In Memoriam: Hunt Blair


In Memoriam: Hunt Blair

A call to action: Let us honor the life and bold vision championed by a true interoperability guru

September 10, 2015

By Carol Robinson, Principal at Robinson and Associates Consulting

Huntington (Hunt) Blair was on a mission to inspire a "Bretton Woods moment" for creating governance around the collection and sharing of digital health information.

Like the 22-day conference in 1944 when the Bretton Woods Agreement to govern international monetary systems was negotiated between 44 Allied nations, Hunt envisioned a similar point in time – soon – when disparate forces will come together to develop a repeatable process for determining standards and policies to interconnect data systems necessary to enable a true learning health system. The right information available at the right time, for the right purpose, to improve health and healthcare.

It was a heady goal for a former radio disc jockey who might have succumbed to his tumultuous upbringing. Instead, Hunt's courage, resilience, and optimism gave him the skills to be a connector of people and concepts that will live far beyond his mortal time on earth.

Hunt Blair was a mentor to many and a champion for big audacious ideas. He regularly implored his friends (everyone, to Hunt) to embrace the complexity of the problems we are trying to solve. He would patiently explain his very complex, ever growing architectural drawings of how data might be arranged and connected in a Learning Health System model. His first iterations were on 8.5 x 11 sheets of paper; over the years they grew into 12-foot diagrams spanning the federal, state, and local health and human service ecosystems. Some of us have versions of "Hunt's Big Picture" printed on enormous paper, decorating our offices and inspiring our daily efforts.

Hunt's commitment to this work was unparalleled. In April, when his flight to HIMSS Chicago was canceled, he rented a car and drove all night, not to speak on a big stage, but to meet with a single person whose opinion he valued. That was Hunt, in a nutshell.

Hunt's family was his inspiration. The mention of his beloved wife Sarah's name would light up his face and draw a story of admiration and gratitude. Hunt fell in love with Sarah on first sight, he would tell everyone, and then fell in love with her parents and her siblings as his own. His pride in sons George and Adam was evident in even the briefest of conversations. Five years after Hunt and Sarah graduated from Brown University they migrated to Montpelier, Vermont, where Sarah teaches fiddle and plays in a band, and Hunt worked to change the world.

Since 1992, Hunt worked on health policy issues, as Director of Public Policy at Bi-State Primary Care Association and as the founder of Vermont's Rural Health Alliance, among other positions. In 2009 he joined the Department of Vermont Health Access where he served as Deputy Commissioner of the Division of Health Reform and as State Coordinator for Health IT. In those roles, he soon became a beacon for others in similar positions across the country. By early 2013, Hunt was invited to serve as a Principal Advisor to Farzad Mostashari, MD, former National Coordinator of Health IT at that time. After a year of commuting to Washington DC, Hunt came back to Vermont, but continued as a contractor to ONC until May of 2015.  At that time, Hunt took a step that few people have the conviction and the courage to make. He chose to walk away from a secure contract role advising the Office of the National Coordinator (ONC) to embark full-time on his quest to drive our nation to a Bretton Woods moment for health IT.

At the center of Hunt's creative genius was his long-held fascination and belief in the power of distributed networks. Hunt knew, and was on a mission to share, that a distributed network for health IT would require a unified and distributed governance process to guarantee a vigorous health information supply chain. He not only believed this can be achieved, he would frequently remind us:  "This is the only thing that can happen." It was Hunt's audacious goal to make it happen faster.

Hunt was confident, provided with opportunities for possibility thinking, leaders across all sectors would unite to break the logjam that has kept healthcare, in Hunt's words, "the last cottage industry in our country". In the final months of his life, the gentle genius set about to ignite possibility thinking across the nation, leading a growing cadre of believers whose interests cut across government, academic, philanthropic and business sectors. He called this effort the "Collaboration for Open Data Alignment "(CODA) and his newly launched blog was titled CollaborationforLHS, where Hunt explained: 

CODA isn't an organization; it's a movement, an invitation to collaboration. The Nationwide Interoperability Roadmap provides a framework and list of interdependencies, a "Table of Contents" for "the Operating Manual" of the Learning Health System's ultra-large-scale system of systems' network of networks. Together, we can build a secure information supply chain capable of evolving into a Learning Health System for the transparent, agnostic exchange of critical data to improve health and reduce cost, governed with a commitment to open and unbiased exchange, organized and operated for the public good.

