- What Works? What doesn't Work? What do we need to know? What do we need to create? (3M5D)
- three components: training and education, policy, increase access (3M5H)
What's working: (3M5I)
- neuroinformatics has shared working space - working grid example (3M76)
- three states working together - but at the beginning - NHIN technology is working - (3M5K)
- not about technology, but people (3M5L)
- 30% Veterans receive care outside of VA - forced movement to interoperability with DoD which is working - Could this be a driver re:private care (3M5M)
- What does/ doesn't need grid? (3M6A)
- SURA grid is working (3M6B)
- centralized credentialing (VA physicians) (3M6C)
- Federal Health Information Exchange - export to states (3M6K)
- strong business case is needed - who we are, what we need and how to go forward (3M6R)
- credentialling EMR (3M6S)
What's not working: (3M5N)
- (3M6D)
- 800 pieces of legislation up for discussion - not much, not accurate re: interoperability (3M5O)
- does bill language contrain opportunity? Wrong language in wrong place? (3M5P)
- e-pharmacy law didn't recognize use cases (3M5Q)
- public laws that prohibit sharing - 12 pieces of law -> sharing not allowed outside the federal gov't. (3M5R)
- need realism - hear "free" ehr - write a quick RFP and work isn't completed successfully (3M5S)
- payor organizations are the primary beneficiaries of interop (gov't. secondary for safety) (3M5T)
- 80% of billing numbers/ etc. are wrong (3M5U)
- Haven't decided who owns the record? this is a state policy level (3M5V)
- Are services sufficiently mature for DoD to be a driver relative to NHIN (3M6E)
- Is there an NHIN grid-based that has the universals needed? (3M6F)
- MEDICUS (3M6L)
- storage is costly (3M6G)
- need to develop the crossboundary sharing policies (3M6M)
- overcome legislation diffferences (3M6N)
- terminologies, standards are major - can we start again - move forward and not index all the past (3M6T)
- physicians not implment EMR - and toward trusted PMR that patient can control (3M6U)
- not all are aligned yet - providers are concerned about maintaining market share - collaboration isn't a given - needed better business model (3M6V)
- HIPAA's universal patient identifier (3M6W)
What do we need to create? (3M5W)
- (3M6H)
- recognized the importance of public-private partnerships (need trade associations/brokers) (3M61)
- need people who can write RFPs (3M62)
- curriculum on survey monkey (3M63)
- Wiede Holt (3M64)
- Who has time? Who can read standards? (3M65)
- role of social networking to change behavior (3M6X)
- ehealth credentially is important - matter to payors - looking at grid-based, physician-controlled credentialling (3M66)
- patient controlled records (3M6O)
- creative organizing to develop the extensible taxonomies/ontologies that can't be stove-piped - big issue if not addressed (3M6P)
- adequate language access re: records - understandable by patient (3M6Y)
- collaboration tools that support language translators (3M6Z)
- need to continue to build momentum (3M70)
- we need mandates (3M71)
- resilience networks after a disaster - rapidly forming network capability w/o overwhelming the city (federation, etc. is strength of grid) (3M72)
- improve diffusion of innovation (3M73)
- NLM has 19 training programs - tap this resource, including the students (3M74)
- how to keep track of all this - automating ontology feeds? (3M75)
What do we need to know? (3M67)