Man in the Arena: Choose Your HIE Vendor Wisely

September 15, 2011

In 1910, President Theodore Roosevelt gave a rousing speech to an enthusiastic audience assembled at the Sorbonne in Paris; the speech has since been referred to as “The Man in the Arena”.  A slightly modifed version of its most famous passage is offered below:

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena… who strives valiantly… who does actually strive to do the deeds… who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

Why, one might ask, would this passage be offered in a blog post about Health Information Exchange (“HIE”).  As a provider of comprehensive HIE technologies and services, I’ve been very fortunate; I’ve witnessed, first-hand, improved patient care through enhanced care coordination within and between communities facilitated by real, useful, intelligent health information exchange.

I do, however, find myself regularly frustrated at the press releases and pronouncements outlining grandiose HIE initiatives that ultimately never leave the paper on which the plans were drawn.  Yet dollars are spent, consultants are engaged, and industry ratings from various third-parties are offered.

Where, amidst all this activity and all this buzz about HIE, has the provider and patient landed?  For some, real value (measured by adoption, participation, use, transaction volumes, and effective clinical communications) underwrites improved patient care; the “doer of deeds… realizes the triumph of high achievement”, not because money is made but rather because care is improved through tangible, “rubber meets the road” clinical data distribution and integration – in other words, by “…the man who is actually in the arena”.

It has been my experience that all too often “could, should, and might” hide behind the veil of slick marketing and stories of what might be, could be, and should be as substantial resources in terms of dollars and time are spent; yet, those that spin such a yarn never actually enter the arena.  For if these “timid souls” entered the arena, their performance would be measured; the performer(s) would be held accountable.

So, I come to my conclusion. When choosing an HIE vendor, be sure to choose wisely.  Choose from those that have strived to deliver, those that have leapt into the arena and learned from experience, those that have stumbled but continue because a relentless pursuit of improved care is the objective.  Avoid those “…cold and timid souls who neither know victory nor defeat.”  Let them continue to sit on the sidelines and pontificate about the struggles and realities only a few of us truly know.

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Posted by Todd Fisher

The Mission: Care Coordination

May 5, 2011

Health Information Exchange (”HIE”) means many things to many people.  Ask 10 people what they believe to be the definition of HIE and you might well get 10 different answers.  Some will define HIE as a noun, some will define HIE as a verb.  Some will define HIE as a public initiative, some will define HIE as a competitive advantage-adding technology, and some will simply suggest HIE is merely a way for large consulting firms to make money as they write and then evaluate massive RFPs.  All that said, make no mistake, the fundamental mission of HIE is to improve care coordination.

But, what do I mean by care coordination?  Coordinating care can involve coordinating the care of an entire population, a specific population with a given disease state, health surveillance for a geographic region, or coordination across the provider payor relationship.  All such care coordination efforts are critical and significantly impact the cost and quality of care; and, all these examples benefit from HIE.  At the foundation of all care coordination, however, is the physician patient relationship.  Specifically, the quality of care coordination is largely defined by the quality of information flow between care providers along a specific patient’s care continuum – care from provider to provider, provider to patient, facility to facility.

So, allow me to offer this: health information exchange is absolutely necessary to improve care coordination if for no other reason than HIEs, such as MobileMD’s offering, liberate clinical information from its source system silos and delivers all the right information to the right provider at the right time within the context of a care community.  Without HIE, clinical data remains highly compartmentalized; care coordination is thus significantly hampered due to lack of timely, context-based information flow.  The result is redundant procedures, unnecessarily long hospital stays, unnecessary ER visits and hospital readmissions, ill-informed clinical decisions, increased patient and physician risk, increased costs, and decreased care quality.

While there are several good examples, allow me to highlight a particularly obvious example. Psychiatric patients often visit numerous specialists as a result of their health condition.  As one might expect, each specialist makes care decisions based on the information available at the time of care.  If a psychiatric patient visits a psychiatrist, a neurologist, and a gastroenterologist, potentially multiple times over a three month period, due to symptoms from both the underlying condition and medication side-effects, how can each care provider possibly deliver quality, comprehensive care without requesting redundant procedures and without prescribing contra-indicated medications, for example, if each provider is not offered a complete care picture for that patient?  Traditionally, patient health information has been sourced by the patient and, if lucky, partial patient chart information sent via courier or fax. The result:  each provider must fly, so to speak, without proper instrumentation.