Hunt worked tirelessly not just bringing together individuals from numerous industries, but also helping build relationships among these individuals.  He empowered people to share ideas and be part of the discussion of how to proceed.  This was no easy task; though constituents agreed and desired these meetings to continue, there were challenges with who should fund such an effort. Hunt did not let this stop him and he was currently working with multiple non-profit groups to fund this work. 

It is often said Hunt was a visionary, a man a little ahead of the rest of us in terms of understanding the data integration to improve our livelihood.  He saw connections between and across various industries - from health care clinics to law enforcement, from academic institutions to financial organizations, from State Government entities to Federal Government groups.  He socialized the notion of sharing data and what it would mean to participating parties. 

At his core, Hunt Blair was a catalyst for collaboration. He was partnering with Josh Rubin of the Learning Health Community to plan the second Learning Health System Summit when he died suddenly, on Sept. 1, 2015.

To honor Hunt Blair and to advance the audacious goal of a unified and distributed governance process to guarantee a vigorous health information supply chain, we ask readers take one or more of the following steps:

  • Stay informed, as a basis for getting more involved;
  • Review the Core Values of a Learning Health System;
  • Endorse those Core Values of a Learning Health System;
  • Participate in conversations about health IT governance and about the business drivers impeding the interoperation of health IT systems through local, state, and national pathways;
  • Consider starting an online forum, or organizing a gathering like The Stewards of Change Symposium, to build on the work of the LHC and to broaden the conversations into the realms of social and community services;
  • Foster conversations, and invite policymakers and business leaders to participate;
  • Send your ideas (big, audacious, or otherwise) about how to advance the work of the Learning Health Community to:

In Hunt's last blog post on July 1, 2015, titled "Something's Happening Here," he talked about a number of the places he had visited during the first 60 days of his quest, and linked to an iconic song from another movement.

During his final 60 days, he continued to traverse the country by plane and car  our friend with his giant brain and tiny ego  making things happen.

Steve Maier, Vermont Blueprint for Health Healthcare Reform and Health IT Integration Manager, Joseph J. Liscinsky, Health Enterprise Director II of MMIS Program Deputy Lead State of Vermont with the Dept. of VT Health Access (DVHA), and Terry Bequette a health information technology, exchange, and transformation consultant, contributed to this tribute.

Topics: Interoperability, Healthcare Information and Management Systems Society (HIMSS), Mostashari, Farzad, The Office of the National Coordinator for Health Information Technology (ONC)

Friday 3/13/2015 -- Joseph H. Kanter Family Foundation Learning Health System Webinar Featuring Many Learning Health Community Interim Steering Committee Members


Kanter Family Foundation Announces Learning Health System Leadership Conference Speakers


Miami, FL – The Joseph H. Kanter Family Foundation (KFF) is pleased to announce its distinguished roster of speakers for their Global Webinar and Roundtable Meetings entitled Leadership Conference: Connecting the Accomplishments toward the Learning Health System and Accelerating our Progress Together in 2015. The free-of-charge Global Webinar will take place on Friday, March 13, from 1-3 pm EST. For those interested in joining the Webinar, an email inquiry should be sent to A series of live Roundtable Meetings facilitated by the speakers will be held on March 14-15 in Miami and Fisher Island, FL. 

