NhinRfi

= (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


 * Executive Summary of Ontolog's NHIN-RFI response.
 * text of original submission, in the record.

Most Critical Task(s) At Hand:

 * ... (insert content here) ...

What's New:

 * BrandNiemann suggested a SICoP-Ontolog joint pilot at FHA-ONCHIT meeting on Jan. 26, 2005.
 * Ref. Brand's post (with background material): http://ontolog.cim3.net/forum/ontolog-forum/2005-01/msg00037.html
 * and continuing discussuion on starting this work at: http://ontolog.cim3.net/forum/health-ont/2005-01/msg00035.html


 * 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) BobSmith
 * Tue Jan 11th 2005 work session
 * Clarify Health Ontolog objectives and scope of an Ontology based Approach to Health Care BobSmith
 * 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
 * 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 BobSmith
 * 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

 * BobSmith 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

 * BobSmith Monday 1-17-05: Post Action Report Format designed for next Opportunity


 * BobSmith 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 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;


 * BobSmith 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

 * Active participants
 * BobSmith - co-convener, project manager
 * MarkMusen - co-convener
 * BrandNiemann - co-convener
 * PeterYim - co-convener
 * AdamPease
 * BoNewman
 * KurtConrad
 * SamsonTu
 * NatashaNoy
 * NicolasRouquette
 * PaulKoch
 * ChrisRichardson
 * DavidWhitten
 * MarkRoest
 * EdwardCherlin
 * AnthonyCheung
 * MichaelHogarth
 * ChristopherChute
 * NadBhatti
 * PatCassidy


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


 * Observers
 * SusanTurnbull
 * SteveRay
 * ConradBock
 * MarcWine

Discussion Archives & Shared-File Workspace

 * Discussion Archives: http://ontolog.cim3.net/forum/health-ont/
 * posting to the discussion forum: mailto:health-ont@ontolog.cim3.net
 * Shared-File Workspace: http://ontolog.cim3.net/file/work/health-ont/NHIN-RFI/
 * List of other NHIN-RFI Responses available on the Internet - see: NhinRfi/Responses

Resources

 * link to NHIN-RFI (courtesy SusanTurnbull)
 * link to NHIN-RFI-FAQ (courtesy BobSmith)
 * the RFI Announcement page is at: http://www.hhs.gov/healthit/rfi.html

Conference Call, Meeting & Workshop

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


 * Co-coveners' sync-up call - NhinRfi/ConferenceCall_2005_05_31
 * Post response submission review during regular weekly ontolog [[ConferenceCall_2005_01_20]]
 * Project work session with the regular weekly ontolog [[ConferenceCall_2005_01_13]]
 * Project team conference call - NhinRfi/ConferenceCall_2005_01_11
 * Project work session with the regular weekly ontolog [[ConferenceCall_2005_01_06]]
 * Project team conference call - NhinRfi/ConferenceCall_2004_12_22
 * Project Kick-off - http://ontolog.cim3.net/cgi-bin/wiki.pl?ConferenceCall_2004_12_16#nid044
 * Precursor to this effort - our joint SICoP-Ontolog ConferenceCall_2004_08_12