[This Transcript is Unedited]

The Department of Health and Human Services

National Committee on Vital and Health Statistics


Virtual Meeting

April 18, 2017

Table of Contents

P R O C E E D I N G S (3:00 p.m.)

Agenda Item: Call to Order

MS. HINES: This is the spring meeting of the National Committee on Vital and Health Statistics, NCVHS, the federal advisory committee to the HHS Secretary on health data, statistics, privacy, standards, administrative simplification, and national health information policy. I would like to extend a warm welcome to committee members, who are calling in from across the country, the federal staff, who make the committee’s work possible, and you, the attendees from the general public.

This meeting is being conducted virtually. The agenda and materials are posted on the committee’s website. You can view and download them on the registration page or directly from the online agenda. They are available.

The meeting is scheduled for two hours, 3 to 5 P.M. Eastern. As Christina just mentioned, toward the end of the agenda, there will be a period for public comment. During that time, we will remind you of the instructions for how to make a comment using the hand raise option, at which time we will recognize you and your phone line will be temporarily unmuted, or you can submit a comment in the Q&A portion of the WebEx.

With that, let’s begin the roll call, starting off with the NCVHS chair, Bill Stead.

DR. STEAD: Hi, everybody. Welcome, also. I am Bill Stead from Vanderbilt University. I am chair of the full committee. I have no conflicts.

MS. GOSS: I am Alix Goss from Imprado. I am a member of the full committee. I am co-chair, along with Nick Coussoule, of the Standards Committee and the Review Subcommittee. I have no conflicts.


DR. PHILLIPS: Hi. I am Bob Phillips with the American Board of Family Medicine. I am a member of the full committee and co-chair of the Population Health Committee. I have no conflicts.

MS. HINES: Bruce.

DR. COHEN: Hi, I am Bruce Cohen from Massachusetts. I am co-chair of the Population Health Subcommittee. I have no conflicts.

MS. HINES: Dave.

DR. ROSS: Hi. This is Dave Ross. I am from the Taskforce for Global Health at Emory University. I am on the Population Health Subcommittee. I have no conflicts.

MS. HINES: Denise. Denise, your phone is muted.

MS. LOVE: Can you hear me now?

MS. HINES: Sure can.

MS. LOVE: This is Denise Love from the National Association of Health Data Organizations, an all-payor claims database council. I am on the Standards Subcommittee and the Population Health Subcommittee. No conflicts.

MS. HINES: Helga.

DR. RIPPEN: Good afternoon. My name is Helga Rippen, from Alertgy. I am a member of the full committee, of the Population Health Subcommittee, the Privacy Subcommittee, and the Data Working Group. I have no conflicts.

MS. HINES: Linda.

MS. KLOSS: Linda Kloss from Kloss Strategic Advisors. I am a member of the full committee, co-chair of the Privacy, Confidentiality, and Security Subcommittee, member of the Standards Subcommittee and Review Committee. No conflicts.

MS. HINES: Nick.

MR. COUSSOULE: This is Nick Coussoule. I am with BlueCross BlueShield of Tennessee. Co-chair of the Standards Subcommittee and a member of the Privacy, Confidentiality, and Security Subcommittee. I have no conflicts.

MS. HINES: Rich.

MR. LANDEN: Rich Landen, private citizen, member of the Standards Subcommittee and the Review Committee. No conflicts.

MS. HINES: Vickie.

DR. MAYS: Vickie Mays, University of California, Los Angeles. I chair the Workgroup on Data Access and Use. I am a member of Privacy and Populations Subcommittee. I have no conflicts.

MS. HINES: Wonderful, thank you. I will hold off on introducing Rashida Dorsey with ASPE and turn it to federal staff.

MS. DOO: Lorraine Doo with National Standards Group, Centers for Medicare and Medicaid Services, lead staff for the Standards Subcommittee.

MS. HINES: Thank you. Susan.

MS. KANAAN: Hi. I’m Susan Kanaan. I am a writer for the committee.

MS. HINES: Erika.

MS. MARTIN: Hi. I’m Erika Martin. I’m at University at Albany, State University of New York. I am a consultant on the workgroup on HHS Data Access and Use. I am the staff writer for the Healthdata.gov report. I have no conflicts.

MS. HINES: I would also like to acknowledge Jim Sorace. Jim, are you on? It looks like he might not have a phone connection. Jim is the lead staff to the Data Access Workgroup. There are several federal staff also on, supporting us today. I want to acknowledge that they are in participation. With that, Bill, I think we can turn it over to you to review the agenda.

Agenda Item: Review Agenda

DR. STEAD: Thank you, Rebecca. We are going to begin with a brief welcome from Rashida on behalf of ASPE. Then we are going to work through our three action items, which people have had in advance. We are hoping to identify any areas where additional improvement is needed and, hopefully, be able to deal with that on the fly, and come to closure on these three items if practical.

After that, we will do updates on the work that is in progress around the Health Plan ID hearing, the Predictability Roadmap, Next Generation Vitals, and a follow-up on the All-Payor Claims Database. We will have time for public comment before adjourning at five.

MS. HINES: Great. I guess we can turn it over, if there is nothing more, to Rashida Dorsey. Rashida, would you like to introduce yourself?

Agenda Item: ASPE Welcome

MS. DORSEY: Yes. Good afternoon, everyone. My name is Rashida Dorsey. I am the Executive Staff Director. I am with the Office of the Assistant Secretary for Planning and Evaluation. I would just like to welcome everyone to the April meeting of the National Committee on Vital and Health Statistics. As Bill outlined, the committee has a meeting filled with many important action items. My remarks will be very brief so we can dive right in.

I want to thank the committee for their work and the expertise that they provide to the Department. Thank you. Again, looking forward to the Committee being able to move forward on action on these different items and, ultimately, moving forward to submit them to the Department and to the Secretary. Thank you.

Agenda Item: Action – NCVHS 12th Report to Congress

DR. STEAD: Thank you very much, Rashida. Rebecca, do you want to bring up the Report to Congress, in case we want to stop at different places? Basically, what we were thinking was the Report to Congress is too long to go through meaningfully, page by page, or in the way we did at the last face-to-face meeting. What we would like to know, I think, first – and I think we will try to use the raise hand process for committee members. If you have got general comments or suggestions, why don’t we raise hands and hear them first? Then, what we are thinking we would do is go – is if people had a specific place they wanted to look at editing, we would ask them to raise their hand, give us the line number, we would hop to that place, and talk through what the question was. That is the basic process we were thinking about.

Does anyone want to raise their hand to make a general comment or suggestion before we get into whatever line or into any comment people have? Go ahead, Linda.

