healthspottr was privileged to participate in a HealthIT roundtable with Federal CTO Aneesh Chopra in Silicon Valley yesterday. Chopra described it as a reconnaissance mission; his pursuit for new perspectives and alternative strategies for healthcare-transformation, "so we don't have to wait for policy reform" to advance the ball down the field, he said.

He assembled an impressive crowd, including: Molly Coye, CEO of CalRHIO; BCG's James Andrew; James Currier of Medpedia; Google's Missy Krasner;Clarence So of Salesforce.com; of Michael Reandeau of Sutter Health; Dana Mead of KPCB; 23andMe co-founder Linda Avey; conference guru Tim O'Reilly; and Judy Estrin, late of Cisco, now a director of Disney. Others from Hewlett Packard, Hummer Winblad, Physic Ventures, Intel, Visa, TechNet, and Science Commons were also there. The day was hosted by Matt James of the Kaiser Family Foundation.

Chopra arrived with an awareness of some of Washington's blind spots to the catalysts for market disruption. Those he couldn't see previously are plain as day to him now, he said.  

Chopra made a committment  "to do something in the next 90 days that will make a difference." Several ideas were tabled.  We're not sure what he will choose as his stake in the ground. Below are are a few of yesterday's takeaways -- they'll give you an sense of some of the options he's considering ...

1) CCHIT gets some media training? Chopra has a fresh handle now on how software innovators perceive the HealthIT certification standards body: Fort Knox surrounded by the Great Wall of China, on an island in the middle of the  Weddell Sea. He heard again that the government's $20 billion in ERM subsidies are but backdoor dividends to Epic, Seimens, GE and their like. For his part, Chopra shared more about CCHIT-M, the new subset of standards designed to lower the drawbridge to IT vendors who build modular and open-source systems for smaller physician practices. Certification for these "lighter" EMRs is a lot cheaper, too (did you know?). Open-source vendors (EHR-S) pay as little as $150. Then Chopra dropped a shoe:  "no one has applied for these new certifications." Which is interesting, because certification increases the likelihood of a small vendor also being able to sell into, say, a Sutter Health. (Maybe some of our readers can share why, even at these low price points, developers won't bite?) Chopra said he'd begin working "immediately" to change the perception that CCHIT is a lock box for the incumbants guarded by the government. Look for new messaging from DC, like "We like open source!"

2) MD Medals for e-Compliance. It was suggested that the government could "badge" doctors who agree to get "e-compliant," a carrot to entice them to modernize. A doctor's e-badge could embellish a Yelp page. Of course, Google would map the  e-docs,  said Missy Krasner, so a consumer could hunt for local physician who happens also to be tech savvy! Chopra loved this idea. And the really nice consequence of giving public recognition and exposure to e-docs is that this also serves to identify an emerging customer base for developers. Right now the difficulties with assessing the customer base of independent doctors has been an obstacle to growth independent software development.

3) Consumer comparative effectiveness. Chopra said he's push for a new comparative effectiveness study, this time to measure the usefulness of consumer-oriented healthcare tools and services. Happily, now instead of merely focusing on which clinical procedures work best, we'll have a chance to examine which home-monitoring tools work best. Such research should  help focus entrepreneurs and investors, given them a bit more lamplight on the consumer-innovation path.  (Intel's man could barely sit still!) It is encouraging to see the administration understands that throwing money at IT isn't enough to reinvent healthcare. Consumer solutions and self-care are equally vital  levers.

4) The war for hearts and minds. Some time was also devoted to the administration's lack of attention to the transformation in culture necessary to transform healthcare. Where are the strategies for promoting wellness in the president's plan? If it is to be successful, healthcare transformation needs champions, champions who aren't delivering clinical care or selling technology. As Tim O'Reilly put it "we need the health enthusiasts!" He was referring to people like himself, who wear pedometers by day and heart monitors by night, just for kicks. Why not build  a coalition-of-the-willing, O'Reilly asked, made up of people who participate in the healthcare system by choice --  like blood donors. These are the types of people who can put a positive spin on healthcare, seedinga grassroots campaign to promote wellness, and happy participation in the system.

5) The Right Stuff.  Who are the healthcare astronauts? If the administration wants to inspire innovators and drive a culture-wide transformation it has to show the country what our healthcare future could look like. It needs to identify success, put a face on it, and promote it to entrepreneurs as an example to follow. (I mean, $20 billion has sticker shock,  but EMRs just aren't emotionally moving.) Chopra is all over this idea. With help from his colleague, Todd Park, the newly appointed CTO of HHS, he is putting together a best-in-class crew to offer up a vision of what the healthcare future looks like in flesh and blood. (Naturally  healthspottr sees this as fertile ground.) A press conference with these new moon-chasers, with all the hoopla of the President's previous event with the 800-pund Gorillas in June, now that would be a really nice start.

Chopra got an earful about the FDA, too : it's  "not-up-to-speed" and so "defaults to the most conservative position." In other words,  trigger happy with bullets that spell "No." Chopra was also pummeled with pleas for payment reform -- something way outside his portfolio. But he'll dutifully look into both.

Meanwhile, Wednesday the President announced his investment in electric cars. Would that we could get one of these initiatives for developers of light EMRs, or for off-the-shelf monitoring tools. Heck, why not a healthcare equivalent to the G.I. Bill to encourage medical school students to enter primary care?