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John Moehrke

Given that the Direct Project simply documented what many dentists and radiologists had been doing for most of the decade (that is using end-to-end secure email); the Direct Project went back-in-time... beating everyone on the scale of the time it took from project Kickoff to working implementations

deltaTime = ImplementationsDate - KickoffDate

It is unfortunate that it has taken so much time and resources to re-invent the wheel.

Keith W. Boone



Arien Malec

That's a major breakthrough in epistemology....

Glen Marshall

I have seen this happen multiple times in health IT: Perfectly good standard exist -- either in cross-industry space or proactively from visionaries.

Then there are months of intense discussions to re-discover, debate, and validate them or, worse, reinvent the wheel. This is followed by delays and hand-wringing by vendors who have overlooked or, worse, refused to adopt the standards. Other stakeholders then push-back, often being ignorant of their choices because they depend on the recalcitrant vendors. Then politicians & bureaucrats get involved and gum up the works even more.

This has happened more than once for data transport, basic security protections, security auditing, digital signatures, clinical documentation, and data vocabularies. It has most recently happened in conjunction with HIPAA, HITECH, and NHIN Direct plus health IT efforts in other countries.

I wonder when we will collectively stop this unhealthy cycle and finally *solve* the problems with existing, proven, and interoperable standards.

Arien Malec

Glen, not exactly sure you are following the conversation.

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Keith really speaks truth))

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