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(US) National Health Information Network, Request for Information - Project Home Page

Work Product

The Ontolog Community's response to the ONCHIT NHIN RFI #4150-24 (updated) - see: http://ontolog.cim3.net/file/work/health-ont/NHIN-RFI/NHIN-ontolog-rfi-response_20050118.doc

Most Critical Task(s) At Hand

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What's New

  • Our response to the NHIN-RFI was delivered Jan. 18, 2005, on time (even with 4 minutes to spare before the deadline!)
    • Kudos to all who were involved and contributed.
  • One page "thesis" that will guide our group response
  • the RFI Announcement page is at: http://www.hhs.gov/healthit/rfi.html
  • a concise summary by Prof. Kroch of Dr. Brailer and other's prior work is at: http://wfs.cgu.edu/lafkyd/cgu-kroch.pdf
    • EMR Definitional elements and requirements
    • EMR Current state:
      • Implementation goals
      • Barriers
      • Opportunities
    • ONCHIT Framework for Strategic Action
      • Data Exchange (Physician, "Physician Assistants", and Clinicians)
      • CareScience Projects
    • Community data sharing
    • Santa Barbara County (example of most medical communities)
      • Core Data Exchange
  • a transcription of the Technical Assistance Call is at: http://www.hhs.gov/healthit/documents/Transcript_RFI_Technical_Assistance_Call.pdf (This is a 48 page document to be summarized;)
    • key points is the needs of the Dr. Brailer Team to discover missing issues.
    • Is Ontology a "Missing Issue"?

Key Date(s) to Note

  • important DATE: Responses should be submitted via email to ( NHINRFI@hhs.gov ) the Department of Health and Human Services (HHS), Office of the National Coordinator for Health Information Technology (ONCHIT), on or before 5 p.m. e.s.t. on January 18, 2005.
    • Weds Dec. 22, 04 ( Agenda approved; "B" Team held ~ 5 discussion Sessions: draft answers to questions)
    • Thurs Jan 6th 2005
      • Prepare for Outline Discussion
      • Prepare to capture issues with NHIN_RFI "Ontology Life Cycle"
      • Issues described and "majority" of alignment conflicts resolved
    • Saturday, Jan 8th 2005 Editing of Outline (Bob, Nad, others) Bob Smith
    • Tue Jan 11th 2005 work session
      • Clarify Health Ontolog objectives and scope of an Ontology based Approach to Health Care Bob Smith
      • Resolve workgroup process (time-limited discussion and vote/polling (informal) )
      • Breadth of Response (Number of sections and questions)
      • Editorial process and final edit responsibility
    • Thurs Jan 13th 2005
      • Review and Comment cycles
    • Sunday, Jan 16th 3pm PST Deadline for Question Submittals
      • Merge, Synthesize, Identify alignment issues
      • Circulate for Review and Comment; Phone Calls
    • Mon Jan 17th 2005
      • Continue discussions and refinement
    • Tuesday, Jan 18th, 4pm EST eMail to Dr. Brailer

Project Mission

  • To round up a joint Ontolog community effort, to author a response and submit that to the (US) National Health Information Network, Request for Information of 2004.11.15. Using that as the beginning of a collaborative effort where the Ontolog community can contribute professionally to the NHIN initiative.

Outline for Deliverables & Deadlines

  • Strawman version 1 Bob Smith
    • The RFI states 4 goals, key missing elements to bridge current practice to a ten year vision, and poses a Decision Scenario including:
      • The NHIN could be developed and operated in many ways.
        • It could include state-of-the-art web technologies or more traditional clearinghouse architectures.
        • It could be highly decentralized or somewhat centrally brokered.
        • It could be a nationwide service, a collection of regional services or a set of tools that share common components.
        • It could be overseen by public organizations, by private organizations, or by public-private consortia.
      • Regardless of how it is developed, overseen or operated, there is a compelling public interest for a NHIN to exist.
    • The RFI has 24 questions structured into 5 parts (But no "Problem Statement" )
  • Team Organization
  • Team 1: 3 Questions;(SMI_Mark_Adam_Samson_Natasha) Overview and working definition of a National Health Information Network for distributing Electronic Health Records:
    • A. General ( Working definitions of a National Health Information Network, models of access to this Network, and appropriate roles at each level)
  • Team 2: 10 Questions;( Kurt_Bo_Bob_Nad ); Enterprise Strategy, Process, Incentive Alignments:
    • B. Organizational and Business Framework (Economic and Policy Criteria for developing Business and Organizational Models in a "Mixed Public-Private, Open interoperable Context )
    • C. Management and Operational Considerations ( Useful and Useable Products, Policy and Managerial Incentives, Contingency-Risk Modeling, Community of Practice governance )
  • Team 3: 11 Questions; ( Nicolas EdwardCherlin MarkRoest) Standards and Incentives
    • D. Standards and Policies to Achieve Interoperability ( What is the current status of the major Standards Development Organizations and their processes/assumptions and relationships to each other and the US Govt... Open Standards developed in an open process )
    • E. Financial and/or Regulatory Incentives and Legal Consideration __ Other ( Do conflicting policies and strategies now exist? Are new architectures and mechanisms available to resolve certain pivotal conflict areas? )

