The Trusted Agent Concept

Med SchoolCollege

AAMC AMAFSMB ABMS AHACMSSAHME

JCAHONCQAACGMELCME ACCME

Residency (Individual in) Practice

Practice Plans

Physical Facilities

Recert/MOCMCAT CME

Subject Exams

In-Training Exams

Cert ExamsUSMLE

Specialty Boards

State Boards

NBME

Specialty Societies Med Schools

A Galaxy of Repositories

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

Envision One Big Virtual Repository

How Would We Share Data in Real Time?

Trusted Agent Data-Sharing Infrastructure

9www.trustedagent.org

NB Nothing happens without authorization of the MP identified by the data

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Creating a Sand Mandala

Expunging a Sand Mandala

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

Common License Application Form -CLAF

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