The wrong conversation, missing CONNECT

Today I heard a session today at the National IT Forum at Harvard entitled “Business-Government Interactions to Support a Platform”.

I felt like I was Alice in Wonderland. Behind me sat two of the top leaders of the Open Source CONNECT project. Which is, frankly, the single largest contribution to Health IT interoperability to come from the Federal Government… ever. Even now, that project will ensure that there will be a National Health Information Network that will create local exchanges that will allow the transfer of health information about individuals from coast to coast.  Or at least this is so likely to happen, that other outcomes would be so random that they cannot be planned for in any case. Yet,  the CONNECT project was hardly mentioned one time during the session about “What we want from the Government”.

The session waxed long on what to expect from the Government, what the Government should do and should not do. Lots of talking about laws and rules and Google.  How should we do health information exchange? Some of it was pretty interesting, but basically it was the wrong conversation.

The right conversation starts with this: we can assume that CONNECT -will- unify the health information transfer in the US. It will serve as the basis for the core NHIN and regional networks will have the option of implementing it. That means that CONNECT sets the bar for health exchange.  Software must be as good as CONNECT to be considered for a local Health Information Exchange, otherwise, why not use CONNECT?

So -given- that the US government will (sooner or later)  solve the problem of health information exchange using CONNECT, the question is how we as platform developers will -leverage- CONNECT to make new and improved patient and clinician-facing tools.

While the first talk was better, and the contacts I have already made here are invaluable, so far there is too much fluff and not enough on the dirty details required to make a platform. I really wish Ben Adida could have made it, because as it stands I feel somewhat ungrounded. The conversation should really have been “what does CONNECT mean for us?” and instead it was just circular nonsense. I really want to ask after almost everyone finishes talking “so… you will therefore code what… exactly?”

For this post I want to make it clear. CONNECT is not perfect, they have warts both as a codebase and as a project. But they are rapidly fixing themselves, and they will change everything. This seems so obvious to me… and yet apparently not everyone gets this.


HIMSS09 day 2: Interview with Vish Sankaran

Today I meet with Vish Sankaran, whose official title is ‘Program Director Federal Health Architecture’ from what I can tell, that post is just as important as it sounds. Vish was, along with representatives of several major federal agencies, presenting the new NHIN open source infrastructure project called Connect. We have been waiting patiently to see code drop, and according to Vish, that should happen at tomorrow!

I first heard about this project when Harris Corporation announced that they had won the NHIN contract. Harris is a big government contract shop and had apparently little experience with either FOSS or Health IT. I was please to be later proven wrong when they found that they did have considerable VistA talent on-board.

I was befuddled about how a company could announce that a product would be both public domain AND open source, seeing as how those terms have very different meanings. After my initial contact with them, it was obvious that they did not really understand the FOSS culture or community, (they actually asked a FOSS development group to sign an NDA to reveal more details of the project) and after hearing my less-than-flattering comments regarding their announcement, they made it clear that they would simply put their heads down and code until they had a product… then they would let the Office of National Coordinator sort out how to interface with the community.

I am not sure when or how Sun became involved in the project. But I was relieved to hear it. Sun has much more experience with the FOSS community, and from what I can tell Sun has bet the farm on FOSS. I have already had a conversation with some representatives from the Sun team about the release, but they were necessarily tight lipped about important details like licensing and project structure ahead of the official announcement. I hope to arrange a podcast with them soon, now that they can speak more freely.

Which brings us to today. Today Vish and his panel were discussing what they had working and what they had planned with regards to both the NHIN and Connect projects. More importantly, Vish was willing to do a brief podcast with me. My audio seemed pretty broken up… but keep listening because he sounds fine.

Vish Sankaran Interview (in ogg)

Vish Sankaran Interview (in mp3)

P.S. I am not the first person to record Vish