I am very proud of the responses to my Send the Questions to the Data. They were thoughtful and fact-based contributions to the discussion.
Of course, the post was prompted by the buzz that ONC has been generating on this topic. The next shoe has dropped in Rich Elmore’s post Distributed Population Queries – A National Priority. It is equally significant to note that Rich has taken a leave of absence from AllScripts and is carrying an ONC business card while he works on this. In this post Rich announced the “summer concert series,” apparently an environmental scan designed to bring a common information base to interested parties.
This beast is obviously not a biped; Rich also announced that a third shoe will drop in September with the formation of Query Health under the S&I Framework. It is significant that Rich was a key player in the Direct Project, at the time a unique combination of a small investment in government time and money with a lot of volunteer work, organized by principles that have been successful in open source communities. These include
- all activities are open anyone can observe and follow through a public wiki
- those that are committed to implementations get to speak and influence the decisions
- rough consensus, running code, final specification
- a lack of formalized governance rules.
Query Health is different than the Direct Project in that it will be handled under the I&S Framework.
Although I hear the monthly briefings on the Framework I confess to being confused exactly what it is. It is easy to understand the projects that lead directly to meaningful use regulations but Query Health deals with an important scenario that may not find immediately available standard that have widespread use.
Maybe ONC wants a way to launch multiple projects with the representative participation, innovation and group dynamics of The Direct Project and yet still have a way to ensure that the purpose and work products of the individual products are well coordinated.
The twin goals of achieving spontaneity and innovation while achieving government-level coordination seem like an oxymoron. Rich will have his hands full. On the other hand, he is an able consensus builder with a great software background, and ONC has walked the tightrope between innovation and the government regulatory apparatus better than any other government interop agency that I have ever seen.
I look forward to seeing the “fourth shoe drop” when the Query Health begins running with live patient data sometime soon.
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