Wednesday, September 29, 2010


The HL7 ballot closed on Monday this week.  I managed to finish voting on all the ballots I signed up for this week, thanks to my knowledge of a few balloting techniques.  Last Friday I was asked to testify to the HIT Policy Information Exchange Workgroup on Provider Directories, so there likely won't be a post tomorrow.

Recently I've been going back to review where we've been for the past decade+ since To Err is Human and Crossing the Quality Chasm.  This review of history shows that while an overall strategy isn't apparent, there really is one, as I alluded to in a previous post.  What is missing here is what we call in Software development a problem of tracability to the requirements.  The two IOM reports identify significant problems and provide some strategies to solve them, but you won't find either as footnotes in the ARRA/HITECH laws, or the related regulation or a lot of other places.

This lack of a written overall strategy leads to a problem in defining scope in many places.  There are a thousand flowers blooming -- projects demanding attention, and many could wilt for lack of focused care and attention (and some arguably even should).  We need, as Doug Fridsma indicates in the ONC S&I framework, a way to focus.  These reports and their recommendations could be used as organizing principles (and in many ways already have), especially if we make the links explicit.

Dr. Fridsma, by the way, will be meeting with the ITS and Structured Documents workgroup committee members at the HL7 Working Group meeting next week.  He has some questions for HL7, and we obviously have a few points that we'd like to make to him also.

That reminds me that I need to practice my Ambassador presentation on CCD that I'll be giving on Monday at that event.  HL7 has the whole Monday afternoon devoted to free presentations HL7 Standards for Meaningful Use available to all meeting attendees (you do have to pay for meeting registration).  I'll also be teaching a class on the HL7 Continuity of Care Document Thursday afternoon.

By the way, if you missed the free HL7 webinar I did on the CCD, you can at least see the Q&A I posted on this blog.  While this presentation wasn't recorded, others may be in the future, and you can always ask HL7 for an ambassador to present for your group or event.

I'll be putting together a more detailed post on my findings after I analyze the two IOM reports, but I also have to be careful that I don't give away my next homework assignment to budding informaticists.  You see, my review was sparked not by thinking that this was a solution to my problem, but rather by a discussion I had with a BU professor who wants me to spend a day with her class.  It was only after I started my review that I realized how it could help bring focus to current events.  As always, when two seemingly unrelated things connect, sparks fly.


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