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Public Hearing
Standards & Interoperability Task Force
Stan Huff, Co-ChairArien Malec, Co-ChairFebruary 27, 2015
S&I TaskforceDraft Work Plan
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Meetings Task
Friday, January 23rd 1:30pm – 3:30pm ET • Kick off and overview of the S&I Framework• Review charge• Action steps
Tuesday, January 27th, 11:30 – 1:00 pm ET • Briefed HISTC on focus and preliminary findings
Friday, January 30th 1:30pm – 3:30 pm ET • Review and discuss action steps• Explore “How” – starting with how “identified
national priorities” should be made Tuesday, February 17th 1:30pm – 3:30 pm ET • Review and discuss action steps
• Prep for Virtual Hearing
Friday, February 27th 1:30pm - 3:30pm ET • Virtual Hearing
Thursday, March 5th 12:00pm – 2:00pm ET • Summarize Virtual Hearing• Develop recommendations
Friday, March 13th 2:00pm – 4:00pm ET • Finalize Phase I recommendations - update documents/plans
• Prep for March HITSC presentationWednesday, March 18th HITSC Meeting • Phase I Recommendations
Progress to Date & Focus Ahead
Approach Discussion / Results
Is there a continued need for the S&I?
Yes, but there are opportunities for improvement
Evaluate the “what” Key Jobs to be Done• Support national priorities & production use• Facilitate Federal participation in SDOs• Recommend needs for infrastructure and non-traditional SDO artifacts
Evaluate the “how” Considerations to Improve Approach• Balanced representation• Measurable, meaningful real-world results• Reasonable implementation path• Interim and long term goals / outcomes• Rapid Cycle Implementation• ONC should facilitate not drive
How should S&I conduct business?
How are the jobs done?• What are the key business processes?• Which have worked well? • What are the successes and lessons learned?
Public Hearing Case Studies: Cross-SDO Perspective; Stakeholder Perspective from Users of S&I Implementer / Industry Perspective; Non-S&I Standards Groups
Recommendations Final recommendations to HITSC
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Goal for Public Hearing
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The goal of the virtual hearing is to better understand the role of the S&I Framework and its' jobs. We would like each panelist to address the following questions:
• The task force has proposed the following jobs to be done for S&I: – Support national priorities and production use– Facilitate Federal participation in SDOs
• Question for Panelists: Would you add or change any of those jobs? If so, which jobs and why?
• The task force has proposed criteria for defining “identified federal priorities”: – Balanced Representation– Measurable, meaningful real-world results– Reasonable implementation path– Interim and long term goals/outcomes– Rapid Cycle Implementation
• Question for Panelists: How would having these criteria in place have affected initiatives you participated in?
Bob Dieterle, CMS Electronic Submission of Medical Documentation
(esMD) Initiative Coordinator
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Jitin AsnaaniathenaHealth
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Larry GarberReliant Medical Group
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Margaret DonahueVeterans Health Administration
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Brian BehlendorfMithril Capital Management
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Justin RicherMITRE Corporation
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Lessons from the IETF and OIDF
Justin RicherBespoke Engineering http://bspk.io/
February 27, 2015
Two Organizations
Internet Engineering Task Force OpenID Foundation
http://ietf.org/ http://openid.net/
Many Standards
Similar Goals
• Produce open standards– Documents intended to drive technology
implementation and deployment– Can be used and implemented by anybody
without license• Broad participation– Big companies– Small groups– Individuals
Two Very Different Models
IETF Structure
• No formal membership or joining process– Join a mailing list, come to a meeting
• Lots of hierarchy– Working groups, editors, chairs– Areas, directors– Steering groups– Architecture review boards– RFC Editor– etc.
OIDF Structure
• Formal membership– Companies, groups, and individuals can join the
foundation for a membership fee– Anybody can join a working group for free • Note: you don’t have to join the foundation
• Formal IPR assignment– Explicitly sign a form to contribute to a group
IETF Process
• Working group mailing list is canonical– All decisions are made and documented there
• IPR handled by the “Note Well”– Nothing to sign, participation implies consent
• No voting– “Rough consensus and running code”
• Artifacts move through a well-established path along the hierarchy
OIDF Process
• Working groups define their own processes– Mailing lists– Phone conferences– In-person meetings
• Mixed consensus model– Rough consensus in the working groups– Formal membership voting on working group
products to produce final standards
IETF in Other Words
• Benevolent dictatorship by council– “The Elders of the Internet”– Very large membership base– Bad or ineffective leadership can ruin things
• Be prepared for heated arguments– Strong personalities tend to win– Good leadership can move things forward
• Susceptible to stalling– Can’t “vote around” a bad actor
OIDF in Other Words
• Small, focused, engaged membership– Slightly more friction for contribution
• Be prepared for heated arguments– Strong personalities tend to win– Good leadership can move things forward
• Susceptible to cliques– Smaller size means funny things can sometimes
sneak through (to a point)– Cases of “It might be a good idea if…”
Take Away
• Commitment to open standards• Different organizational structures have
strengths and weaknesses– No system is perfect
Thomas SparkmanAmerican Clinical Laboratory Association
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Walter SuarezKaiser Permanente
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Clem McDonaldNational Institute of Health
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Committee Discussion and Next Steps
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