In Memoriam: Hunt Blair

A call to action: Let us honor the life and bold vision championed by a true interoperability guru
By Carol Robinson
09:10 AM
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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: Josh@JoshCRubin.com

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.