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Tom Lloyd: Where are we at from where
you started this morning to where you are now?
Discussion
We have a clearer picture.
Tom Lloyd: The Romans had a method of
voting based on thumbs. Where are we regarding the project? (vote shows
approximately half way.)
There’s still too much uncertainty around why we are here.
Is it things you haven’t touched on or is it just needing more
clarity and understanding?
Discussion
It’s that and how will we get to that understanding of what we
need to know, decide, and move forward on. We need contractual agreements.
The clarity is around what we need to become best partners on.
Presenter: Eric Ford
The group from market X is willing to participate based on certain
conditions. We want to see a governance and project management plan.
The stakeholders need to understand that. What level of risk are we
facing and what is the nature of it? We need the work plan distributed
and we need to find an intermediate version to work off of. Once the
governance is formed, we have some oversight. The levels of participation
need to be clearly defined and there needs to be options on how you
participate.
The deliverables need to be clearly outlined and have a probability
assigned to them. One of the guiding principles needs to be transparency.
The greater New Orleans market has some involvement in putting the
partnership agreement s together. We want to open this up to Jefferson
County and others. The governance group has to drive the technical
specs with the vendor. Some of the participants simply won’t
join without that agreement.
We also want to obtain a business model and implement it, not just
a working meeting.
Discussion
It shouldn’t be the system architecture that drives the policy.
The governance group for New Orleans wants to make sure that the governance
group in Baton Rouge, New Orleans, and at the state level has clear
input.
We’re making a suggestion that it’s focused on the sharing
of information by emergency departments. If the Baton Rouge group
has
come up with something different, that could be a problem. There needs
to be access to a whole set of information, and it should be scaleable.
We think this will meet your needs because it does address the catastrophe
aspect. I think the ED has a number of good points for you.
How long do you think it would take to iron out the position? These
are big questions.
Our governance issues need to be short-term for the project that gets
us through September 30. That’s an interim group to drive the
process, meet the deliverable, and lay a foundation that will grow in
the future. Why do you think all of you were invited? Who are the decision
makers? You are for your institution and group. The governance has to
start with you guys. I don’t want this to become my need. The
state of Louisiana needs health outcomes improved. This is one of the
ways to see that happen. A governance model is an interim model that
I hope will be governed by many of the people in this room.
Mark mentioned earlier that successful models operate outside of HHS.
Maybe that’s a goal since you can’t start with that. This
group could be the interim governance group.
Whatever the governance model is going to be at the state level, it
needs to be well understood by the participants before we leave this
space.
The map room may help. If you want, you can use a Hypertile there to
list ideas that might help.
Tom Lloyd: I heard Team B’s view
of governance. Did Team C have anything else to add?
Presenter: Jenny Smith
We started with a timeline showing the program and project perspectives.
In September we would start phase two governance. The governance document
would include program management, steering committee, ownership, and
scope. There could be an executive summary listing the risks.
Discussion
There’s also a sustainability model due in July. A draft to the
governance group buys additional time.
The evaluation is due September 30.
Then you’d have a sustainability model with comments.
We also came up with evaluation metrics.
Discussion
What do you think about the emergency department?
Our scope was limited. What’s the easiest thing to knock out?
They recommended a shared data set and something we could all agree
on that added value to the patient. To create something quickly that
can show the value add would be good. That helps us limit it. However,
the care environment would not be limited. The core data set is transferable.
We want to be sure it doesn’t tie us too closely to one vendor.
Are the technological solutions driving our governance, or vice versa?
As long as it gets you where you need to go, does it really matter?
What’s wrong with that if the governance is set up properly and
there is oversight? Having a shared goal is important. Getting a data
set out there and having flexibility around that is also important
Trust is still something that has to happen and is so important.
Our discussion was about the patient, not the provider. I would like
to see a med list all together. We want a quick lens.
We have the same problem but use the long arm approach. Philosophically,
we have the same reasons but use it in a different way.
If hospital XYZ doesn’t want to put the data out, and as long
as the central organization asks them how will they continue to churn
their data, does it matter?
Tom Lloyd: We’re talking about the
same governance model, correct? Or is it two? Some sound like policy
decisions.
Discussion
There will be some different governance structures. New Orleans may
be in a different model to work with each other than Baton Rouge. That
has to be reflected in the flexibility of the system. We don’t
want to focus on something that’s not pertinent to our market.
Now that we have common governance, let's look at the markets. A common
architecture could work for both.
Tom Lloyd: Will there be one, two, or
more by November?
Discussion
There should be one that both markets can talk to.
But are they compatible?
This is a diamond decision we don’t know how to answer yet.
The contract says that if you have two markets, you use the same technical
approach.
But there would still be flexibility.
Where is the feeling of taking a different approach coming from?
Trust is not the issue.
Solutions across the country have gone across the spectrum. It’s
irresponsible to say there is only one way to do it.
What’s the technical feasibility of completing the demo project?
We’d love to do both over time, but it’s not feasible to
do both by September.
Do you do the long arm approach in one area and the CCR approach in
the other one?
The problem is we need an entity to implement the long arm.
It’s not retrieving the data, it’s access to the system.
I’m concerned that the technical solutions are not fully understood
here. The pros and cons of the two separate approaches need deeper discussion.
The New Orleans and Baton Rouge groups differ in that. It needs to be
really clear. The technical solution needs to accommodate both approaches.
Tom Lloyd: So I’m hearing there
needs to be a team on governance and one team working on market. Correct?
Discussion
The technical team, as far as the long arm approach is concerned, is
to grab one data element. Is the expectation for the long arm now to
go in the system and bring all the CCR data back?
No.
It’s work for tomorrow.
Mark Frisse: I see two themes. There
is the New Orleans model and it’s worthwhile for the New Orleans
team to work more on that. The Baton Rouge model also could use
time to work. I would value understanding more definitions around those
two groups. Each group could present their assumptions, and then come
back
for a group discussion.
Roxane Townsend: Thank you for all your
hard work today, and thank you for voicing your concerns Thank you for
your input and hanging in there. Enjoy the evening and we’ll see
you tomorrow.
team tiles (not reported out)
team tiles (not reported out)
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