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Subject: Re: [ihc] Operational Model for IHC


Hi Sally,

My opinion, as always, is that we need a mix of larger and smaller 
entities. However, for this field in particular I think it is 
imperative that we attract at least a few major IT vendors as well as 
some international governmental players and the public service, 
non-profit international NGO community, and, as the recent 
international disaster highlights, the emergency management 
community. This is due to the overlap of significant communities of 
interests, none of which should find itself in the driver's seat, so 
to speak.

The primary reason for this is that this is such a highly contentious 
arena AND it produces such an opportunity for concentration of wealth 
and power. Largely, that simply hasn't been recognized sufficiently 
for underrepresented communities to enter the fray.

I dislike using conflict metaphors but we do have an ongoing battle 
and we do have two incredibly important, and extremely lucrative 
outcomes that need to be understood fully:

	1. Monetarily, several groups stand to benefit hugely, 
starting with the Insurance Industry which can realize enormous cost 
reductions while maintaining currently rising premium rates if they 
can control an industry (business-interest) dominated patent pool 
which can establish unregulated, necessarily grandfathered, de facto 
standards across the healthcare field ensuring higher profits for 
interlocking directorates (in terms of intersecting Boards of 
Directors) among pharmaceutical and medical supplies interests allied 
to these insurance/financial interests; and,

	2. Politically, supporting a greater concentration of 
economic power for the patent pool mentioned above, can firmly 
establish a pipeline of ongoing political contributions based on 
those profits pointed out above, aimed to entrench existing patterns 
of political dominance, which just happens to be the environment that 
a powerful economic interest community will usually prefer if it 
benefits them as it does now, with the somewhat mitigated 
circumstances in several members of the European Union.

Thus, this TC in particular needs to attract the active participation 
from some large IT vendors, whose wealth and power and legal 
resources can offset this situation, bring a balance of powerful 
interests to bear on this environment as they compete for the bulk of 
IT business--the vast global middle tier of businesses, in whose 
interest a non-royalty-dominated healthcare industry is clearly of 
more than passing significance.

Please understand that my analysis of the situation is not intended 
as a diatribe against any specific interests, but only as an advisory 
that an unfortunately unbalanced and potentially harmful set of 
factors is currently at play. For their own sakes, these currently 
short-term-myopic interests which support this trend, should be 
fitted with corrective lenses. So for us, this trend needs to be 
headed off by attracting attention to the field, by players who 
cannot be ignored.

It needs to be borne in mind by the global business community that 
eventually, due largely to the internet, there WILL be a global 
village, and it WILL become very well informed, and when it catches 
up with an understanding of how current vulnerabilities are exploited 
for the profit of a few, there will be a price to pay that is likely 
to outweigh any current profits.

Specifically, I would like to see IBM participate actively in this TC 
as part of its partnerWorld ISV Healthcare specialty focus. I would 
like to see that participation bring in Sun and Oracle and Microsoft 
at least, if not the whole top tier vendor community, at least as 
observers.

I would also like to see DHS and HHS and DoD involved in this work, 
too, since they all have a stake here whether or not they know about 
it. Since we already have some EU involvement, and some IBM 
involvement, I didn't want to appear to be saying that they are not 
involved nor take them for granted. I would be thrilled if they cared 
to publicize this effort.

Lastly, as shown in the thread following Ed Dodd's post yesterday 
about the OMG Healthcare group meeting, I would like to see a very 
active liaison with that group and HL7.

Regards,
Rex



At 1:30 PM -0800 1/6/05, Sally St. Amand wrote:
>I joined Brett on the call this morning. I spoke to him about the 
>'operating model' for this TC. Other TCs I have belonged to have 
>relied on a (or more) large company to provide the resources that 
>have enabled the TC to function (picking up the teleconference 
>calls, etc) and providing a 'spotlight' to attract additional 
>participants/attention. I have heard some people advocate for this 
>approach for this TC; or more properly question if the TC can be 
>successful without the endoresement of major players.
>
>I suggested to Brett that this TC try and get backing--financial and 
>media--from one or more of the foundations that have a history of 
>supporting health care reform. I would like to see this issue be on 
>the agenda or list for discussion.
>
>Personally I believe there is more mutuality of objectives with 
>various advocacy groups and foundations than either the vendors or 
>the corporations. Most established businesses are more comfortable 
>getting behind an idea or effort that already has traction. 
>Foundations are usually more acustomed to initiating ideas. And I am 
>assuming we are not talking about a huge amount of dollars to 
>provide the wherewithall for us to do enough work to produce intial 
>work products. And .. advocacy groups are not infrequently funded by 
>businesses who want change but prefer to keep some distance at least 
>in the beginning.
>
>Any other ideas on an operational model for this TC? Any suggestions 
>on foundations/advocacy groups to pursue?
>
>Sally


-- 
Rex Brooks
President, CEO
Starbourne Communications Design
GeoAddress: 1361-A Addison, Berkeley, CA, 94702 USA, Earth
W3Address: http://www.starbourne.com
Email: rexb@starbourne.com
Tel: 510-849-2309


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