1. The Current State of the Art of EHR: Requirements of Interoperable EHR to Use Consistent Standards to Support Information Sharing Across Wide Networks Udi E. Ghitza, PhD Gregory J. Downing, DO, PhD

2. 11:30 amOverview: Standards Necessary for Interoperable EHR Christopher G. Chute, M.D., Dr.P.H. Mayo Clinic College of Medicine 12:00 pmHurdles & Solutions to Development of Interoperable EHR John W. Loonsk, M.D. CGI Federal 12:30 pmDeveloping Interoperable EHR: Maximizing Quality of Care Gregory J. Downing, D.O., Ph.D. Office of the Secretary Department of Health and Human Services 1:00 pmGeneral Discussion Speakers and Timeline

3. What is Interoperability? …the ability of health information systems to exchange and use healthcare information within and across organizational boundaries to advance the effective delivery of healthcare for individuals and communities. HIMSS 2006

4. Standards – Semantic and Syntactic Interoperability depends on the ability for systems to understand information. Semantics convey meaning –Multiple structures can have the same meaning The dog eats red meat. Red meat was eaten by the dog. Syntax is structure –Proper structure does not prevent nonsensical statements The dog eats red meat. The dog drinks blue sky. Time flies like an arrow. Fruit flies like a banana. -Groucho Marx C. Mead

5. Changing nature of medical practice Complexity of diagnosis and treatment Time Intuitive medicine: regulation of resources Empirical medicine: regulation of processes Precision medicine: regulation of outcomes Technological Progress Unpredictable and iterative Straight forward With permission: Christensen, Clayton M., The Innovator’s Prescription: A Disruptive Solution for Health Care