I feel like parties should be required not to speak on the matter unless we decide to make everything completely open and public. Maybe you could allow the parties to choose. Particle manipulated the process and caused harm to national interoperability when they aired their version of events.

I think this is less an indictment of provider practices and more an indictment of EHR settings. Providers need to turn on other PoUs today in their EHR and most have elected not to. We need to engage with them on critical use cases to engender trust and make responses automatic.

Right now I’m thinking a lot about fiduciary responsibility and how that could work for a more patient centric healthcare ecosystem. If executives were legally bound to manage their company as if they were the patients their company touches would that lead to better alignment of principles?

I don’t think that regulating profit is the right idea. In fact what we’re seeing now is that the Minimum Loss Ratio the ACA put in place may have actually driven industry consolidation and created a more imbalanced system. (Link in comments)

🤷 a single manual client registration using networked FHIR w an intermediary can achieve the same scale as Dynamic client registration with point-to-point connectivity. We can’t require responses to the same degree as TEFCA SOPs and there are some performance and auditing downsides but it works.

Absent FAST security IG implementation eHealthExchange Exchange can scale FHIR nationally today (and is continuously pushing providers, pub health, and payors, to do it)

Hah I’m 36 and 3/4ths. Shows what you know.

I understand your concerns, but the way we scale ePA is by practicing it. We need to implement the standards and suss out the issues across EHRs, networks, and payors.

I’ve got 6 credit monitoring companies working for me at this point. Meanwhile I locked my credit so who cares

I appreciate the insight

So how would an OMB EO meeting impact publication? Looking to see if I can help here.

Thank you!

It did?! Is there a way to confirm this? Would love to see the rule get published, rigamarole or not