MS. KLOSS: Good afternoon. I guess I just want to lead off by saying this is a really remarkable report. I think one of the things that it does particularly well for us, that will serve us well going forward, is the use of extensive footnotes to capture a lot of background information that then allows the document to flow well. I think that maybe because of the formality of this type of meeting, it may be useful to have a motion to approve the report and a second to the motion, and then discussion, in that context. Would that be an appropriate way to proceed?

DR. STEAD: That would make sense to me. Would anybody like to make such a motion?

MS. GOSS: This is Alix. Linda, are you going to make the motion? I would be happy to second it.

MS. KLOSS: I was intending to move approval of the Report to Congress.

DR. STEAD: Do we have a second?

MS. GOSS: I will be your second. This is Alix.

DR. STEAD: Okay. So, it has been moved and seconded. Is there any discussion?

MS. GOSS: This is Alix. I would just like to acknowledge everybody’s work. It has been a collective process to get us the input and to enable Susan to bring this all together. I think it is a really great piece of work. Thank you for everybody’s contributions.

DR. STEAD: This is Bill. I want to double the thanks to Susan. She has made a remarkable effort and been a remarkable partner to all of us.

Other discussion around the Report to Congress? Are we ready to take a vote then? If people remember, the voting tabs have now been cleared out. If the members of the committee, once Rebecca – yes, she has now pulled it up. At this point, if you will click on your megaphone tag and either click yes or no.

It looks like it is unanimous. Congratulations, folks.

(Motion carries.)

MS. KLOSS: Yes. That was just really a well-done process.

DR. STEAD: The teamwork and partnership that has gone into this has completely been a joy to participate in. I cannot thank people more.

So that lets us then move, if we can, to Bruce and Bob, to deal with the letter, Making Recommendation on Measuring Health at the Community Level: Opportunities for HHS Leadership.

Agenda Item: Action – Letter: Recommendations on Measuring Health at the Community Level – Opportunities for HHS Leadership

DR. COHEN: Great. This is Bruce. We have all had an opportunity to review this letter that is the outgrowth of our journey, not only our workshop, but a long journey looking at community data use. It has been an incredible journey. It is not over yet, but this is a really important weight point for the National Committee.

Essentially, our recommendations are in three buckets: establishing an HHS intermural departmental workgroup on community data, secondly, providing leadership to form a cross-departmental workgroup, and then third, connecting the federal activity to the enormous amount of activity that is going on already in non-federal community data efforts.

Not only are we focusing on actionable, geographic, small area-level data, but we have made an incredible contribution to developing the measurement framework as part of this activity. I won’t go into detail describing the framework, which is a current version up on the NCVHS website, but that has been, I think, a really dynamic and successful project, which we will be continuing in no small part because we have been able to find a non-federal home for continuing activities in this area.

Again, I have to commend Susan for the incredible job that she has done synthesizing feedback from the workshop, from the many long years of looking at community data as learning systems, and since the workshop, from the variety of inputs that we have gotten from committee members, from committee staff, and from others who were involved.

I will stop there and ask to see if there are any questions or discussion. But before I do that, I actually want to make a motion that we approve this letter and get a second and then we can discuss. So, I move that we approve this letter.

DR. PHILLIPS: This is Bob. I would second that.

DR. COHEN: Open to discussion.

DR. STEAD: Linda, your hand is up, but that may be from the last time.

MS. KLOSS: No, I cleared it and raised it again. I like this little hand thing. It is easier than tent cards.

I thought this letter read very well and it did just what we wanted it to do, which was wrap the pieces of this really important project together in a positive way. It made a compelling statement why this is important for HHS to continue to work on.

If I had any suggestion, minor as it might be, it is just that there be something that would close the feedback loop. Not only have we offered to continue to help in this regard, but that we would be eagerly looking for what progress is made. I don’t know if that is presumptuous, but I really felt that we had done so much good work that it would be great to have some more formal way of checking back in.

DR. COHEN: Are you asking for a response from the Secretary’s office, Linda?

MS. KLOSS: Yes, I am.

DR. COHEN: Do we traditionally include them as part of our letters? I seem to recall some we do and some we don’t.

MS. KLOSS: That is what I recall, too.

MS. HINES: Generally, what happens, if I am tracking the conversation, is that after a letter is submitted, we typically get a response from somebody at the HHS level. Is that what you are referring to?


MS. HINES: Yes. So, and when those arrive, we put them on the web for all to see.

MS. KLOSS: Right, but sometimes they are quite generic and it is not clear what action has been taken or might be taken. I don’t know that we can go further than that. I wanted kind of a sense of the urgency to come through.

DR. STEAD: We have got a hand up from Vickie and Bob. Are your hands up on this question or – I mean on this point that Linda has raised or on another point?

DR. MAYS: Mine is on Linda’s point.

DR. PHILLIPS: Mine is on another point.

DR. STEAD: Then let’s start with yours, Vickie.

DR. MAYS: I agree with Linda. I think that this letter is – the timing is great. I think it is important to raise as issues about community data and community efforts, to be on the table. I am quite excited about this going forward.

The only thing I didn’t know and it is kind of the same thing Linda is saying, are there either other groups we should engage or is there some way to really see if we can get a response? Sometimes in our letters, we have cc’s. I just wondered if there were – like should we cc non-HHS federal agencies on this as a way to keep this alive in some ways, like Department of Transportation, you know, the groups that – Department of Justice? Should we also share it with them as cc’s?

DR. STEAD: What you are really referring – should we share it with the departments that we were able to include in the workshop, in essence. Is that the question you are raising? That was a fairly targeted effort at trying to get the key other departments – cabinet-level departments.

DR. MAYS: Well, yes, but I also would like to make sure – I couldn’t remember if the census was there or not. I think it is like whether they were able to be there that day, if we think they are key to moving this agenda forward, I would suggest that we cc them. I think that is in the spirit of something of what Linda is saying.

I think even if HHS takes only action A, if these other departments want to take an action guided by this letter, that would also be great. The initiative may come from them to HHS. I am just trying to make sure we get our partners kind of onboard with responding.

DR. STEAD: Rebecca or Rashida, is there any problem with our doing that? It makes sense to me if it is appropriate for us to do.

MS. HINES: Right. I don’t know if your line is open, Rashida, but still being relatively new to this, we haven’t, since I have been here, done that. I don’t see any problem with it. From your standpoint, would that be okay?

(No response)

MS. HINES: I think we will have to just circle back around and follow up on this. I think it is a good point for sure.

DR. STEAD: Let us keep track of what we are agreeing to do. One is, unless there is a guidance from a federal perspective through Rashida and ASPE that we should not do it, we will add the key cc’s to the other departments that work with us.

DR. COHEN: Also, guidance from Rashida and ASPE about whether we should explicitly ask for a response from the Office of the Secretary, I guess. That is what I was hearing Linda say.

DR. STEAD: Those would be two questions that I think the committee would be in agreement with if, in fact, it is appropriate for us to do.

