation Track
Geogrpahies Meeting 2012-07-04 -- Cancelled due to Independence Day holiday
Geographies Meeting 2012-06-27 -- Post-Implementation Track (Note: this meeting was cancelled)
Geographies Meeting 2012-06-20 -- Pre-Implementation Track
Geographies Meeting 2012-06-13 -- Post-Implementation Track
Geographies Meeting 2012-06-06 -- Pre-Implementation Track
Geographies Meeting 2012-05-23 -- Pre-Implementation Track
Geographies Meeting 2012-05-16 -- Post-Implementation Track
Geographies Meeting 2012-04-25 -- Pre-Implementation Track
No Meeting on 2012-04-11 due to S&I F2F
Geographies Meeting 2012-04-04 -- Post-Implementation Track
Geographies Meeting 2012-03-28 -- Pre-Implementation Track
Geographies Meeting 2012-03-21 -- Post-Implementation Track (Note: this meeting was cancelled)
Geographies Meeting 2012-03-14 -- Pre-Implementation Track
Geographies Meeting 2012-03-07 -- Post-Implementation Track
Geographies Meeting 2012-02-29 -- Pre-Implementation Track
Geographies Meeting 2012-02-15 -- Pre-Implementation Track
Geographies Meeting 2012-02-08 -- Post-Implementation Track
Geographies Meeting 2012-02-01 -- Pre-Implementation Track
Geographies Meeting 2012-01-25

View 2010-2011 IGW Meeting Agendas / Notes