Convert your FHIR JSON -> XML and back here. The CDA Book is sometimes listed for Kindle here and it is also SHIPPING from Amazon! See here for Errata.

Monday, February 1, 2016

There is still good in me!

The tag line to this comes from a joke where a long-time friend of mine upon being transferred from Engineering to Product Management claimed that he was going over to the dark side.  I have a weird dual role in that I'm reporting up through the engineering line, but matrixed into product management.  So, I haven't gone over to the dark side completely!

In some ways, I feel like one of the very rare gray Wizards of Recluce, who must carefully walk between two worlds. The challenge for the main character in that story was to learn how to look at things differently from either perspective did normally so as to manage much more than could be done from either perspective alone.

I'm still getting settled in, and until I do, I expect to be spending a good deal more time on the dark than the light.  I hope you'll bear with me until I discover that middle way.

Thursday, January 28, 2016

A belated post on Day 1 at the IHE Connectathon

I'm a bit behind in posting on my Connectathon experiences this week.  After you read my day one post you might understand. I started off this year as I always do, hunting down the guy who was going to tell me what our priorities are this week so I could help him to make a plan for succeeding (what I usually expect him to have prepared in advance).  Some years are better than others, and there's a plan to work from.

When I got to his seat, I had a stunning realization. Oh shit, that's where I'm sitting.


Monday, January 25, 2016

Five things you can do to succeed in HealthIT

1. Reuse, repurpose, but do not reinvent.  
NIH is the anathema, if you must invent, invent something new, not something old. That way you are always spending your time on problems that haven't already been solved.  That gives you capabilities nobody else has, and thus, no competition.

2. Build upon and contribute back to the excellent work of others. 
Being associated with good work creates value and reputation without the comensurate investment associated with building alone.  It's not about the tech, it's about the rep.

3. Be known for what you can do with what you have, not with what you have.  
Your most prominent customer feedback will be on your service, not your technology. What you have can change overnight, skills take longer to develop.

4. If you have really good technology (or skills), maintain it.  
Technology and skills needs to be significantly refreshed about every three years or so to stay current, and needs ongoing maintenance to avoid getting stale between refreshes.  The worst thing you can do with great technology is to let it become just good, and the fastest way to do that is to rest on your laurels.

5. Mentor others (Thanks to one of my mentors, Glen Marshal, for reminding me of this)
Leave your competitors in the dust, but not your colleagues.  Don't be irreplacable; you will also be unpromotable.  

Thursday, January 21, 2016

Is this your home or are you just visiting?

It's fairly common in standards work groups and organizations to see fluctuating membership depending on the topic currently under consideration.  Some people are interested in the topic, rather than the work group (or SDO), and others vice versa.  I had just finished visiting with CDS on a project that I'm working on for HSI today, when I realized that the notion of "visiting" and the notion of "home" really impacted how I dealt with the work group.

Home is where you go when you have nothing more urgent to do.  But it also describes who can call on you when something urgent comes up, or who will wait for you to become available when they know they need you.

Just visiting are those places where you go because they are working on something of interest to you, but they don't always do that.

How you deal with standards differs depending on whether you are home or just visiting.  When you are home, you have a bit more leeway.  When you are just visiting, you have to work with the group that you are visiting, and be more accommodating towards their needs.

HL7 is home.  IHE is home. HL7 Structure Documents is home.  IHE Patient Care Coordination is home (though it used to be IT Infrastructure). Any group I co-chair is home. In HL7 more and more, FHIR is becoming another home, and may push me into being more of  visitor to Structured Documents, but hasn't yet.  It really depends on how much attention SD pays to FHIR.  Healthcare Standards Integration is kind of home, sort of like an extended family vacation home though, in part because it is still nascent.  Attachments is kind of like my kids house.  I'm just visiting, but I get many of the benefits of being home.  S&I Framework projects are about just visiting.  Because of the short length of these projects (most are 1-3 years), it's hard to "setup house".  HL7 CDS is a close friends house -- I'm still just visiting, but we know each other pretty well, and I know where the beer and glasses are kept.

As I shift roles, I expect that it may influence where home is in the coming years.

Where is your home?  Are you planning on moving anytime soon?


Wednesday, January 20, 2016

Leveled Up

Last night (on the eve of my Birthday) I accepted a role as Principal Interoperability Architect within GE Healthcare IT.  My new role also includes interoperability product management responsibilities. My first official act in this new role will be attending the IHE North American Connectathon this Monday where a number of my colleagues will be testing my employers products.  This Connectathon will NOT be my first, but it will certainly be my first in this new position.  I'm certainly going to be looking at interoperability in a whole new way in the coming years.

I've been working towards obtaining this kind of responsibility for the past year or so.  You, my readers might ask, how this will change my blogging content and habits, or my standards participation.  I've already given that considerable thought:

  1. My blog posts here will continue to focus on standards and standards related policy.  Any work that I participate in on for the development of standards has always been within public view, and will continue to be so.  I don't talk about my employers products in this blog, and that won't change either.  I have other venues for that sort of thing.
  2. Habits will very likely change, just as they did when I started school.  I'll try to keep up, but will likely be overwhelmed with more operational responsibilities that will make it difficult to do so.  I know I can do better than a post a week (on average), but will likely not return to a level of 1 a day that I had before I started school when I finish that later this year.
  3. Standards participation will become more focused.  I'll have to implement, instead of teach implementers.  It won't likely have a huge impact on quantity or quality of participation, but will likely affect the quadrants that I focus on.
Finally, my business card will change.  No longer will it say Standards Geek. In the past I've been responsible for the creation of standards, and now will be responsible for implementation of them in product.  As is fitting, when standards get implemented, my title (on my business card) will also reflect that.  I think I'll start introducing myself as an "Interoperability Geek".

   -- Keith

Tuesday, January 19, 2016

Bring out Your Dead ...

ONC and CMS clarified today what the premature announcement of the death of Meaningful Use by Andy Lavitt last week means for Doctors and Hospitals:

  • Current law requires continued measurement of Meaningful Use as specified under existing regulations!  MACRA neither eliminates MU, nor makes it better.  But ONC and CMS are apparently listening well enough to put a good spin on things.
  • The M in MACRA stands for Medicare, and only affects physician and clinician payment adjustments. EHR incentive programs for hospitals still needs work.
  • The new approach will likely take a couple of years to figure out, though you can expect some of that regulation to start showing up later this year.
  • CMS will be making it easier for healthcare providers to claim hardship.

As Monty Python would say: "It's not dead yet!"


ONC Accepting Comments on Standards Advisory

In my inbox ...


ONC is Accepting Public Comments on the 2016 Interoperability Standards Advisory
ONC is accepting public comments on the recently released 2016 Interoperability Standards Advisory [PDF - 2MB]. Public comments will be used to begin the process of developing the 2017 Advisory. The comment period will be open for about 60 days and will end at 5 p.m. on Monday, March 21, 2016. The public comment submission form and the preferred comment template [XLSX - 22 KB] are available for download.

The Interoperability Standards advisory is a coordinated catalog of existing and emerging standards and implementation specifications developed and used to meet specific interoperability needs. It represents the results of ongoing dialogue, debate and consensus among industry stakeholders on the standards and implementation specifications that are best available. But most importantly, it is a critical element of our delivery system reform vision where electronic health information is unlocked and securely accessible to achieve better care, smarter spending, and healthier people.

If you need additional information or more time to submit comments, please contact Chris Muir at before the March 21, 2016 deadline.