MS. KLOSS: There may be a third, if I may add. The final paragraph of the letter, you know, it reiterates the importance of the work and then thank you for your consideration of the recommendations outlined in this letter. It is there that I thought we just needed more of a sense of reinforcing how important this is to any health improvement agenda. I just thought that ending wasn’t forceful enough.

DR. STEAD: Rebecca is typing. While Rebecca is typing, Bob still has his hand up. Helga has added hers. Bob?

DR. PHILLIPS: Sure. I thought Bruce’s summary was fabulous of this letter. I did want to point out that since the last full committee meeting, we did submit a comment to New England Journal of Medicine that pointed to the final report that came out of the hearings, the Measured Framework, that the letter refers to, in response to an article by Patrick Conway and Karen Joynt about should Medicare value-based purchasing take social risk into account. That is the allusion here, in the conclusion, to the Impact Act, which require that HHS respond about the use of social determinants for payment.

We did submit a comment that pointed to the Measurement Framework and that makes this letter and the effort behind it so important. I just wanted to make sure that was known publicly.

DR. STEAD: Thank you. Helga.

DR. RIPPEN: I just wanted to kind of reinforce the level of the cc’s. If it is going – if the letter is going to the Secretary of Health and Human Services, it should be going to the Secretary level. One can always send a copy of the letters to anybody that participated in the workshop, but you tend to want to keep it at the same level.

MS. HINES: That is a good point. I just wanted to let folks know that any day now, the workshop report will be live on the NCVHS website. We can send then a message out to the folks who attended the workshop and then connect with them, perhaps, even on who their relevant secretary or person we should put – I am assuming we should put a name rather than a role here. Maybe we can just put the role.

MS. DORSEY: This is Rashida. I’m sorry. I was on mute. I had muted myself before.

I am not sure about the levels of the cc, since we are addressing the Secretary here. I will get back to you on that. I don’t want to say it is a go, but I will look into it. There are a couple of questions that I have. I am not sure. You certainly can think about who that would be and I will get back to you with the response definitively very soon.

DR. COHEN: Rashida, thanks, but we are asking you to do two things. First, check about the appropriateness of cc’s and at what level. The other is asking how appropriate or what language we use to ask the Office of the Secretary to respond to this letter.

DR. RIPPEN: This is Helga. Just to address that point, again, every letter that we write actually is responded to by the Secretary. The only thing that we do need to think about is are we asking them – other than just summary reports, for them to respond in a unique way in addition to the letters that they do respond to. I am just saying be careful what you wish for because there will always be a response.

DR. STEAD: We always have the opportunity to follow up and find out where things are. We are actively reaching out and making sure the conversations continue with the NGO. My sense is, if I remember right from the exchanges over the last couple of days, that there will be a meeting in Washington August 2 and 3, in which the NGO will actually try to get together, probably a mixture of face-to-face and virtual. I think – you know, I don’t think we make demands on the Secretary. I think we make recommendations. I think we need to be careful of the right balance.

MS. DORSEY: I am happy to look into that. I would say that, as Helga pointed out, the Secretary – we generally do – you do get a response from the Secretary to indicate that the letter or any reports, anything that you submit has been received. I don’t know beyond that, if I would recommend asking for more.

As Bill alluded to, there are ways that we can follow up. If there are additional questions that come from the Secretary from within the Department, then there are ways that we can follow up on that. In terms of asking the Secretary for more than that kind of a response – again, I can look into it, but I would probably say that the standard of what we do now is what you should continue with.

DR. STEAD: We have got the question on the table. You will – we will know what we can do. Vickie, your hand is up and then Rich’s.

DR. MAYS: I just wanted to make sure there was an understanding about the level of response. I wasn’t suggesting that it would be the people that were at the meeting, but instead, the agency, and that it is at the same level of respect that we are giving the Secretary. So that this really is a kind of interprofessional, cross-HHS sharing of this letter. I think the people should get it as everyone will. I think on the letter, it really is the agency.

MS. HINES: Right. I hear you. If we get the green light – I think it would just also be good to let the staff-level people who came to the workshop know we are doing it, even though it will be posted on the web. Just good to let them know. Maybe they can then close some loops on their end.

DR. STEAD: I agree.

MS. DORSEY: I have one question. I might get this question. Could you confirm – for the people who attended the workshops that were a part of the federal government, were they going representing their agency?


MS. DORSEY: Did we identify them and say this is someone from HUD, who would be great, or did we go to – was there someone within HUD who we sent a request to and said this is what we are trying to do and someone in leadership there said, this is who we want to officially represent us? There is a little bit of a difference there.

MS. HINES: Like in the case of CMS, they had to get approval. It depended on the agency. Some agencies had to get approval, like CMS. Others, we identified the correct program area and they got approval from their supervisor to represent say HUD, say DOT, EPA, CMS. Each agency had its own approval process but we did identify the right person or else we probably would never have heard back from them.

DR. COHEN: I think it was kind of a mixed bag, Rashida. We knew the right people and requested them for some agencies. For others, we asked the agency to identify the appropriate person.

MS. DORSEY: Okay. I am just asking because if we are – I am thinking about, in terms of doing a cc and who it goes to. If we are sending – if there is an interest in sending things to other parts of the federal government at the same level that we send it, you know, within HHS, you know, depending on how we selected that person to participate in the workshop, we might have identified the right people, but if it didn’t – if that request didn’t come through maybe certain channels, then that level of participation and how we got that person might – there might be questions about, well, should this also now – would we send a memo or send a letter or recommendations at the same level that we send it here because there could just be a different kind of a connection in terms of the staff who participated in the workshop. It is just helpful for me in looking into this a little bit, in case I get that question.

DR. COHEN: I think the answer is, I agree with, I think, Helga and Vickie’s notion that our recommendations are broader than targeting the people who were at the workshop. So, since we are sending this letter to the Secretary, it should be an equivalent for all federal executive secretariats, I think, in addition to reaching out to those who were actually there as part of our, you know, just feedback for the workshop participants. Since the ultimate recommendations to the Secretary were broad, considering the development of a cross-departmental workgroup, and connecting all of the federal departments with non-federal representatives. So, that is a level above, perhaps, the level of staff participation, but certainly, those staff who were involved in the discussion should be made aware of what we are recommending that may affect their agencies.

DR. STEAD: Let us try to deal with some of the other hands. We are going to need – Rich, are you – your hand is up?

MR. LANDEN: My hand is up. If this is saying the same thing that Vickie said a couple of minutes ago, I apologize, but I am not quite clear. On the issue of the cc’s, I think this was a great process. It is a great summary and letter. I would think that irrespective of the answer on who is openly cc’d on the letter, that we should probably just send an email update to the key participants saying we have concluded this stage of the process, we have sent the letter to the Secretary, and, FYI, it is on our website, thank you very much for your participation.

