Dave,
Hmmm... I can see what you are saying... and on its face, this would seem 
to argue against my suggestion that we need a new "doctors EMR standards" 
organization.  But some key component must be missing if we have had the 
organizational structure in place for 15 years and we still do not have 
uniform EMR standards to hand out to our PMS vendors.  I think the missing 
ingredient is input from the doctors... but then doctors do not attend 
standards meetings... they go to medical meetings, and that's not likely to 
change.

To pull in the rich domain knowledge of doctors (and staff), we will need a 
new, highly proactive, well funded/organized model... one that can reach 
out and [painlessly] *suck* the business requirements right out of the 
provider community (HIPAAsuction?).  We need to keep little "standards 
suggestion/comment boxes" right under doctors' and PMS vendors' noses... 
making it trivially easy for them to contribute any complaint or idea to a 
centralized committee... without flying anywhere.  We should inundate them 
with effective advertising messages about the value of standards-based 
e-biz... show them the VISION that we all take for granted.  I just do not 
see the passive, volunteer model SDO working for doctors.  Payors and CH's 
with actual budgets for this WILL send people to meetings... but only to 
look after their own needs... perpetuating the doctor's belief that he/she 
is being increasingly "run" but payors.

Each week I see a few more office managers and PMS vendors stumbling out 
into the harsh light of HIPAA... and these folks are horrified to find out 
that nobody's working on their problem and that there is no big, friendly 
HIPAA Office to point them to or a "Welcome to HIPAA" packet to mail out. 
(see the recent post here, "Long term care readiness and the Taliban ate my 
homework").  Just wait a few months!  I really admire the ones who are 
posting their concerns to a listserve.  For every one of them, I suspect 
there are 50 who walk out, take one look at this mess, and decide "This is 
b--- s---!"... and just return to their patients.

This would be a huge project... with significant capital and operational 
needs.  But with a simple license fee model, we can extract the necessary 
cash from the doctors (the end users) to pay for both the HIPAAsuction and 
the marketing necessary to explain to them why this is all such a brilliant 
idea!

I think it's just crazy enough to work!  (and I'm obviously crazy enough to 
want to help create and manage it!)

Regards,
Chris

At 02:20 PM 5/13/02 -0700, David A. Feinberg, C.D.P. wrote:
>Chris,
>
>HL7 would not be the "'parent' or central coordinating body".
>With the exception and collaboration of the additional, parallel
>organizations noted by the NCVHS,  HL7  *is*  the body that already
>(for over 15 years now) sets the standards -- data content and
>format -- for communicating patient medical records information "that
>doctors and hospitals must collect and manage".
>
>                     Dave Feinberg
>                     Rensis Corporation
>                     206-617-1717
>                     [EMAIL PROTECTED]
>
>
>----- Original Message -----
>From: "Christopher J. Feahr, OD" <[EMAIL PROTECTED]>
>To: "David A. Feinberg, C.D.P." <[EMAIL PROTECTED]>;
><[EMAIL PROTECTED]>
>Cc: "Fulton Bob" <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>; "John
>Warren, OD" <[EMAIL PROTECTED]>
>Sent: Monday, May 13, 2002 11:38 AM
>Subject: Re: HIPAA Patient Medical Records Information Standards
>
>
>Dave,
>Thanks... this is very exciting news.  It would appear that HL7 is
>proposed as the "parent" or central coordinating body for PMRI
>standards.  It also appears from the scopes/missions of the three
>specific SDOs mentioned, that a need may exist for a separate SDO (or
>perhaps a committee within HL7) to  consider format and content
>standards for the [non-image] PMRI information that doctors and
>hospitals must collect and manage.  Would you agree... or is there
>already a designated committee working on this?
>
>Regards,
>Chris
>
>At 08:30 PM 5/12/02 -0700, David A. Feinberg, C.D.P. wrote:
> >Chris,
> >
> >Funny you should mention [way way below] standardizing electronic
> >medical records. The National Committee on Vital and Health
>Statistics
> >released their latest recommendations on this topic this past
> >February.
> >
> >Following is a cut-and-paste from  www.ncvhs.hhs.gov/020227lt.htm.
> >You'll note about a third of the way down that "NCVHS recommends that
> >HL7 be recognized as the core PMRI standard and that DICOM, NCPDP
> >SCRIPT and IEEE 1073 be recognized as standards for specific PMRI
> >market segments."
> >
> >                     Dave Feinberg
> >                     Rensis Corporation
> >                     206-617-1717
> >                     [EMAIL PROTECTED]
> >
> >
>
>
>
>
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Christopher J. Feahr, OD
http://visiondatastandard.org
[EMAIL PROTECTED]
Cell/Pager: 707-529-2268        


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