If, however, each provider along the continuum described above has real-time, ready access to complete patient health information, better informed procedures are  requested, accurate diagnoses are more easily derived, and medications are better aligned, to name just a fraction of the care considerations that lend to quality and cost and emanate from a coordinated care effort.

As the rapidly emerging primary medium for clinical information flow, Health Information Exchange serves as the cornerstone for care coordination.   Better care means less expensive care, thus rendering to the shadows those that would suggest care must be rationed to control costs.

With that, I request that you “tune in” to a future post for more about “right care at the right time” vs “care rationing”…

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Posted by Todd Fisher

Evolving HIE: The Cornerstone for Healthcare’s Social Network

March 8, 2011

When I consider what direction to take HIE, I do what any entrepreneur would do… I look at the market, market trends, what is deemed valuable and worthless, what is used and what is not used.  I then extrapolate from that and determine how to move HIE in a direction that makes sense given not only current habits and patterns of technology use, but also what does history tell us about the path forward.  I then try and pick a point on that path forward and plant a flag, an objective to reach.  In small, bite sized chunks, I then move up the path, a path that never stops, but always delivers a scenic, valuable view.  For those of you reading this and thinking of the now famous (or infamous depending on your perspective) phrase, “bridge to nowhere”, the path I write of is not a path to nowhere; it is a path to the future.  A path to better health information delivery and by extension improved patient care.

In technology years, I need only go back a short while to evaluate innovations and glean direction.  As with any entrepreneurial endeavor, evolving HIE has risks.  But, risks can be mitigated.  So, let’s take a look at two unrivaled market leaders for some insight.  Over the past decade, give or take a few years, we’ve witnessed a clear path from silo-based systems to sophisticated search (i.e., pull) tools ala first generation Google to individual profile-based information delivery (i.e., push) ala Google Ads, new Google search algorithms and, of course, Facebook.

Google essentially started as a logical simplification of an increasingly difficult task – find information stored in a very diverse and geographically and technologically disparate, increasingly large network known as cyber-space.  Google developed innovative ways to aggregate content from any public website, regardless of format, organization, or corporate entity (sound familiar?). Google’s brilliance was in their simplicity; users could visit their single text box web site and ask simple questions of the entire Internet and get consolidated, meaningful responses in the form of usable, readily accessible information.  This should sound familiar, because in healthcare we have the same issue, diverse, geographically and technologically disparate systems, which all house critical information that when consolidated create a sum that is far greater than the parts.  Health Information Exchange has successfully begun to address this problem – the consolidation of and access to health information generated and natively stored in multiple facilities, disparate health IT systems, and various corporate entities.  That’s HIE Act I –query methods (i.e. pull metaphor) for information exchange.

HIE Act II gets very exciting and follows more closely to the Facebook paradigm, thus setting healthcare exchanges up for true collaborative computing in the social networking sense – a highly specialized social network.  By collecting end-user profile information, cloud-based applications intelligently deliver (i.e., push) mass-customized information to subscribers, which in the case of Facebook is a staggering 500 million plus unique users.

How does this manifest in health information exchange? Well, I’ve spent a good deal of time pondering this question.  And, the answer is that it manifests in many very useful ways.  Originally as a means to avoid information overload for physicians, HIE vendors, such as MobileMD, innovated and invented new ways to provide PHI consumers (i.e., providers, patients, and payors) the ability to create mass-customized subscription profiles to control the flow of information.  This added the intelligent push metaphor to providers, in particular.  The result is better information automatically delivered where it is needed and when it is needed.

So, as I consider an “intelligent push encore” for HIE, I have come to the realization that the profile-based push metaphor not only benefits physicians and payors through intelligent filtering, rapid delivery of pertinent information, and the elimination of unnecessary, and redundant PHI, the profile-enhanced push metaphor stands at the precipice of effectively and usefully bringing HIE to the patient population – a truly staggering opportunity, a tipping point.