MS. HINES: Thanks, Rich. We are going to do that both with the report and this letter. Yes, definitely.

DR. COUSSOLE: My question was a bit of a process question, here. If, in fact, we wanted the letter to be distributed to other areas that we think would be relevant within the federal government, would it make sense to issue the letter to the Secretary as we normally do per our charter? We could conceivably draft a cover letter to other potentially interested or participating departments and send that letter along with it.

I don’t know if that is normal or we have ever done anything like that before, but that is a way to, I think, meet our obligations of responding to the Secretary, as well as informing other groups that may have an input or impact.

DR. STEAD: Very helpful suggestion. Rebecca and Rashida, that would be different than a cc. In essence, we could send a copy with a cover letter, a copy of the letter and the full report.

MS. HINES: Yes, that is another way to go about it because the recommendations really are targeted at several departments, not just HHS.

DR. STEAD: Okay. I think we have got the idea. If you will work with Rashida to help us know what is possible. Helga, your hand is up.

DR. RIPPEN: Yes. I just wanted to kind of say the nuance – since our authority is with HHS, I am not sure about sending letters to other heads. That is the only nuance to consider. But Rashida will review.

DR. STEAD: Okay. With this discussion, the – scroll back to the bottom a second.

MS. HINES: Sure. Just a second. Where would you like to go?

MR. SORACE: This is Jim. Can you hear me now?

MS. HINES: Yes. Jim, you are on.

DR. STEAD: Go down to the bottom of the letter, please. Jim, do you have a comment about this letter or are you just letting us know you have made it through the ether.

MR. SORACE: I have made it through the ether.

DR. STEAD: Welcome.

MR. SORACE: Thank you.

DR. STEAD: Basically, your scrolling is not quite at the right place, but it looks to me like what we are proposing to do is to add a sentence that would reinforce the importance of this work to a viable health agenda, trying to reinforce it and make it stronger. We will deal with the cc and the issue around whether there is any utility in asking for a response based on Rashida’s guidance from ASPE. Subject to those changes, are we ready to vote on approval?

MS. LOVE: Yes. Do you need a motion or do we already have one?

DR. STEAD: I think we have already got a motion. Well, we need to amend the motion to reflect those changes.

DR. COHEN: I accept those as friendly amendments. Can I do that?

DR. STEAD: Bob seconded it.


DR. STEAD: Let us bring up the vote icon.

MS. HINES: I think that is 100 percent.

DR. STEAD: Unanimous. Congratulations team.

MS. HINES: And we are a half-an-hour ahead of schedule to boot.

DR. COHEN: Thank you all.

DR. STEAD: Thank you. Now, we are ready to pass the ball to Erika and the mic to Vickie to take up the letter and report on recommendations on healthdata.gov for maximizing its value.

Agenda Item: Action – Letter: Recommendations on HealthData.gov for Maximizing its Value

DR. MAYS: Thank you. On behalf of the Work Group, I thank everybody for their work. I want to especially recognize Erika and Jim and Rebecca for their efforts to bring this to, I think, two manageable pieces. One of which is a letter to the Secretary. Then we decided to have a report that could be a longer, fuller report. With the Secretary, we wanted to keep it down to very manageable – I think it is three pages.

The letter and the report, for those of you – just a bit of background. The letter and the report is really a response to a request by HHS that we look at healthdata.gov and offer some perspective of its value, kind of going forward, in terms of supporting the data access and use mission of HHS. During this time where there is a focus on evidence policy making, during this time where there is a focus on making sure that open data is valued and available, we were asked to actually look at the extent to which healthdata.gov is valuable in helping HHS accomplish its mission.

The process was the workgroup, as well as consultants that we thought would be useful to us in this process, were called upon. We went through several steps in looking at the healthdata.gov website, which included looking at some of its metrics, which you can see in the report, looking at the opinion of others, and looking at how this fits into the open data movement. What you have here is the result of that.

What I thought would be useful, unless people have another way they would like to proceed, is for us to take the letter and actually focus on the recommendations, make sure that those recommendations are acceptable, and then take, if there are any comments on the body of the letter, as it goes to the Secretary, and then ask that we move it for a vote for approval and then we can do the report in the same way. Does that seem acceptable?

DR. STEAD: Seems like a good process to me.

DR. MAYS: Okay. I am not sure who has the ball, but if we could get down to the recommendations, that would be great. Then we can go back. I think I want to make sure that the recommendations are – the committee – the full committee, is in agreement with them.

Our first recommendation is asking HHS to develop and integrate and coordinate a strategy within its operating divisions to advance healthdata.gov’s vision and mission. As we went through, we didn’t see that there was a fully developed vision and mission for healthdata.gov, but felt that having a more articulated vision and mission, would actually help with the uptake of healthdata.gov across HHS. Any comments/questions about that particular recommendation?

Okay. Seeing no hands, I will go to two.

MS. KLOSS: I’m sorry. I was just slow in pushing on my button. As I was reading this, I just had kind of maybe a step backward. Are you really calling on HHS to realize the full potential of this and make the necessary investment? It sort of seemed like that is the header for this.

DR. MAYS: If you said at the end of the day, what would we like to see, it would be, yes, to take healthdata.gov and continue its growth. It was a great idea when it started. What it really needs is to continue to be uplifted, embraced, and invested in, in order to achieve the mission that we think is really the mission that it was designed to accomplish.

MS. KLOSS: I guess I was wondering if there would be some value in sort of making that statement as part of a header to what unifies these recommendations? It is that, you know, there has been a lot of investment, clearly, a lot of uptake, but this only works with continued focus and investment. I guess I was feeling a need for some unified message of what the ask is. That, it seems to me, is what we are asking for.

DR. MAYS: And that, you are asking to be down in the – as kind of like the beginning of the recommendations to kind of pull it all together. You want that much earlier.

MS. KLOSS: I am not sure I can answer that question. I have a few other comments with regard to kind of format and flow. Maybe we can come back to that. I think of all the letters, it is a particularly tangible program that now exists and shows substantial uptake. Certainly, it is in line with how people work today. I just wondered if we didn’t need to be kind of pretty direct in what we were recommending. That wasn’t quite coming through for me.

DR. STEAD: Helga also has her hand up.

DR. RIPPEN: I think building on that, I think there is something to be considered as it relates to balance and decision. At a minimum, I think the initial focus was that HHS needed to continue to have it available. It shouldn’t be cut because people are benefiting from it now. The second is that we can accelerate the benefits by making the investment – by making additional investments and how it can benefit everybody else. You could put that story.

What I think we have to be mindful of is if there is a decision that, well, you need to have significant investment during a tight – you know, limited resources, would we be at risk for actually having a closed shop? The intent then is, well, we just have to pour money into it. Of all the programs, this is the priority. I think that if there is a way to nuance it, I think it would be important.

