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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
Trus
ted
Agen
t
Appl
icat
ionsUse
rs
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