Process+Questions

**What are the core principles of the S&I Framework?**
toc The S&I framework is based on the core principles of Transparency, Prioritization, Consensus, Engagement, Rapid Results. These principles are further elaborated below.
 * //Transparency// //-// The S&I Framework activities need to be transparent and open to stakeholders. These objectives are achieved by making all the artifacts available publicly to everyone, following an open process that creates consensus. The S&I Framework process is based on the W3C consensus process.
 * //Prioritization// //-// Each of the Initiatives executed within the S&I Framework are prioritized to ensure that each Initiative meets the larger goals of healthcare reform and healthcare system improvement. Specifically, the Framework strives to remain aligned with national health priorities, and with the overall goals and expected outcomes of all the various stakeholders involved in the activities of the framework.
 * //Engagement// //-// It is imperative that in each phase of the S&I Framework, stakeholders affected by the Initiative are engaged. This ensures that each of the Initiatives within the framework will be executed with full participation from affected stakeholders, and ensures the involvement of qualified and knowledgeable resources within the phases of each Initiative. This is especially important in working with healthcare standards, which in most cases have been developed by collaborative processes external to this framework and have a cumulative body of knowledge to draw from.
 * //Consensus// //-// Consensus is a core value of S&I framework. To promote consensus, the S&I framework process will consider all legitimate views and objections, and endeavor to resolve them, whether these views and objections are expressed by the active participants of the group or by others (e.g., the general public).
 * //Rapid Results// //-// Every Initiative and it’s phases are designed to achieve rapid, quality results, through the articulation of the expected outputs from each phase and by documenting a smooth flow and transition among the phases of the framework. This will ensure that expected results can be achieved, ensure that bottlenecks and risks that are interfering with the success of the Initiative are identified and resolved, and the outcomes measured and published to the healthcare community.

**What is an Initiative Coordinator?**
The Initiative Coordinator is assigned by the S&I Steering Team to coordinate activities in the Initiative to ensure that the Initiative meets the Initiative Goal.

**What is an Initiative Group?**
An Initiative Group is the core group of participants who have committed to a specific S&I Framework initiative.

**What is an Initiative Committed Member?**
An Initiative Committed Member is an organization or individual who has a particular interest in solving the problem statement and reaching the Initiative Goal and commits to actively achieve the Initiative Deliverables.

**What is an Invited Expert?**
Invited Experts are individuals who do not individually meet the requirements of the Initiative Group and whose organization is not an Initiative Committed Member. These experts are invited by the Initiative Coordinator to participate in discussions and to provide specifically-needed subject matter expertise that an Initiative Group may require.

**Can an initiative member resign from an initiative?**
Of course, an Initiative Member may resign from a group.

**How does the S&I Framework deal with perceived or real conflicts of interest?**
Individuals participating materially in S&I Initiative work MUST disclose significant relationships when those relationships might reasonably be perceived as creating a conflict of interest with the individual's role in the S&I initiative. Each S&I participant MUST disclose their affiliating and sponsoring organization.

**What type of consensus policy is used by the S&I Framework Initiative Groups?**
Consensus is a core value of the S&I Framework. To promote consensus, the S&I framework process requires Initiative Coordinators to ensure that groups consider all legitimate views and objections, and endeavor to resolve them, whether these views and objections are expressed by the active participants of the group or by others (e.g., the general public). Decisions MAY be made during meetings (face-to-face or distributed) as well as through email. The following terms are used in this document to describe the level of support for a decision among a set of eligible individuals:


 * 1) Consensus: A substantial number of individuals in the set support the decision and nobody in the set registers a Formal Objection. Individuals in the set may abstain. Abstention is either an explicit expression of no opinion or silence by an individual in the set. Unanimity is the particular case of consensus where all individuals in the set support the decision (i.e., no individual in the set abstains).
 * 2) Dissent: At least one individual in the set registers a Formal Objection.

By default, the set of individuals eligible to participate in a decision is the set of Initiative Committed Members in Good Standing. The Process Document does not require a quorum for decisions (i.e., the minimal number of eligible participants required to be present before the Initiative Coordinator can call a question). A charter MAY include a quorum requirement for consensus decisions.

The goal is unanimous consent, which is obtained by carefully considering and addressing significant input from the Community of Interest. Where unanimity is not possible, a group SHOULD strive to make consensus decisions where there is significant support and few abstentions. Any significant deliverable of the Initiative Charter will be approved through a formal Consensus process.

**How do I specifically dissent on an Initiative Group decision?**
In the S&I Consensus process, an individual may register a Formal Objection to a decision. A Formal Objection to a group decision is one that the reviewer requests that the Initiative Coordinator consider as part of evaluating the related decision. Note: In this document, the term "Formal Objection" is used to emphasize this process implication: Formal Objections receive Initiative Coordinator consideration. The word "objection" used alone has ordinary English connotations.

An individual who registers a Formal Objection SHOULD cite technical arguments and propose changes that would remove the Formal Objection; these proposals MAY be vague or incomplete. Formal Objections that do not provide substantive arguments or rationale are unlikely to receive serious consideration by the Initiative Coordinator.

A record of each Formal Objection MUST be publicly available. A Call for Consensus (of a document) to the participants MUST identify any Formal Objections.

**Can I appeal a decision made by an Initiative Group?**
When group participants believe that their concerns are not being duly considered by the group, they MAY ask the Initiative Coordinator to confirm or deny the decision. The participants SHOULD also make their requests known to the Team participants. The Team participants MUST inform the Initiative Coordinator when a group participant has raised concerns about due process.

Any requests to the Initiative Coordinator to confirm a decision MUST include a summary of the issue (whether technical or procedural), decision, and rationale for the objection. All counter-arguments, rationales, and decisions MUST be recorded.

**How will Initiative Groups deal with deadlocked decisions?**
In some rare cases, even after careful consideration of all points of view, a group might find itself unable to reach consensus. The Initiative Coordinator MAY record a decision where there is dissent (i.e., there is at least one Formal Objection) so that the group may make progress (for example, to produce a deliverable in a timely manner). Dissenters cannot stop a group's work simply by saying that they cannot live with a decision. When the Initiative Coordinator believes that the Group has duly considered the legitimate concerns of dissenters as far as is possible and reasonable, the group SHOULD move on.

Groups SHOULD favor proposals that create the weakest objections. This is preferred over proposals that are supported by a large majority but that cause strong objections from a few people. As part of making a decision where there is dissent, the Initiative Coordinator is expected to be aware of which participants work for the same (or related) Member organizations and weigh their input accordingly

**What if I don’t want to commit? Can I still participate in the S&I Framework?**
The general public is invited to participate in discussions and can provide comments and feedback by joining the wiki. However, non-committed members do not have voting rights in the consensus process.