DR. MAYS: Let me ask a question because I am pretty sure that we have nuanced that in the report. Moving to the letter, we have had to, of course, lose several things. Is this something you want in the letter or is it the report or both?

DR. RIPPEN: I think in the letter, I think it would be wise to reinforce the value and the importance of it as is and the – a significant increase in potential with additional investment. I think that, in the letter, you need to really reinforce the value. They may not get to the report.

DR. MAYS: Okay.

DR. STEAD: Rebecca, you have your hand up.

MS. HINES: Yes, there was a sentence maybe two or three drafts ago that actually had a dollar amount. I think it fell onto the floor when we went back and forth between report, letter, report, and then letter and report, that we might want to resurrect back into the report.

DR. MAYS: That makes me nervous because I think its amount is like $100,000. I guess what I worry about is that – almost what Helga is saying. If you then say, well, to fix this is going to cost me double that or some amount, that then what you might say is then maybe it comes off the table and is blended in with just data.gov. I was a little concerned about used the money.

MS. HINES: Okay, well, it just seems like we had some kind of sentiment or statement that it is a pretty small investment and look what you have built with that. With a little bit more, you could really – some members here are saying let’s make the case here. With minor investment, you’ve got x. With a little bit more investment, you can have x, y, and z. We did have language in there at one point. Whether you want to use the dollar amount, I don’t know.

MR. SORACE: This is Jim. I think that we tried to thread the needle between the two extremes. We can put the dollar amount back in. The truth of the matter is to actually get it to its full potential would take an undefined amount more. We haven’t really haven’t figured that out. That does put it at risk.

What we tried to do was to say that, basically, you have a considerable enterprise going as is. We could add the dollar figure back. And then say if you do these extra steps, you would actually get a more efficiently run health IT data system within HHS. That being said, actually outlining to the Department how that would be operationalized would require, I think, more information than we put in either the letter or the report. I mean, the report points to the promise. It doesn’t actually say what the roadmap would look like. We are just hoping that they would keep spending the 100K and we would whet their appetite for fleshing out the rest. If you actually start the debate as to how much it is, I think you get yourself into a very risky area.

DR. MAYS: I think the investment would need to be more than the current investment. We are probably talking about fixes plus personnel.

MR. SORACE: Yes. I think it is a segue, as written, to continuing the storied past and work for a more promising future. I don’t think we can sit there and offer – I just don’t want to see a tremendous debate come out of the letter instantly as to what the funding might be. That is going to require a lot more thought than what we have been able to do thus far. I am sort of on Helga’s side, in terms of advising caution here.

DR. STEAD: Linda’s hand is up.

MS. KLOSS: I wasn’t really thinking about including specific operational milestones or budget, but a sense that in any tool like this, in any process like this, if you aren’t investing in it, it will deteriorate. I think – you know, I think we do need to just caution that we can’t assume this will continue to meet the growing needs of more sophisticated users without some realization that there needs to be continued investment. I was not thinking specific dollars. Just the reality that it will become less and less valuable without investment.

DR. MAYS: Erika, have we captured that? I think that we will want to fix that.

MS. MARTIN: I have taken a note on it. I’m not yet sure the best place to stick it in there.

DR. STEAD: I think the – my sense of the conversation is we want to be conservative in whatever we say in that vein.

DR. MAYS: Yes. Okay, so Bill, I don’t know if there are other questions or whether I can go down to the second recommendation.

DR. STEAD: Dave Ross’ hand is up.

DR. ROSS: I don’t want to beat this to death. I agree with Helga. I think a note of caution here is warranted. It has got to be clear that it creates value as-is. While I agree with what has been said about further investment, I think right now, it is important to make it clear that there is value, it should continue, and then there is the option to improve it.

DR. MAYS: Great. I think that that is a worthy caution.

DR. STEAD: Move to number two, Vickie.

DR. MAYS: Okay. Number two, HHS should implement evaluation and performance metrics and solicit data customers’ input regularly to increase the use and usefulness of healthdata.gov for diverse consumers, for the work of HHS staff, and facilitate the development of data-driven health innovation.

Here, what we were asking is – it is kind of engaging some of the tools that are used by other platforms, in terms of having the ability to see what is working, how to utilize that information to actually respond to customers. Part of what you want is to try and learn which customers you are serving and how to serve more customers. In this one, it really is some very simple fixes, I think. We have even specific information about that. Any questions or comments about number two?

DR. STEAD: Helga’s hand is up and Dave’s either has not been put down or is back up. Helga?

DR. RIPPEN: It goes back to the original point. It is a big recommendation. I think it really should be up and front is that this is a really important resource. HHS should continue to make it available. If that is the underlining kind of like starting point that should be, in and of itself, the major recommendation.

The second part then is, well, what can be done to further enhance it? Everything is going to cost money. Because all of the other recommendations are – require investment – more investment. Maybe that might be a way to bucket it.

DR. MAYS: Let me make sure I understand. So, we have a new first one and then are you saying these are like subs under it?

DR. RIPPEN: Yes, because they are all about how to improve it, right? First, you should do coordination. Then you should do evaluation so you know kind of how you should improve it, which would then inform that. That would be part of 3.2. Then the governance is really more related to perhaps, one, because you are talking about coordinated strategy, except now this is a formalized governance. So, yeah, so I would make a recommendation – because ultimately, I think it is at risk. This is a really important resource. I think the big recommendation is this is important. We need to maintain it. And then, two, we really think there is significant value in formalizing it. You should keep it and formalize it. Some of these things are formalization. That might be a way to consider it.

DR. MAYS: I actually like that because I think that it means that the sum total of this then says that what is important is that we think it is a valuable tool that should be maintained. That way there is no second guessing where we stand on that. Then enhancing, augmenting, et cetera, is second. Here are some of the ways. So, they could choose to just adopt one or they could choose to then go through and think about some of the enhancements and they could pick and choose based on what is available, in terms of resources and capacity.

DR. STEAD: I think that captures the sense. Linda, your hand is up.

MS. KLOSS: I was just going to say that that captures the sense of where I was going. I thought it needed some overarching comment. It is serving an important and growing need. To realize further potential is going to require continued and perhaps new investment. But, yes, thank you, Helga.

DR. STEAD: Vickie, you can go with number three.

DR. MAYS: I will do three and four, but I like that they are now kind of sub-bullets under the first one.

Three is enhance the platform’s capabilities to make the data more meaningful to a range of data customers to extend its reach.

Four, formalize the governance, stewardship, and business operation of healthdata.gov.


MS. KLOSS: I just wondered about the word meaningful in recommendation three. It seems like it is relating to accessible, but – I was curious as to what was your discussion behind that.