Presentations on the state of creating a national standardized Learning Health System (LHS) utilizing a shared patient-centered outcomes research database will be given by KFF Founder and Chairman Joseph Kanter, a WWII veteran, real estate developer, cancer survivor and philanthropist who has funded the LHS mission with $10 million over the past 20 years; Learning Health Community Governance and Policy Chair Holt Anderson, who served as the North Carolina Healthcare Information & Communications Alliance, Inc. Executive Director from 1995-2014; Dr. L. Charles Bailey, a physician at the Children’s Hospital of Philadelphia  Cancer Center who specializes in leukemia and lymphoma; Landen Bain works with CDISC, a global medical research standards development organization, as liaison to the healthcare information community to develop and implement data exchange standards between healthcare and medical research; and Anvita Health Co-Founder/CEO Dr. Ahmed Ghouri, a certified anesthesiologist and author of 70 scientific publications. 

Other presenters include Bipartisan Policy Center Director of Health Innovation Janet Marchibroda, MBA, who works with stakeholders across every sector of healthcare to promote the use of IT to improve the cost, quality and patient experience of care; University of Michigan Medical School LHS Initiatives Program Officer Joshua Rubin, JD, MBA, MPP, MPH, who is a healthcare and health information technology policy expert; North-Shore University HealthSystem Vice President and Davis Family Chair of Informatics Dr. Jonathan Silverstein, who also heads the Center for Biomedical Research Informatics; TrustNetMD Chief Innovation Officer Dr. Richard Singerman, who specializes in developing and implementing initiatives to support health system transformation; and KFF Board Member Dr. Richard Tannen, an informatics research/epidemiology expert and University of Pennsylvania School of Medicine Emeritus Professor.             

Approximately 1,000 invited guests along with other interested individuals worldwide are expected to attend the Webinar and participate in a question-and-answer session following the presentations. Attendees will be encouraged to share their knowledge and experience in the healthcare informatics field and offer suggestions as to how we can work together to accelerate building a national Learning Health System that enables doctors and patients to share outcomes-based research and treatments to advance cures 

The agenda for the speakers’ roundtable meetings will focus on developing new approaches to motivate healthcare providers to base payment on cures rather than the number of treatments administered; and strategies to increase healthcare providers and patients’ participation in sharing healthcare experiences in order to discover more cures. A report summarizing the proceedings will be posted on the KFF website.

I have been working on establishing a national Learning Health System for 20 years, noted KFF Founder Joe Kanter. I have organized this conference of leading healthcare experts to help us attain this goal.      

For more information about the Learning Health System Leadership Conference, contact KFF Public Relations Specialist Suzanne Grossberg at 914-248-0568 or


About the Kanter Family Foundation (KFF) and Philanthropist Joe Kanter

The Joseph H. Kanter Family Foundation (KFF)/Health Legacy Partnership is a 501 (c)(3) nonprofit organization founded in 1998 to advance patient-centered outcomes research by developing a standardized National Health Outcomes Data Sharing Network. We have offices in Los Angeles, CA and Miami, FL.

Mr. Kanter (AKA Joe) is an Alabama native, WW II veteran, successful real estate developer, film producer and cancer survivor who has dedicated $10 million to the KFF mission over the past 20 years. He is the author of a newly published book entitled Your Life Your Health: Sharing Your Digital Health Data Could Save Your Life (ISBN: 978-0-9856362-8-9). To learn more, visit or call 305-604-3209.



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Weaving Together a Healthcare Improvement Tapestry

Learning Health System Brings Together Health IT Data Stakeholders to Share Knowledge and Improve Health

By Joshua C. Rubin, JD, MBA, MPH, MPP, and Charles P. Friedman, PhD

As the “Vision” section of AHIMA’s website states, AHIMA aims to “lead the advancement and ethical use of quality health information to promote health and wellness worldwide.” In many ways, the Learning Health System’s (LHS) overarching vision represents what can happen when diverse stakeholders connect and harmonize efforts at multiple levels to do just that. The LHS vision can, in many ways, serve the learning needs of all healthcare stakeholders. Many feel the LHS is urgently needed to foster a cyber-social transformation of healthcare— transformation needed at a magnitude that can only be realized by multiple and diverse stakeholders working together toward achieving a shared vision. The vision of the LHS is being realized, in part, through a grassroots movement known as the Learning Health Community, which is currently under way.