This makes sense for a few reasons:

  1. Patients represent a logical extension of the HIE “network”, thus further contributing to the “Metcalfe Law” effect – the value of the network is proportionate to the square of the number of participants on the network.
  2. The patient market as beneficiary and consumer is massive.
  3. HIE’s networking roots, real time aggregation of meaningful clinical data, collaborative computing capability, coupled with a profile-based architecture contribute seamlessly to a health community social network.
  4. Extending on the profile-based architecture and availability of real clinical data – who better than a well-architected and deployed HIE is better positioned to intelligently push not only clinical results but also useful, mass-customized content to patients such as articles and medically vetted suggestions pertaining to issues of particular importance to the patient given the patient’s condition?  The alerts, content, and suggestions are enriched by information that arrives from and is delivered across the care continuum via the HIE.  The inherent shortcomings of partial information originating in technology silos is eliminated.

Centralized HIEs, in particular, sit on a mountain of valuable clinical, quality, and administrative data and are thus well-suited to deliver that data along with other relevant content based on profile.

As Einstein once said, “The secret to creativity is knowing how to hide your sources.”  In other words, it doesn’t matter how HIE gets to the right place, it simply matters that it does get to the right place.  The larger “digital information sharing” market, as represented by the likes of Google and Facebook, has pointed to a path and effectively said, “go that way”.

As you read this entry, it’s important to remember, “Rome wasn’t built in a day.”

 

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Posted by Todd Fisher

Regional Extension Centers vs. the Competition

July 6, 2010

The HITECH Act created the Health Information Technology Extension Program, an effort to drive HIT adoption among primary care clinicians. The program creates Regional Extension Centers (RECs) across the country, each working to assist providers learn about health IT, find EHR solutions, procure and implement those solutions, and become meaningful users. HHS defines the REC’s mission as:

The Regional Extension Centers will focus their most intensive technical assistance on clinicians (physicians, physician assistants, and nurse practitioners) furnishing primary-care services, with a particular emphasis on individual and small group practices (fewer than 10 clinicians with prescriptive privileges). Clinicians in such practices deliver the majority of primary care services, but have the lowest rates of adoption of EHR systems, and the least access to resources to help them implement, use and maintain such systems. Regional Extension Centers will also focus intensive technical assistance on clinicians providing primary care in public and critical access hospitals, community health centers, and in other settings that predominantly serve uninsured, underinsured, and medically underserved populations.

During the first two years of the program, the REC receives funds from HHS for each provider that they assist in attaining Meaningful Use. Funds continue in the third and fourth year of the program but at a vastly reduced rate, with a goal of weaning off of federal dollars and ongoing sustainable independence.

The REC concept is a promising one. It brings localized support to providers looking to swim in the EHR pool, with the watchful eye of an “EHR lifeguard” nearby. The model fills a potential gap between the software and services provided by an EHR vendor and the actual amount of work it takes to get a small practice to be a meaningful user.

I believe one of the issues we’ll see play out is how RECs compete with EHR vendors themselves. Providers can buy from a REC or an EHR vendor – the choice is theirs. Frankly, the RECs are in many ways offering the same solution as the vendors: they resell EHR software and services, they provide consulting services, and they push providers to the Meaningful Use level.

Of course most of the providers’ purchase decisions will come down to value per dollar… RECs need to keep costs down and consider value-added services. I offer some ideas of value-adds:

  • Stay Local – The hands-on support of local service suppliers who have EHR expertise is critical. This might be a tough to offer across a broad or rural geography, but RECs should look to small boutique partners to fill this role. Large EHR vendors cannot provide this same level of intimate support, and it is essential to truly meaningful use (note lowercase!)
  • Bundle HIE – This is a great opportunity to connect EHRs to local resources right from the get-go. RECs can require that EHRs include connectivity to nearby HIEs, local labs, local service providers, and others critical to the patient care continuum in the community. The “local” nature of this service cannot be beat by national vendors, and RECs can bring value with their regional expertise.
  • Drive Volume – Probably a no-brainer, but RECs bring the ability for a small provider to benefit from a leveraged, large group purchase. Volume pricing will bring costs down considerably for small physician practices.
  • Centralize Operations – Providers can benefit from a centralized hosting and support offering, so they all can expect the same service level, same helpdesk phone number, same folks with local knowledge of the products, services, and healthcare providers within the REC community. A local operations approach also brings economic development within the REC community, a nice side effect. I believe many large EHR vendors would struggle to offer local personalized support like this.
  • Offer Portability –
    Having been in this industry for a while, we know that relationships between a healthcare provider and an HIT vendor looks more like a high school sweetheart fling than a committed marriage; they last for a while, going through high highs and low lows, but frequently end up with the provider looking for another partner. The REC could be a long term partner, offering a variety of EHR vendor solutions, and giving providers an outlet to switch technology and a “painless” method to move records from one vendor platform to another.