DR. MAYS: Yes. I was going to tell you what is behind that is, for example, a data user might go on and want to find items on tobacco. Remember, this is the platform. One of the ways you could make it more meaningful is to have mapping that shows them not only is tobacco in this dataset, but it is here and here is a relationship between these, in terms of what year or the gender or something like that. That is part of making the data more meaningful.

The access issue, I think the platform does, but helping people to surf other than just what they usually come on for and understanding that they could have greater information about a topic if they knew about other datasets that they didn’t come on to tap into, we thought would be helpful. If the meaning isn’t coming across, it might be we need a different word.

MS. KLOSS: I hate to add words, but it – more meaningful and accessible. That is for the group to consider. Meaningful just seemed a little narrower than you were implying here or in the body.

DR. MAYS: Okay.

MS. LOVE: Is it utility? We use a lot – you know, making it – I am trying to say improve the utility of the data – accessibility and utility? Meaningful has some subjective connotations.

DR. MAYS: I think that that would actually probably help with the clarity because of the ways in which people think about meaningful. I think that that may help. Thank you.

Anything else, in terms of the recommendations? If not, I will take us – that is why I thought it was important to do the recommendations first. Now that we have done that, can we go up in terms of the body of the letter and get any recommendations that people have or questions or comments?

MS. HINES: Vickie, did you get to the fourth one?

DR. MAYS: We did not discuss it separately, but I read three and four together. Let me just make sure, is there anything on four?

DR. STEAD: I think people are good with four. Linda’s hand is up on the body.

MS. KLOSS: I had one suggestion that you might want to add to the letter. There is a good definition –

DR. MAYS: Erika, can you take us up in the body? If you have a specific place where, tell us.

MS. KLOSS: It is the first page of the report. It starts out with a –

DR. STEAD: Report or letter?

MS. KLOSS: Report.

DR. MAYS: Oh, you’re in the report. We are still in the –

MS. KLOSS: Wait. I just want to suggest that the letter needs the definition of healthdata.gov because it takes me a couple of paragraph to know what the letter is referencing. Yet, the report does that in one sentence, healthdata.gov is.

DR. MAYS: Okay.

MS. KLOSS: I just thought that could help the letter.

DR. MAYS: Okay. Got it.

MS. KLOSS: Maybe if I – since I have the floor for just a moment, let me just say one other thing. I know we went from a lengthier letter to a letter and a report, but I don’t think – either the letter has a little bit too much content or it just doesn’t stand on its own without the report.

In essence, what we have here, in terms of format, is the letter serving as sort of an executive summary to the report. In that regard, I think as I kept looking at it, I thought, well, then I would like to make the letter a lot shorter and just say here is what this is regarding. Please read the report. Or I need to put more in the letter because the letter doesn’t stand well on its own.

I hate to be nitpicky in this format, but maybe it just needs one more pass through to look at whether we’ve got enough substance in the letter to do what you wanted to do or whether we consider going back to having a single letter with an attachment to the letter, rather than letter and report. I just had some concerns about format and then how you have had to decide what content went where. I am sure you have struggled with this.

DR. MAYS: Can you talk a bit more about the issue of a letter and attachment so that I understand – and I guess others are getting a sense of what that looks like for you?

MS. KLOSS: I think we did that, to some extent, when we stripped out a lot of the detail and a lot of the discussion in the Minimum Necessary letter. We tried to make the letter support the recommendations and then put all kind of the background augmentation – like some of your data and example – as part of an attachment, rather than the body of the letter. I don’t know. Maybe nobody else had that issue. Maybe it was just me. I thought that – I know we tried to tease it apart, but it didn’t flow. There was more than I needed in the letter to have to really understand it. I kind of wanted to go back to a single letter, I guess. It reads like two letters.

DR. MAYS: Okay. It would help to hear what others are thinking on this. I don’t see any other hands up.

DR. STEAD: I will comment while people are thinking. We have come at this from a number of directions. I think, from my perch, a short letter with a concise recommendation, in particular, strengthening the language without major change that you have – that we have discussed around – it is important value here. There are options to improve it that are within – relatively easy to do. Then the report, itself, goes into other ways that this could be taken much further. I think, in the end, we ended up with a fair balance. I would advocate staying with the structure that we have evolved to. That is just one opinion.

DR. PHILLIPS: I am curious, has there been any standard format in the past? Are there any other FACAs that use a standardized format for a very pithy letter that gets the recommendations quickly with the goal of helping someone really see the high-level view of the recommendations and then dive into the report if they need to. I think the letter is helpful as it is. I am just curious if other FACAs have found a way to make this even more parsimonious in introducing a full report.

DR. STEAD: I am not aware of clear examples. We received a fair amount of feedback from the Department that the long letters that had been characteristic of NCVHS frequently were sufficiently complex that there wasn’t an easy person to hand it off to. In that case, it sort of sat. Then, personally, as I went back and read everything we had done in the three years that were covered by the report to congress, that came through in spades to me. I have been encouraging us to – as you have worked through with the Pop Health example – get to really concise, useful letters and then to back them up with additional material in the form of a report.

I think we are feeling our way, but we are feeling our way in an attempt to increase uptake and to make what we do have more impact. The committee has to judge whether we are achieving that.

DR. PHILLIPS: I don’t want to delay Vickie’s – the work of her committee getting out. I would be happy to work with anyone who was interested to try to develop a template even that helps us get to that shorter introductory letter that might get us heard better, if that would be useful.

DR. STEAD: Thank you. Dave, Bruce, then Rich is up.

DR. ROSS: This is Dave. I fall down on the side of the concise letter laying out the recommendations with an understanding that a letter to the Secretary is going to be handed to staff who are going to have to dig into the detail. I think highlighting the key messages is our best chance to be most effective. I do appreciate the great amount of work that has gone into Vickie and her team to draft all of this. I am easy, however you want to go forward, but I do think a brief letter laying out recommendations probably has more overall impact. Thanks.

DR. COHEN: I think this is a brief letter. I like the flow of this letter. I think it has the recommendations, particularly with Helga’s suggestion of the key suggestion of maintaining and supporting healthdata.gov. I don’t think we can get any briefer in a letter without fully explaining the basic issues.

I like the way the initial long letter or the initial report has been divided into this letter and a subsequent report. I don’t care whether we call this follow-up piece an attachment or a report, but it contains more details that the staff is going to want to look at after they review the letter. I think this is actually a pretty decent template, as Bob suggests. I don’t know how much we can shorten the letter without making it difficult to understand for those who aren’t familiar with the topic. I really think, Erika and Vickie, you have done a good job laying out the key issues in the letter and providing the details in the report.

DR. STEAD: Rich.

MR. LANDEN: I am with Bruce on that. I think a – this is under four pages, double-spaced. The first paragraph is very general intro. The next two paragraphs give some context. And then we get right to the recommendations. I don’t see much opportunity for significantly shortening the transmittal letter. That being said, I am happy with whatever our decision is and will support it. As far as letters go for something like this, this is not anything other than what I think is a very brief and to the point letter. That is it.