The LHS can be seen as the tapestry that emerges from weaving together efforts across the health information management, health IT, patient engagement, clinical care, research, and public health arenas aimed at utilizing data, information, and knowledge to improve health. In its 2011 “Digital Infrastructure for the Learning Health System” report, the Institute of Medicine (IOM) defined the LHS as a system “in which progress in science, informatics, and care culture align to generate new knowledge as an ongoing, natural by-product of the care experience, and seamlessly refine and deliver best practices for continuous improvement in health and healthcare.” Understanding the transformative potential of a system that optimizes every participant’s ability to learn from the ever-increasing amount of digitally captured health data, patient activist Regina Holliday in 2012 described a key component of the LHS vision by asking,

“What if your data did not have to die in dusty paper files and unconnected electronic silos? What if many private institutions, non-profit organizations, research centers, government entities and individual patients decided to share data? What if we could do this over a span of years creating an ever larger data set? That data set could be accessed by the many in a timely fashion that will enable both the individual and the organization to make informed health decisions.”

Read the rest of the article here.

State of the Industry: A Grassroots Movement Is Underway to Realize a Nationwide Learning Healthcare System

Click here for original article.

April 8, 2013

By Charles P. Friedman, PhD; and Joshua C. Rubin, JD, MBA, MPH, MPP 
April 2013, HIMSS Clinical Informatics Insights

As the nation’s health system goes digital, a clear consensus is emerging: Our historic investment of over $150 billion in health IT will yield the anticipated benefits only if we harmonize efforts nationwide into a national-scale Learning Healthcare System (LHS). Just as the internet had transformative impacts on numerous and diverse stakeholders’ ways of working, communicating and interacting, the LHS promises to have broad and far-reaching impacts on health. 

What is the Learning Healthcare System?
The IOM defines an LHS as “... one in which progress in science, informatics, and care culture align to generate new knowledge as an ongoing, natural by‐product of the care experience, and seamlessly refine and deliver best practices for continuous improvement in health and healthcare.”

The LHS is one infrastructure, serving multiple purposes, being built collaboratively atop a foundation of meaningful use and other health IT investments. The LHS allows the increasing amount of health data that is captured digitally – about 30 percent now, expected to be 80 percent by 2019 – to be aggregated, analyzed and converted to actionable knowledge.

This knowledge is then shared with stakeholders who can benefit and learn from it.  The LHS holds the potential to transform care delivery by shortening the 17-year gap between knowledge generation and its application, to empower clinicians and patients with knowledge to inform their decisions, and to create a more robust public health and biomedical research infrastructure for the nation.

What is the Learning Healthcare Community Movement?
At the same time, this imperative is spawning a national movement: a grassroots Learning Healthcare Community mobilizing multiple and diverse stakeholders to realize a shared vision for the LHS. This vision was articulated in a set of Core Values developed collaboratively at a multi-stakeholder meeting last May. Noting their alignment with HIMSS’ mission,HIMSS was an early endorser of the LHS Core Values.

The LHS is being realized by initiatives growing out of the Learning Health Community, and, like any grassroots endeavor, it will become what the members of this community make it into. To help give shape to the LHS, we encourage your active participation and invite you to contact the authors to become engaged.

Evidence of support for the Learning Healthcare System
The LHS imperative is supported by a series of reports by the Institute of Medicine (IOM), the Federal Health IT Strategic Plan: 2011-2015, an issue of Health Affairs dedicated to rapid learning, and a recent New England Journal of Medicine commentary.

About the Contributors
Charles P. Friedman, PhD, is the Professor of Information and Public Health at the University of Michigan.  Joshua C. Rubin, JD, MBA, MPH, MPP, is Executive Director of the Joseph H. Kanter Family Foundation.

