S&I Framework F2F: Session Notes
Initiative: Workgroup Leads (All Initiatives)
Session Topic
Facilitator
Location
Attendees
Workgroup Leads
Doug Fridsma, Jamie Skipper,
John Feikema
The Westin: Alexandria, Virginia
All Workgroup Leads
Date / Time
Scribe
April 11, 2012
Heather Stevens
Materials
Key Points
Question asked of Community-Led Initiatives: What benefits have you been able to realize by leveraging
the S&I platform?
1) Wiki set-up
2) Coordination of logistics (e.g., calls)
3) Reuse of use case and harmonization artifacts
ONC – what’s the lightweight solution for community-led initiatives?
 Wiki + Change Management Facilitation (e.g., SDO convening)
For Meaningful Use 2016 edition, we need to keep in mind that we have about an 18-month horizon.
Need to think about scope, priorities and building upon what we have done.
The NwHIN Power Team is in the process of trying to articulate the qualities of a “good standard”.
Cross-Initiative Coordination & Awareness Suggestions:
 Include summaries of previous standards analysis criteria and results (ideally on the repository)
 Share Pilot Implementation Lessons Learned
 Continue focus on scalability – how do we or can we accommodate community members that
would like to be involved in >1 S&I Initiative?
 Is there a structure we can build that can direct community members to the various experts in
the S&I community on various topics, Initiatives and/or artifacts?
 Need to consider options in addition to everyone getting in the same room
Policy Considerations:
 Need ONC assistance in addressing policy issues arising during S&I Initiatives
o e.g., this is a definite struggle being encountered by Public Health Reporting
o Need to “play nice in the policy sandbox”
 Does the community have suggestions for a way to facilitate these discussions on an ongoing
basis?
Pilots
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Workgroup Leads Meeting, 4/11/12
S&I Framework F2F: Session Notes
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The community has heard a lot about the importance of pilots
Resources are needed to get that activation energy out there
For pilots, ONC may need to provide resources for coordination since this is such a critical piece
of us getting it right
Need to focus on partnerships
o Pushing the S&I work out to the community and receiving feedback
Need to also be able to differentiate between Reference Implementations (RI) as RI and RI as
working production software
ONC support alternatives
Drive  when it’s a matter of regulatory compliance
Coordinate  because it’s important
Monitor  to support alignment and readiness
There is a “big hole in the floor” when it comes to adoption though
Make sure we are keeping an eye on the patients and the end users of the data
Community commented on a struggle they’re setting with adopting the tools and implementations
when the health care reimbursement methodology is acting as more of a disincentive to care
coordinators. With S&I, they see a real opportunity for efficiency, coordination and reducing costs.
 The challenge is making the business case
o Lowering costs is okay but adding value is better
Make sure we are taking advantage of learning networks and leveraging tools outside of S&I
Try and make it as easy as possible for the community to engage and adopt
We need exposure to the disconnects encountered once the real-world efforts get underway
Keith Boone mentioned the RFI out for OMB A-119 (http://www.gpo.gov/fdsys/pkg/FR-2012-0330/html/2012-7602.htm) and recommended S&I community members review and response
Question keeping some folks up at night…Are we doing the right thing? Exchanging information without
maintaining authenticity of the source brings the data integrity and context into question.
 This will be the focus of the esMD Author of Record use case
 ONC wants us to keep three (3) things in mind…
o All digital signature requirements should go to Sam Elias, esMD Initiative Coordinator
o Provenance (PCAST) – an important issue that is yet to be solved
o This is a huge problem – how can we break it down into increments and what can we fix
in 18 months? (Path of least regret)
We are talking a lot in theoretical solutions right now. Need to focus on getting things functional.
Force collaboration and adherence.
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Workgroup Leads Meeting, 4/11/12
S&I Framework F2F: Session Notes
Increase standards focus on usability and adoptability. This is just as important if not more so than
technical feasibility.
Some say the government is moving too fast, slow down. Others felt its moving too slow. The
increments don’t really show value and adoption until we can “close the loop”. For example, LRI is
valuable but without LOI and the compendium, we’re missing the round trip. We can pilot pieces but
need the whole for adoption.
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Workgroup Leads Meeting, 4/11/12