DR. STEAD: Then, Linda, are you willing to be influenced by the sentiment and basically let us proceed with this letter, subject to the kind of changes we have talked about making in it.

MS. KLOSS: Of course. I hope you take no criticism. All of these are labors of love. I do think that perhaps, this letter and the report will benefit from one more round of tightening and editing. I am comfortable approving it with the assumption that there may be some subsequent editorial changes. I apologize for not forwarding those in advance. I just saw some areas that I thought could be clearer.

DR. MAYS: Okay.

DR. STEAD: I think if we follow the thing we – we are all struggling a bit trying to do this in this format. I think if we follow the way we have done it in the past, if we have, in essence, about got the content right, Rebecca and her team could do that edit pass, as much as they are currently finishing up doing with the last Pop Health report, in that sense, getting it consistent and so forth, once we have got the basic content right.

MS. HINES: Bill, I would also like to encourage Linda and anyone else with those kinds of specific suggestions for improved clarity to just send them to Vicki and Erika so that we have that information before we do that final polish.

MS. KLOSS: Will do.

MS. HINES: That will be super helpful.

DR. MAYS: My sense of the comments and – they, I think, are all taken as really making a difference in the letter. Linda, please, I think that your comments have been very helpful. I think Helga’s – let’s kind of start with this, we think this is important, and kind of the sentiment of the group around – that helps us in terms of protecting it. I think it is very important. I think having the other bullets be sub-bullets, which gives the reader a sense of if you want to enhance it, here are some other things, I think is probably a great tone to have. I think it will have the letter – Linda, my sense is that doing it that way also makes it a little more focused and crisper.

MS. KLOSS: Agree.

DR. STEADS: I was thinking from a process point of view, we – my sense is we have actually – may be at a point that we could vote to approve the letter, subject to these changes in an edit pass. Is that a bridge – do we want to see if somebody wants to make a motion and get a second to that effect? Or whether – the other option – we have about five more minutes before we have got to get into the other pieces of the agenda. The other option would be to bring it back at the June meeting. The question is whether this is close enough that people would be willing to vote on it subject to those edits or whether they feel that it needs to come back to the full committee.

MS. HINES: Bill, the sub-option in between the two would be to approve with one edit pass and do one more circulation with the full committee by email and just make sure no one has any objections to the edit pass. Then we don’t have to wait until the end of June.

DR. STEAD: That would be awesome if we can do it that way.

MS. HINES: I would say so, as long as we have a vote today that that will be our plan. Then if there are any objections, then it would go to the June meeting. My assumption is that we will get it done right and then we can expedite it.

DR. STAD: Vickie, would that work from your perch?

DR. MAYS: Yes. I think that that is a – I always like to make sure the committee is totally onboard. I think that that is a great in-between, Rebecca.

DR. STEAD: Well, then it is – could somebody make a motion along those lines?

DR. ROSS: I would move that we adopt Rebecca’s approach.

MS. HINES: The approach is to make one more edit pass to the letter and the report and send it back out to the full committee. Give say ten calendar days to send objection, otherwise, it will go forward.

DR. RIPPEN: This is Helga. I will second it.

DR. STEAD: We have got a motion and a second. Any further discussion? Can we bring up the vote tab?

DR. MAYS: Can I ask a question before we vote? Does that mean the report is also a part of that?

MS. HINES: Yes. They are a packaged deal.

DR. MAYS: Okay. Great. Just want to make sure.

MS. HINES: The green check marks are lighting up the screen. I think we’ve got a go.

DR. STEAD: It looks unanimous. Congratulations Vickie. Congratulations Jim and Erika.

DR. MAYS: Thank you everyone. Your comments are well appreciated.

DR. STEAD: We are now ready to move into the update on the Health Plan ID Hearing. Nick and Alix, do you want to take over?

Agenda Item: Health Plan ID Initiative Hearing (May 3)

MR. COUSSOULE: I will take that one, Bill. The hearing, the Health Plan Identifier Hearing, is scheduled for Wednesday, May 3rd. The agenda or I should say the tentative agenda, although it is pretty close to final at this point, has been provided as part of our update today. It is now visible on the website through the link to this meeting. It is a relatively short day. It runs from nine o’clock until two o’clock with four different panels. That covers different kinds of constituencies to weigh in on the current status of health plan identifiers plus the legislation that is in place today along with any kind of comments or recommendations or challenges.

The agenda is there. The speakers are lined up. There are a number of written comments being provided – that we understood would be provided. The questions have been well established. I think everything is set to look forward to a very productive day on Wednesday, May 3rd.

MS. HINES: Bill, do we want to ask if any committee members have any follow up questions or clarification?

MR. COUSSOULE: One comment I would make is this is a – kind of a standard subcommittee meeting, but we clearly wanted to invite any committee members who has a desire and need to be part of this.

DR. STEAD: Does anybody have any questions or comments for Nick? For my clarification – this may be Rebecca – will we get a transcript of this hearing?


DR. STEAD: Thank you. I am not seeing any hands go up. So, Nick, thank you. Let’s move on to the Predictability Roadmap Workshop.

Agenda Item: Predictability Roadmap Workshop

MS. GOSS: Bill, I am going to cover that. This is Alix.

DR. STEAD: You are going to cover it, Alix?

MS. GOSS: I am. Nick and I are tag-teaming today. So, I am going to give you the update on the Predictability Roadmap, which we have talked about at a few of our prior meetings, helping us to define some of the scope and thoughts around how we might approach and who might be involved in establishing a Predictability Roadmap related to the adoption of standards and operating rules for the nation.

So, we are planning – taking the feedback we have received so far and we have been having subcommittee discussions to further advance a detailed work plan. The objective is that we will convene one or more workshops of standards development organizations and operating rule authoring entities to validate the current timeline and procedures for updating the adopted standards and operating rules. We will be identifying barriers to updating the standards and operating rules in a seamless manner and on a predictable timeline. We will identify opportunities for mitigating those barriers and also identify the recommendations from the vetting process that we can elevate for discussions within the full committee and, ultimately, produce documentation and recommendations for the Secretary.

The subcommittee’s discussions have been very productive. We are hoping that we can finalize our timeline this month. We are meeting biweekly on this effort and are currently questioning our timeline and whether the August face-to-fact workshop is going to be feasible. We will have a better idea within the next week – week and a half or so. We will keep you posted. The initial meetings with the standard development organizations and operating rule authoring entities is anticipated to be virtual, leading up to a face-to-face meeting and then produce some output that we will bring back to the full committee for discussion.

We will also likely have a hearing, the results of any recommendations that are produced if we need to solicit industry feedback before advancing recommendations to the Secretary.