Joseph H. Kanter Family Foundation Convenes Historic Learning Health System Summit; Stakeholders Collaboratively Work Toward Realizing a National-Scale Learning Health System

Washington, D.C. – The Joseph H. Kanter Family Foundation (KFF) convened a two-day Learning Health System (LHS) Summit on May 17 and 18 where over 80 prominent individuals representing organizations and stakeholders across the health care and health IT communities gathered at The National Press Club in Washington, D.C.  Participants worked together to begin laying key foundational elements that promise to harmonize and coalesce cutting-edge work presently underway into a national-scale LHS.

A multi-stakeholder, 16-member Planning Committee, including two former United States National Coordinators for Health Information Technology (Dr. David Blumenthal who served under a Democratic administration and Dr. Robert Kolodner who served under a Republican administration), has been working for the past half-year to plan the Summit.  The Planning Committee played an instrumental role in identifying participants to be invited and organizations to be represented at this limited-capacity, invitation-only Summit.
Utilizing a definition developed by the Institute of Medicine (IOM), a “Learning Health System” is defined as “one in which progress in science, informatics, and care culture align to generate new knowledge as an ongoing, natural by-product of the care experience, and seamlessly refine and deliver best practices for continuous improvement in health and health care.”  Achievement of a national-scale LHS will improve health care quality by streamlining research, by supporting public health, by advancing patient safety, and by empowering clinicians and patients alike to make better-informed health decisions through enabling investigators to study what works best for every disease for every patient.  Through a learning system, new biomedical knowledge will find its way very quickly into health care.

Participants in the two-day Summit began working toward achieving multi-stakeholder consensus on a set of principles that would underlie the development of a national-scale LHS benefiting stakeholders across the health care spectrum.  In certain respects, the Summit was modeled after the 1944 Dumbarton Oaks Conference where a critical mass of key world leaders convened to achieve consensus around principles that ultimately served as the foundation upon which the United Nations was built; the Summit aspires to be to the creation a national-scale LHS what the Dumbarton Oaks Conference was to the founding of the United Nations.
KFF Chairman Joe Kanter framed the two-day summit by asking two critical questions of all participants: 1.) What can a Learning Health System do for you?  And 2.) What can you do for a Learning Health System?
“KFF sponsored the Summit because our nation’s health care system is facing a grave crisis and the time for action is now,” said health care pioneer and prostate cancer survivor Joe Kanter, who is the namesake of the foundation.  “A special kind of leadership is required to foster an environment where stakeholders can work together to harmonize and synergize efforts currently underway to collectively build a national-scale LHS.  Such leadership must facilitate the development of a national-scale LHS not by controlling, but by stimulating creativity and innovation, as well as providing simple and trustworthy governance.”  Paying tribute to the Summit’s historical significance, Kanter concluded, “The efforts of Summit participants collectively represent one of our nation’s great feats in health care by engaging such an impressive and diverse group working together in a collaborative and bi-partisan manner to give the gift of health to our children and our nation.”

 “I am struck that we may have started something transcendent.  I do not believe that, in the history of health in the United States, a multi-stakeholder group like this has ever gathered around an issue of such importance and common interest,” said Dr. Charles Friedman, director of the Health Informatics program at the University of Michigan, who chaired the Planning Committee

The Summit generated significant enthusiasm.  Recognizing the urgency of harnessing this momentum, KFF Executive Director Josh Rubin stated that, “Key next steps include continuing the consensus process around the principles and working to create a Learning Health Community.  This community will develop bottom-up as a coalition of the willing.  Its collaborative work ultimately aims to spawn a series of activities catalyzing the rapid development of a national-scale LHS that promises to empower individuals to transform health care and health.”