Regional Extension Centers play a key role in covering the difficult “last mile” of provider HIT adoption by targeting their support at primary care practices with ten docs or less. RECs should consider the list above when amassing their teams of suppliers and vendors to go to market (not just EHR vendors, but also consultancies, HIE vendors, hosting facilities, and operational support groups). I hope RECs can sustain their important service by putting together these pieces in a high value, low cost way, and help us all improve healthcare.

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Posted by Chris Voigt

Are State-based HIEs Good for Healthcare?

June 9, 2010

In our attempt to offer the marketplace genuine value, HIEWorks aims to offer our readers a combination of information and experienced-based opinion.  It is therefore necessary for HIEWorks to occasionally stake out a position, popular or not, when it may be more convenient to sit on a fence.  HIEWorks, is genuinely concerned with issues related not only to making HIEs functional, but, more importantly, leveraging HIE services to accomplish the greater goal – improving healthcare.  So, let me get to my point very succinctly: monolithic, state-based HIEs are not the best vehicle for leveraging federal and state investment dollars intended to improve healthcare through information technology adoption and modernization. I’d like to address three specific reasons I believe this to be so. 

Accountability and responsibility:  Accountability for clinical and administrative data exchange is diluted by the introduction of numerous layers of bureaucracy, leaving no clear desk at which the buck stops. Consider healthcare reform: providers are incented and penalized (via reimbursement) based on measurements regarding the quality of care.  Several information technology initiatives are underway to support quality care improvement; critical among those are HIE initiatives.  How can providers’ reimbursement be based on quality care and outcomes when the systems designed and implemented to support improvement are governed by an organization outside the control of the health system being evaluated? 

When a state-based initiative charges for a solution, the problem is exacerbated.  In short, doing so creates the appearance that control is transitioned over to the “buyers”. But, in reality, a solution forced on a health system arms those that should be accountable and responsible with the argument that they did not choose the technology and service and therefore can’t be held responsible for its performance and errors. Making matters worse is the appeal, to some, of the potential to abdicate such important clinical information management and communications responsibility.    

Innovation: There’s no better way to douse the innovative spirit than to off-load technology assessment, selection, and implementation to government-sponsored entities without the support of the “invisible hand of self-interest”.  Time and again the drive for competitive advantage has led to rapid and beneficial innovation.  Loss of such a drive creates complacency, and stagnation. 

The perfect opportunity exists now to seize on the clinical data digital revolution.  Let us not squander this opportunity by putting crucial information technology decisions in the hands of those that are not “in the field” and empathetic with providers in desperate need of clinical information access when and where care is provided.

Regional Nature of Healthcare:  All too often state-based HIE initiatives fail to appreciate the real-world regionalization of healthcare and underestimate the communication standards that do exist and are being developed currently. While healthcare is clearly a regionally-based market, health system service areas regularly cross state lines.  As a result, there are numerous technical, operational, legal, and regulatory issues that require rigorous analysis and accommodation. In a state-based initiative, who is responsible for handling such diverse requirements that result from the need to cross state lines?  Are the needs of a community in the middle of a state that has no issue with state boundaries the same as those communities that sit along state lines with patient care crossing into many states, at times?  These are real issues of consideration that are hampered by abdicating HIE choices and implementations to the state.  In short, state boundaries are arbitrary in the context of a patient’s network of care.

Summary: If a state wishes to assist with health information exchange, great!  Provide financial incentives to health systems to acquire and implement solutions for which the health systems feel responsible and accountable – let choice serve as the basis for such responsibility and accountability. The state funding should come with the stipulation that these networks can interoperate, thus accomplishing ONC’s goal of interconnecting physicians across the state.  Health systems should be provided the opportunity to compete for physicians and patients using information technology as a competitive advantage.  If the same solution is used by all because the state selects that solution, the state is 1) enabling health systems to abdicate responsibility and accountability for critical information technology selection, implementation and adoption, 2) dissuading free market competition and thus muting innovation, 3) drawing arbitrary boundaries around care geography that have no real relationship to patient movement.