Are there any questions on the roadmap process? Back to you, Bill

DR. STEAD: Thank you, Alix. I look forward to seeing how the timeline shakes out. My sense is this is going to be a topic that our industry partners have intense interest in. I really appreciate your leadership.

MS. GOSS: Thank you.

DR. STEAD: Bruce, would you like to update us on the Next Generation Vital Statistics Hearing?

Agenda Item: Next Generation Vital Statistics Hearing (Sept 11-12)

DR. COHEN: Sure, thanks. The subcommittee working on this is Dave and Helga and Vickie and myself and staffing it are Rebecca, Terry, and Kate. We have made enormous progress, moving forward on the agenda. It will be a two full-day hearing. The agenda is almost set.

The first day will be key level set, which will describe where things are. We have gotten Dr. Steve Schwartz, who is the head of Vital Statistics for the City of New York to agree to do this level set. The rest of the first day will be an assessment of the current status from a variety of perspectives, from the jurisdictions, the states, from NCHS, from the other federal data stewards, including SSA, CMS, as well as perspectives from the data users, Census, BOS, other federal agencies, as well as researchers, health insurers, pension funds, and a variety of other perspectives.

The second day will focus on what these different groups see as the current challenges and what their ideas are for potential solutions to overcome some of these challenges. We will finally end the two days with brainstorming about where we go from here.

It is really exciting to get back to our roots with the National Committee for Vital and Health Statistics. This has been a great group. I look forward from input from a variety of folks.

Dave, Helga, and Vickie, do you have anything you would like to add?

DR. RIPPEN: It is exciting. Come join us.

DR. MAYS: I think it really will be an exciting hearing, in terms of the issues, given the diversity of stakeholders that will participate.

DR. COHEN: Certainly, the entire committee is welcome to come. It will be the two days preceding our September meeting.

MS. KLOSS: That was my question, whether this – whether the full committee is invited to participate. It certainly does sound monumental.

DR. COHEN: Yes, certainly.

MS. HINES: Marietta sent out an Outlook invite this morning that you can accept.

MS. KLOSS: Terrific.

DR. STEAD: Rich’s hand is up.

MR. LANDEN: Yes, I am very much looking forward to attending the hearing. It looks really good. My question is more on interpreting the preliminary agenda data producers. Where I am going with that is I don’t see anything explicit there about HIT software developers, who would be capturing this data at the provider sites, whether that is EHRs or some other application. Is participation by that segment of the industry included in your planning and thinking for the hearing?

DR. COHEN: We will make it more explicit, Rich, but we do have – on panel two, we are including the state IT and HIT leads. I think the software developers is a good group to make sure that we explicitly invite. If anybody on the call has any suggestions about folks or organizations that should be in attendance, please, please forward those recommendations to me and to Dave. We will make sure that they are invited. We will make sure the developers are represented, Rich. Thanks.

DR. STEAD: I do not see any other hands. Are there any further questions or comments for Bruce? Thank you, Bruce.

We will now move on to Bob’s update on the plans around the report from the June 2016 hearing on claims-based databases for policy development and evaluation.

Agenda Item: Follow up on June 2016 Hearing on Claims-based Databases for Policy Development and Evaluation

DR. PHILLIPS: Thank you, Bill. You all may remember we had this hearing back in June of 2016 and came out of that with Walter Suarez leading the effort to summarize the excellent testimony that we received. In fact, members of the full committee were on an ad hoc group that helped shape a draft report at that time. With Dr. Suarez’ transition, this went fallow for a little while. I was asked to pick it up again this winter. With considerable help from Rebecca Hines, we have gone back not only to the initial draft testimony, but through her tireless efforts to supplement that with some of the additional testimony that weren’t captured at the time.

We have made a run at doing a summary letter and are in the process of reconvening that ad hoc group to help us go over the rest of the reconstituted testimony with the goal of having a letter for the full committee to consider at our June meeting, upcoming.

Rebecca, anything else we should add to that?

MS. HINES: I think the main goal right now is to get a good summary of the hearing in the hands of the executive subcommittee. I think from there, we will be able to proceed.

DR. STEAD: Good. Does anyone have any questions or comments for Bob? I really want to thank Bob and the Pop Health Subcommittee for reconstituting the ad hoc group and working to bring this to closure. It is, I believe, our last major outstanding task from the past, as we begin – now, begin to move forward to our next round of work.

We are actually a few minutes ahead of when we should go to public comment. Do we know if there have been questions posted in the Q&A? I have not seen them.

MS. HINES: Bill, there have been a few things, but I think that – I pinged Alix and Nick to take a look at them. What they are is they are suggestions by somebody, perhaps who is on the call, of what could be included in the hearing, some questions for testifiers.

MS. GOSS: It looks like somebody took the questions we had on the agenda and put them into the Q&A. It was labelled WebEx Uploader. I am not – maybe our facilitator did that or something. I am not sure.

Agenda Item: Public Comment

MS. HINES: I think the next thing to do, Bill, is just to move right into public comment. Is that where we are?

DR. STEAD: That works from my perch.

MS. HINES: Christina, you can help us out here. On the screen, here, are the instructions for making a public comment. You can use the hand raise option in the lower right corner of the pod on the right-hand side of your screen.

DR. STEAD: We have a slide to show that.

MS. HINES: We have a slide to show that. Thank you for the reminder. You can raise your hand if you would like to make a comment. The little arrow is pointing to the hand. Then your line would be unmuted. Otherwise, you can write something in the Q&A section of the platform on the right side of your screen. We will give you a minute to do that.

Christina, do we have any hands raised from the general public?

OPERATOR: I am not seeing any hands raised at this time. As a reminder, ladies and gentlemen, if you would like to ask a live question, please click on the raise hand icon located below the participant’s name. We will go ahead and say your first name and unmute your line and then you can go ahead and ask your question.

MS. HINES: One round of row, row, row your boat in your head and if nobody, in that period of time, puts their hand up, I think we may be done. Let’s give people 15 more seconds.


MS. HINES: I am not seeing any raised hands.

DR. STEAD: Do we have a motion for adjournment?

(Moved and seconded)

DR. STEAD: One last vote.

MS. HINES: A reminder to committee members, we are going to have a post-meeting session if you can stay on for a minute. We are adjourning a few minutes early, it looks like.

DR. STEAD: We will take the few greens and no reds as saying we are adjourned. Is there a way to convert us back into practice mode, in essence?

MS. HINES: There is. Bill, do you want to adjourn the meeting?

DR. STEAD: I adjourn the meeting.

MS. HINES: Thank you all. We appreciate your interest in the committee. Our next meeting, full meeting, will be June 21st and 22nd at the Humphrey Building. Of course, there is the HPID Standards Subcommittee Hearing on May 3rd. Thank you very much. Appreciate your interest and attention.

(Whereupon, the meeting adjourned at 4:45 p.m.)