Summit participants represented organizations and stakeholder groups including: patient advocacy and consumer organizations, provider organizations, research organizations, government agencies, payers, clinicians, the pharmaceutical industry, health IT vendors, philanthropic organizations, professional associations, research initiatives and organizations, and thought leaders.  For a complete list of participating individuals and the organizations they respectively represented, please see
Joseph H. Kanter Family Foundation:
The Joseph H. Kanter Family Foundation and Health Legacy Partnership, a non-profit organization based in Washington D.C., aims to effectuate a health system that leverages the power of health information technology (HIT) and electronic health records (EHRs) to learn from real-world patient experiences by putting patients at its center.


For Immediate Release: May 23, 2012
For More Information:
 or Stan Smith (954) 762-7000




Core Values Underlying a National-Scale Person-Centered Continuous Learning Health System (LHS)


The national-scale, person-centered, continuous and rapid learning health system (LHS) will improve the health of individuals and populations.  The LHS will accomplish this by generating information and knowledge from data captured and updated over time--as an ongoing and natural by-product of contributions by individuals, care delivery systems, public health programs, and clinical research--and sharing and disseminating what is learned in timely and actionable forms that directly enable individuals, clinicians, and public health entities to separately and collaboratively make informed health decisions.

The proximal goal of the LHS is to efficiently and equitably serve the learning needs of all participants, as well as the overall public good.  The LHS offers an important opportunity to facilitate sharing of data in order to serve this goal, aiming to surmount obstacles to such sharing.

The LHS will develop as a synergy of initiatives already underway, as well as new ones that will be launched, by creating an environment that fosters collaboration and harmonization among all stakeholders.  It is anticipated that the LHS, in its operation, will leverage a data federation rather than a centralized national database.  The LHS will build upon enablers already taking shape, including the national pursuit of Meaningful Use of electronic health records, personal health records, and other health information technologies.  Ultimately recognizing that better health for all is a global imperative, the LHS aspires to embrace strategic approaches that facilitate harmonization with other nations in pursuit of a global system, as well as within the United States.

Core Values

The design and operation of the national-scale LHS derive from its core values:

{C}1.     {C}Person-Focused:  The LHS will protect and improve the health of individuals by informing choices about health and healthcare.  The LHS will do this by enabling strategies that engage individuals, families, groups, communities, and the general population, as well as the United States healthcare system as a whole.

{C}2.     Privacy:  The LHS will protect the privacy, confidentiality, and security of all data to enable responsible sharing of data, information, and knowledge, as well as to build trust among all stakeholders.

{C}3.     Inclusiveness:  Every individual and organization committed to improving the health of individuals, communities, and diverse populations, who abides by the governance of the LHS, is invited and encouraged to participate.

{C}4.     Transparency:  With a commitment to integrity, all aspects of LHS operations will be open and transparent to safeguard and deepen the trust of all stakeholders in the system, as well as to foster accountability.

{C}5.     Accessibility:  All should benefit from the public good derived from the LHS.  Therefore, the LHS should be available and should deliver value to all, while encouraging and incentivizing broad and sustained participation.

{C}6.      Adaptability:  The LHS will be designed to enable iterative, rapid adaptation and incremental evolution to meet current and future needs of stakeholders.

{C}7.     {C}Governance:  The LHS will have that governance which is necessary to support its sustainable operation, to set required standards, to build and maintain trust on the part of all stakeholders, and to stimulate ongoing innovation.

{C}8.     {C}Cooperative and Participatory Leadership:  The leadership of the LHS will be a multi-stakeholder collaboration across the public and private sectors including patients, consumers, caregivers, and families, in addition to other stakeholders.  Diverse communities and populations will be represented.  Bold leadership and strong user participation are essential keys to unlocking the potential of the LHS.

{C}9.     {C}Scientific Integrity:  The LHS and its participants will share a commitment to the most rigorous application of science to ensure the validity and credibility of findings, and the open sharing and integration of new knowledge in a timely and responsible manner.

{C}10.  {C}Value:  The LHS will support learning activities that can serve to optimize both the quality and affordability of healthcare.  The LHS will be efficient and seek to minimize financial, logistical, and other burdens associated with participation.

July 20, 2012

Developed at the May, 2012 Learning Health System Summit