Don: Nice response. You seem to be coming from the other BIG end and I am from the smallest practice. I am not familiar with what's happening at the big hospitals. I have to learn from you a lot ( to get the big picture) .I am hoping most of the practices don't need to go through CON if FOSS is in the mix. Of course, practices that want to burn cash can do what ever they want ( except for finding solutions for connectivity ). Now, coming to VHIEN. I am typically scared of data repositories/silos storing highly correlated, clustered data. Believe me, physicians love it so much that they can't see the security and confidentiality risks involved. With that libertarian fear in mind I like the Indivo model where patients control all access. Another model to consider is patients carrying their own health care records on some memory card ( may be implanted :-) ). Of course, there are some implementation problems, nothing that can't be overcome. Regards, balu ps: I can't be there today for the meeting - inaugural + xportation problems
On Tue, Jan 20, 2009 at 12:18 PM, Dan Connelly < [email protected]> wrote: > Flint: > > FAHC did not choose any of VITL's preferred vendors. They went their own > way into EMR. Thus, FAHC acquisition of their Epic system is a model, of > sorts, for getting off-list systems connected to VHIEN (network), though not > funded by VITL. > > FAHC was required to file a Certificate of Need (CON) to spend their cash > (state cash?) on their new Epic EMR system. (Perhaps small practices do > not need to file a CON. Dunno.) > > Any health care CON related to IT will need to be in compliance the VITLP > (plan), *once VITLP has been adopted* by the full legislature, Its only > a "draft" until adopted. > > 1. VITLP *is* still a draft, AFAIK. It not yet been adopted by the > full legislature. Only the House has adopted it. The Senate has not. > 2. VITLP, draft or not, is a soft standard and does not guarantee > connectivity. I suspect it is intentionally soft so CON approval doesn't > get bogged down. Leddy and ChitCo Senators will be needed for the Senate > approval. Hence, cannot have standards running against FAHC path. > 3. VITL does have two roles. They may be incompatible roles: > 1. Prepare the Plan and get it adopted by the Legislature for the > sole purpose of folding it into BISHCA's CON process. State funds are > used > for this, legitimately so. > 2. Run the VHEIN. Private funding here, to some extent. Vendor > list is pre-selected, but cannot be dictated. Should off-list vendors > be > encouraged. BTW, Epic is not FOSS; far from it. > > With respect specifically to the FAHC CON covering their acquisition of > Epic EMR (as opposed to one of VITL's preferred vendors), the acquistion was > approved by BISHCA. There were 2 controversial issues that got > side-stepped: 1) privacy, and 2) compliance with VITLP draft. > > 1. > > http://www.bishca.state.vt.us/HcaDiv/CON_docs/Statements_of_Decision/CONs_dkt2007/07-069-H_propSOD.pd > 2. fhttp:// > > www.bishca.state.vt.us/HcaDiv/CON_docs/StaffReports/StaffRep_2007/docket_07-069-H.pdf > > Pretty dry reading. My summary with respect to compliance with VITLP: > Technical consultant said Epic is "minimally compliant" with draft VITLP and > this does not ensure connectivity to VHIEN. Farnum commented that FAHC's > use of Epic would be consistent with the VITLP "vision". > > There are FOSS systems that are also minimally compliant and consistent > with the VITLP vision. We need to demo them. And demo connectivity. > > However, O now think that Balu is correct that VHIEN is in jeopardy. My > reasons: a) Vermont funding will tighten, b) there is no pressure for open > connectivity, c) no FOSS alternative to demo. > > Some other group, not VITL, will needed to add this pressure (and to ask > that FOSS gets the same breaks as FAHC). Could there be federal funding > for such a group?? > > -- Dan Connelly > > > > > >
