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The Trusted Agent Concept. AAMC. FSMB. AHME. ABMS. CMSS. AMA. AHA. State Boards. Specialty Societies. Med Schools. Specialty Boards. NBME. MCAT. USMLE. Cert Exams. CME. Recert/MOC. Subject Exams. In-Training Exams. Med School. Residency. LCME. ACGME.
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AAMC FSMB AHME ABMS CMSS AMA AHA State Boards Specialty Societies Med Schools Specialty Boards NBME MCAT USMLE Cert Exams CME Recert/MOC Subject Exams In-Training Exams Med School Residency LCME ACGME ACCME NCQA JCAHO Practice Plans College (Individual in) Practice Physical Facilities
The Result • Inability to compile an evidence base to support • Lifelong learning • Self-improvement • Program evaluation • Professional self-regulation Needed: the ability and willingness to share data massively and in real time
Why Don’t We Share Data Now • Technical Barriers and incompatibilities • Legacy systems • Operating systems • Data storage systems • Political and business issues • Legal issues
New Promise for Data Sharing • New technical solutions (XML, web services, service-oriented architecture) • Concept of co-opetition LEADING TO • Massive Growth in online commerce and services creating • Value for the user • Efficiencies for all • Revenues for the providers
Trusted AgentData-Sharing Infrastructure Users Applications Trusted Agent NB Nothing happens without authorization of the MP identified by the data 9 www.trustedagent.org
Data Mandalas for Individuals • Compiled and reported to the individual • Expunged from system after reporting • Recompiled ad libitum • “Just-in-time, just for you” • No “super” new repository • no new discoverability • No data refresh issues • No threat to primary repositories • No “big brother”
Dissemination of Data Mandalas Beyond the Individual • e.g. to satisfy regulatory requirements (licensure, certification, credentialing, privileging) • If data is identified, reportable to third parties only with authorization of the individual • De-identified or grouped data can be used for research purposes
Why “Trusted Agent”? • Has access to participating repositories 24/7 • Can act on behalf of physician 24/7 • Is functionally effective, saves time and hassle • Never compiles data mandalas unless requested by the individual identified • Never reports mandala to third parties unless authorized by the individual identified • Ownership and governance across more than one participating organization
CLAF – Results To Date • 2810 MD and DO applicants in KY, NH or OH have registered • 533 submitted completed applications without major problem. • To date the shortest time to complete the process is eight minutes