Project Work-in-Progress

  • Bob Smith OUTLINE Draft # 1
    • Executive Abstract-Thesis
    • Problem Statement (Embracing Ontology as a means to knowledge-enabled health care systems?)
    • (General) Core Technical Issues: Knowledge Applied to useful and useable Health Records and its Network
      • Identify key ontology questions about Health Records (Was EHR)
      • Identify key ontology questions about Health Knowledge Delivery (Was NHIN)
    • Organizational and Business Framework (NOTE: ONCHIT Leadership Panel Strategy about to be published)
      • Scope (Context, Feasible Strategies, and Time Frames)
      • Semantics of Public-Private Ontologies
      • Is Health Care Competition a major ontological problem? ( Economics of Competitive Strategy Options?)
      • Alternative Views and Policy Creation Mechanisms that work
    • Management and Operational Considerations
      • Design and Maintence
      • Is Health Care "Value Chains"
      • Need for Ontologies in FHA Projects
      • Institutional structures (GAO, for example, may add unexpected value to Ontology projects)
    • Standards and Policies for Interoperability
      • Ontology questions for Standard Setting Bodies
      • Examples of effective use of Ontologies in SSB
      • Interoperability and MetaStandards (Steve Ray citations)
    • Incentives and Legal Issues
    • Other
      • Q 23: Design Principles
    • Terms, Concepts, and Tools
      • Ontology
      • Policy
      • Ontology Policy
      • Etc.
    • Bibliography
    • need to add: conclusions and recommendations
    • Brand suggested we cite the Hardvard Study on CoP in Government.

Action Plan and Chronology

  • Bob Smith Monday 1-17-05: Post Action Report Format designed for next Opportunity
  • Bob Smith Sunday 1-16-05: Note that many of the 24 RFI questions are now "answered" by ONCHIT Staff in their five presentations to key stakeholders "Suggestive Answers?"
    • Extensions of the earlier "Framework" of 4 goals and strategies to achieving these defined goals
    • Specific project thrusts with start and finish points
    • Increased specification of concepts: Regional solutions; Public-Private Partnerships; CHI-eGov Architectures;
  • Bob Smith Tuesday, 1-11-05: What is our primary objective?
    • Convincing Dr. Brailer to use an Ontology Approach to evaluate technical and non-technical NHIN-EHR design choices
      • HL7 and ICD 9 "improvements"
      • A Protege based solution set
    • Convincing Dr. Brailer of the links between Interoperability, Enterprise Architecture, and Ontology
  • Resolve Option 1 -- Option 2 language
    • Mark and Adam create a 1 page "thesis" and use it to guide the group response
  • Achieve sufficient Membership interest in completing this RFI phase and future opportunities
  • To consider the alignment tasks between the three major sections in light of calendar realities
    • 1. Focus on just the "ontology" used by the RFI writing team of Dr. Brailer (Agree)
    • 2. Develop a "Strawman" of working definitions of the two central terms (NHIN and _EHR)
    • 3. Expand, in parallel, the Enterprise Topics and the Regulatory Topics
    • 4. Assess the internal alignments within each of the three topics
    • 5. Integrate, as needed, alignment problems within and between the three topics
    • 6. Reality Checks
    • 7. Complete the resulting document and essential graphics ( 1-3 pages per question?)
      • pull a response to the RFI together and submit that by the 2005.01.18 deadline.

The Team

    • ...(add names of any missing team member here)...

Discussion Archives & Shared-File Workspace

Resources

Conference Call, Meeting & Workshop

  • ...(list and link to agenda & proceedings pages here)...



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