 If you go to an ICD-9 code and you look up what anemia is, you'll find 37 different codes for anemia. Well, clearly, if you're trying to communicate the fact that a patient has anemia, you can't develop 37 codes that then get sent out to systems for the other system to understand them. So there has to be some harmonization, bringing together of those standards in one place to allow people to have one standard that they can actually work against. And that's what the HITSB work does, works on. So it's not only the data interchange, but it's also the other clinical vocabularies. And they work to include the HIT vendors as well as the medical device vendors so that they can be part of setting those types of standards. And then to make sure that they work, they utilize use cases, which is an example case of, okay, here's a clinical case, here's what we want information to be transferred. Let's take these standards and see if they work within that particular environment. It's kind of like a simulation. What does CCHIT do? Well, we wanted to set up an organization within the U.S. that would say, let's go stakeholders, vendors, as well as users, and it certifies the electronic health records and their networks to ensure that there's that level of interoperability. The SDOs are standards development organizations, which there are many of. HITSB also works with them. And CCHIT works with HITSB to understand those standards. Again, in this situation, CCHIT is an independent, non-government entity. What's Kim's vision for Chang? Well, interestingly, in December, after the presidential election, we brought together in him a variety of our committees, particularly advocacy committee but others, and said, what do we need to do for a call to action to the new administration? And here are some of the things that we came up with that really bubbled up from our volunteers up to our higher level staff, actually went to our board of directors, which we reviewed back in December, and then became part of an announcement as part of a press conference. We believe that health information technology should be used for reforming healthcare to address a couple of issues. One, it needs to improve quality, reduce costs, and enhance safety. And all of those three things are related. Use of EMRs, personal health records, and eat prescribing to achieve those goals, and none of this can happen without facilitating good foroperability. So this was our message to the new administration. The immediate challenge is still in several areas. You need leadership. Everyone within the government needs to say, this is what we are going to try to accomplish, and we're going to bring people together to accomplish that. There needs to be interoperability. We can't have separate systems not speaking to each other. We can't have systems of organizations not willing to share information. I'm involved in an organization called the Global Health Alliance, and what we are trying to do is we're working, we're a not-for-profit organization, and at this point we're trying to leverage the eHealth to be able to share meetings in an organization that's working with the folks at GHAs, Global Health Alliance, to support their services within a Wexwell platform through a social network. It allows the exchange of information, discussion of various types of cases. It's a virtual clinical tool. If you're familiar with YouTube, you would be familiar with this concept. It's a way to exchange images, as well as video, as well as comments on a variety of types of sessions. And I just pulled up a couple of examples of how that information can be exchanged in this medicine platform. Again, the social network of way of sharing information amongst clinicians that might exist in their environment may be a very important tool, HIT tool, that you might actually want to use within your organization. An eHealth approach within Wexwell through the social networking would encompass a variety of different types of initiatives, whether it's the social networking that we're currently discussing on the case, whether it's personal health records where the individual consumers can actually access, whether it's peer-to-peer networks that are set up between clinicians to talk about different cases or to exchange information. There are a variety of organizations in the U.S. and around the world that work in these types of initiatives. Let's talk a little bit about clinical adoption because you're not going to be successful in health IT unless you address the issue of adoption. I've witnessed many failed health IT initiatives because of the failure to engage individual physicians and nurses and others that are using the system. In the U.S., HIMS Analytics has developed this model to address the different stages of HIT adoption. In this case, we're dealing with electronic medical records. As you can see, even looking at Q2, we're very far, we have a very long wage in the U.S. to have complete electronic medical records with clinical decisions for data warehouse and good things like that. This is a very difficult process but you're not going to be able to move up these stages unless you involve the clinicians and get them involved. To secure clinical adoption, we have to understand two, one particular thing that's incredibly important to physicians, which is their workflow. How is it going to impact their care? How is it going to impact the quality of care that they deliver? How is it going to impact their costs associated with providing care? How is it going to impact their efficiency, their time to obtain information? How long is the encounter? How long is it going to take to enter the information and report the findings? Also, physicians check in the U.S. but I think all around the world think about if they engage health IT, will it keep them in the office longer than they normally are there? And will they be unable to be home to have dinner with their children or to go out or other things that they need to do? It's part of a work-life balance in an environment. So workflow is incredibly important. It impacts the quality of care and it impacts the cost, but it impacts the physician's personal time. If you want to be effective in using health IT, you have to pay attention to the whole concept around clinical processes and workflow and measure them in these types of an environment. Well, what drives adoption and the transfer to medical aid? The nursing, the physician, asking the same questions that were initially asked is not a really good way to do a process. It's quite inefficient and also creates an environment where there can be errors. What you want to be able to do is you want to streamline your processes so that every single thing that you do provides some level of value and you document the value associated with it. The concept of path innovation is taking the going from a current stage to a future stage in terms of your process. We're doing it in a way that you can enhance it. What I mean by this is that oftentimes when people look at clinical processes, they bring in, and they want to use IT, they'll bring in the physicians and then they bring in the process-reengineered people and then they bring in the IT people. And that works okay. But if you took the time within that community and had the IT people educate the cross-screen engineering people and the clinicians, what's the IT condition? And the process-re-engineered people educated the IT people and the clinicians about the importance of process engineering and how that works. And lastly, the clinicians educated the other two, the IT person, the process engineering person, a bit about clinical medicine. By doing that, you take a group of people who normally would look at the world with blindness on to understand what the other people do to do two things. One is they can ask intelligent questions and then additionally come up with new ideas about how to do things. For example, if I wanted to get from one city to another and I didn't know airplanes existed and they were 600 miles apart, the only way I think of getting there was driving, walking, biking or taking rewards. But if you told me that airplanes existed, I could think, well maybe I could fly there. I know it sounds a bit silly, but you probably don't remember the fact that if you don't know that things exist, you can't think of them as being a solution. That's what pathogenation tries to do. It takes the re-engineering of those processes but does it through cross-training and teamwork with the people that are involved.