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Posted by Todd Fisher

All Roads Lead to HIE

April 27, 2010

While discussing where the HIE market is headed and how to convert healthcare providers from market observers to market participants – we find ourselves returning to three basic questions:

  • Did the ARRA legislation trigger HIE market activity?
  • Did healthcare reform expand the HIE market?
  • Are the payors’ latest games  “plans” apt to create demand for HIE?

Across the board, the answer is yes, yes, and yes – though ARRA  circumvented market dynamics a bit by throwing a $19B “gift” on the table.  Hey, whatever it takes.

Here’s the bottom line: ARRA, overall healthcare reform, and new payor models seek to achieve considerable change in healthcare.  To achieve such broad change effectively, those close to healthcare have come to realize the need to forcibly move healthcare information technology into the 21st century.  We therefore hear calls for the mass digitization of patient health information – in essence, a healthcare digital revolution.

Digitizing patient health information is important, but not the end game.  Once discrete information is available, it must be securely processed, communicated, exchanged, integrated, accessed, and analyzed to be truly useful.  HIE is the platform, the enabler, the catalyst that makes such processing possible. Without HIE, information silos continue to persist, limiting health information technology’s ability to deliver on of the promise of care improvement.

So providers are waking up, realizing they need to get on the HIE bandwagon. And, providers are not just looking around to join an HIE effort in their community - many are finding value in an HIE directly supportive of their own organizations, an Enterprise HIE.  They are recognizing such solutions help protect their market, position them for exchange with others, and establish an on-ramp to broader HIE initiatives. And, these organizations realize they need such HIE now, before their competitors eat their lunch, and long before the government rolls out their pieces and parts of meaningful HIE.

Healthcare visionaries have known this for a couple of years now; call it the “tip of the spear”, entrepreneurial organizations that have adopted HIE as a competitive advantage. Now, the center of the market is shopping – they see Enterprise HIE as an instrumental component of their success as we all live through this Healthcare Digital Revolution.

For years Enterprise HIEs were simply not discussed.  They were, by definition, not considered “true HIE”.  Broader perspectives have prevailed, however.  An Enterprise HIE can quickly generate depth and breadth of connectivity between ambulatory and acute providers, built upon a strong, sustainable economic case. From that point a community can weave together these Enterprise networks (say, using the NHIN specifications). Done properly, which requires all four dimensions of HIE, you can get to the community-wide, holistic solution faster than ”waiting for Godot” – poorly funded, loosely organized state and community initiatives that lack genuine economic incentive to innovate.

More and more I’m hearing HIE works: HIE helps and even solves today’s many challenges faced regularly in healthcare – clinical and business challenges.  The market is rapidly coming to understand the clinical and business issues of tomorrow cannot be solved without HIE. Yes, in fact, all roads do lead to HIE.

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Posted by Chris Voigt

HIE in 4D

April 15, 2010

Time and again, vendors deliver technology and indifferently move on while these “solutions” sit and collect dust. Purchasers, once rapt with the blinking lights of automation, rapidly devolve, suffering buyer’s remorse.  While technology is important, it’s just one dimension within which HIE operates.  To work, HIE must operate in four dimensions: Technology, Service, Care, and Economic.  As a way of creating a mnemonic, let’s compare HIE’s four dimensions to the space-time dimensions learned in school – width, depth, length, and time.

Without technological innovation, HIE would never move past fax, courier, and a myriad unsupportable point-to-point interfaces.  Consider the Technology dimension as width.  A broad set of proven capabilities are important to ensure relevance, usability, security, scalability, and regulatory compliance.  Without sound Technology, utilization is muted, stability is jeopardized and liability is increased.  The Technology dimension, therefore, is significant to ensure a working system is in place, built on a solid, scalable foundation, protecting all stakeholders from the risks inherent in communicating patient health information – legal and clinical.

To truly operate within the Service dimension, HIE must wrap Service around deployed technology. Community outreach support and strategic utilization consulting are vital components. Visualize the Service dimension as the depth – the extent to which and sophistication with which HIE permeates a community.  Without such depth, HIE languishes, left unused, neither deriving nor generating benefit.

