Innovation Process for a Common Interest Workgroup

Bootstrapping. The CONNECT Project Management Office at HHS/ONC bootstraps the workgroup with an initial mission statement and a set of publicly-committed participants. A dedicated forum is created for the workgroup, separate from the main CONNECT forums, as is a separate data space in the issue tracker, a separate wiki tree, and a separate directory within the source code system.

Baselining. Discussion starts with an outline of requirements, perhaps expressed as "user stories" or other sorts of raw descriptions of scenarios or optimal outcomes. Towards the end of this phase, discussion converges on the most important requirements or themes. The co-chairs may decide to adjust the mission statement at this time to reflect the conversation, with consensus support from the other participants.

Iteration. After the initial baselining of requirements, scope and mission, an agile process evolves among participants, iterating between idea generation, discussion of existing systems that could be integrated, the pros and cons of different approaches, and software implementation to explore the systems discussed. The key element here is a direct connection between conversation about features and implementation of those features in CONNECT, as both a demonstration of the ideas and an accelerant once the ideas reach consensus and release.

Nationwide Health Information Network and Change Control Board Coordination. If the proposed functionality requires modification to the Nationwide Health Information Network technical standards, or changes to the main CONNECT Gateway, then conversations behin with the Nationwide Health Information Network Project Office or the CONNECT Change Control Board, presenting the workgroup's ideas as proposals. These discussions may drive changes back to the workgroup on their proposal; so this discussion should happen late enough to represent a fairly well-thought-out approach to addressing the mission of the workgroup, but still early enough to allow for changes based on feedback before significant investment is made in a wrong direction.

Final Call. As consensus arrives on both specification of the new features and sufficient prototype implementation appears in the repository, the co-chairs issue a final call for comments on the specification. This should last a week or two, sufficient time for participants to give a final perspective and create a realistic picture of the public perception of the quality of the specification. After this final call, the specification is published, with a version number such as 1.0, suggesting both a process has come to closure and a new phase of iteration begins. A roadmap to completing the implementation work and working with the CONNECT PMO office and Configuration Control Board (CCB) for integration of that software into the CONNECT software release is then coordinated by the co-chairs and developer community.

Continuance. The workgroup shall continue, perhaps in a more response-oriented and less time-intense mode, for long enough past its initial release of its code to address issues that arise from the deployment of that code across the CONNECT user base. It is likely that such feedback and further ideas would drive both minor and possibly even major changes, going again through an agile cycle of brainstorming on user stories or other requirements, final call for comments, and implementation. So long as the common interest defined by the mission statement still exists, the workgroup resources should remain available for those stakeholders.

This process is designed to allow the CONNECT initiative to evolve to meet new needs, and to decentralize the process to those with the interest and capacity to invent and implement. It attempts to embody the principles that have made collaborative Internet processes work well – embodied by phrases such as “rough consensus and running code.” As the healthcare industry innovates, CONNECT will be there to support the health information exchange requirements that new innovations and constituents bring.