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Tuesday, October 26, 2010

Cogitating on Standards Harmonization, S&I and Canadian Collaboratives

Just for fun, and so you can keep up, go back and read the following posts.
  1. Hello again, it's me, stirring up the pot
  2. A Canadian Perspective on Standards Harmonization
  3. What happens to HITSP Now?
  4. In which I have something positive to say about ONC
Now anybody who has been paying attention will realize the the ONC S&I Framework discussed in #4 is something that will be replacing HITSP (see #3), for which Canada has a particular solution (see #2) that I recommended we might apply south of the border in #1.

I've been thinking on this out loud for a while.  That first post is in July of 2009.  I still don't have all the answers, and I suspect I never will, and in fact, I'm still thinking...

Where I'm focused right now is trying to figure out what the governance model should be. 

I was listening to David Riley's presentation on CONNECT last week.  The idea that FHA came together as a way to represent the entire Federal government in CONNECT was interesting, because, yeah, the Feds have way to much weight for an agile organization if every agency gets involved.  And the same problem happens with SDOs, and payers, and ...

And yet the HITSP model left me wanting too, because if only X gets to elect X, then all X's will be the utmost in X and well, nobody different will ever get heard from, and the small ANYTHING will be completely drowned out.

And it shouldn't be about any one kind of anything...

So, what should happen here?

And then I think about the current election cycle here in the US, and I think about casting dice instead of votes in some races...

Which leads me to think that random chance might have some role to play...

And then there's the case where we made a leadership role in an association I'm a member of specifically to address a part of the group not usually heard from...

So, if the US were to have a new HITSP, or something like it, how should it be governed and who should do the governing?

I know one thing that desperately needs to change.  It needs to be able to say NO, and set its own schedules.  The people doing the work need to have that control.  Somebody else may be able to set priorities, but I don't care what you do, 9 men still won't be able to birth a baby in one month.

You need to have the right resources, and the right amount of time in place to make it work.

Still thinking...

Maybe if I sleep on it, I'll wake up with the answer...

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