The Care dimension is lost on most vendors, as it requires a true understanding of, appreciation for, and empathy with the criticality of the ultimate mission – providing quality patient care.  The Care dimension introduces the human element to provide what I equate with length.  Every patient, every piece of information, every clinician, and every episode of care is critical in its own right and must be treated with a keen sense of urgency and worth.  HIE can’t do this without a human element that expresses understanding, appreciation, and empathy.

The Economic dimension is best viewed as time.  I’ve previously written that an economic model based on self-interest’s “invisible hand” is important to ensure sustainability.  While some cooperative models have succeeded, they are, unfortunately, the exception:  those that have proven successful are directed by passionately committed strong leadership able to place benevolence above self-interest in a manner that provides sustainability. 

Generally, however, without competitive market pressures, HIE falters with inadequate funding, structure, and incentives.  While altruistic cooperative purpose is noble and achievable, our economic activity is predicated on the notion that such altruism is achieved through self-interest. Community good is realized when individuals (e.g., healthcare organizations) achieve what is good for themselves.  Competition, therefore, must precede cooperation.  As the market matures, however, cooperation inevitably evolves. Consumers lean heavily against healthcare’s regional nature, forcing providers to cooperate to ensure quality care.

There you have it; HIE in 4D.  If you want to know how HIE works, use 4D lenses.  Those dimensions missing will become apparent, and corrective action can be taken to adjust appropriately.

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Posted by Todd Fisher

Changing the Direction of HIE?

April 13, 2010

I’ve been talking with folks who do HIE on both the community and enterprise levels. Questions come up as to how NHIN Direct might impact HIEs and the secure messaging services they offer: does NHIN Direct erode the business value of a ‘proprietary’ (i.e. non-NHIN-Direct) secure messaging network? Can we wait for the NHIN Direct open source and just use that?

So let’s look at NHIN Direct in the context of both the current and future state of HIE. These Health IT folks are keenly aware of the economic viability and sustainability issues with respect to the HIE. And the promise of an open source solution can certainly have an impact on implementation cost and long term support for such a system.

So, can we wait? My short answer is no. But just ending the blog at “no” is no fun… I’ll expand on my answer in three parts:

  1. The ability to push information in support of an effective, secure clinical dialog between providers in different care settings (or between clinical systems and providers) has an immediate impact on patient outcomes. It therefore presents an opportunity to add immediate value to healthcare providers.
  2. Looking back on my experience with similar initiatives, one can safely assume it will take a while for NHIN Direct to formalize to the point of being production-ready, and even longer to have operational significance. We’re 5+ years down the NHIN road, and that production network is barely off the ground (officially called “limited production exchange” by ONC). I hope Direct moves faster, but the industry, the government, and the process are what they are – the best way to predict the future is to look at the past.
  3. No matter how or when NHIN Direct rolls out, we also know from experience that it will take years for the standard to be supported in the systems and tools of the healthcare community. Until 100% of the provider community uses tools that support Direct out-of-the-box, somebody will need to provide an alternative solution – said differently, an HIE’s “proprietary” solution will continue to deliver value. Compare this to the adoption of IHE’s interoperability profiles for information exchange: currently there are just a few 100% IHE-compliant exchange networks, and they have virtually no IHE-based connectivity to EMRs (through no fault of their own – it is just how the HIT ecosystem evolves).

There are many new pressures on providers to accelerate the need for provider-to-provider messaging: hospitals are concerned about bundled payments, and all providers are watched and measured with respect to readmissions, care transitions, and handoffs.

Secure messaging solutions facilitate the clinical integration and coordination that supports improvement in these areas, as well as supplying what we’ve come to expect in terms of delivery of lab results, consult reports, transcriptions, alerts, and such – all key elements of information exchange that increase efficiency and reduce errors.

So you can see where I’m leaning: NHIN Direct is going to take a while to become relevant, on the order of years, not months. The provider community cannot wait that long.

It still makes sense to invest in an extra-enterprise or community secure messaging solution now, get it operating ASAP, broadly deploy it across the region, and insist that the platform vendor stay 100% compliant with Direct.

The NHIN Direct work groups are striving to have a demonstration later this year. I’m a part of that effort, and I too would like to see something that soon.

In the mean time, let’s not allow the momentum of robust information exchange to slow.

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Posted by Chris Voigt

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