JANUARY 2014

HL7 Takes a Leadership Position in the Era of Patient Empowerment By Leslie Kelly Hall, Senior Vice President, Healthwise; Russell Leftwich, MD, Chair of HL7 Professional Engagement and Chief Medical Officer, Office of eHealth Initiatives; and Lisa R. Nelson, Consultant, LOTS, LLC

The era of patient and consumer an interchangeable digital docu- engagement in healthcare has ment that uses standards already dawned. The HIPAA Omnibus adopted by Meaningful Use. The Rule and Stage II of the Meaning- introduction of this critical ele- ful Use EHR incentive program ment enables EHRs and other have created a new paradigm for health information technology Leslie Kelly Hall an individual’s access to their own (HIT) systems to utilize documents healthcare information. The value generated by systems designed to of access will be complemented interact directly with patients. and magnified by the opportu- nity for individuals to contribute The new US Realm Header for data and information to their own Patient Generated Document health records. This new paradigm template further constrains the US offers the opportunity for two-way Realm General Header template exchange of information between for CDA® documents. It provides individuals and their healthcare the needed guidance and specifica- providers, but it will require new tions to encode the header infor- tools to be created. To realize the mation of a CDA document when Russell Leftwich, MD full potential of this shift, interop- a patient is the author. It addresses erability standards have been situations where a patient’s fam- updated so that data coming from ily member or legal representa- individuals, their family, and com- tive authors the document on the munity caregivers, as well as other patient’s behalf. It also addresses data generating devices that the in- cases where a device operated dividuals operate, will be interop- by the patient is used to create a erable with existing healthcare IT document with information to be systems. The 2013 update of the shared with the patient’s health Consolidated Clinical Document record. This new header template Architecture (C-CDA) Implemen- does define a separate document tation Guide includes the Patient type. When a document conforms Lisa R. Nelson Generated Document Header to the Patient Generated Document template. It provides implement- Header it can contain structured ers with a standard way to encode or unstructured content using tem- patient generated information in plates defined in the HL7 C-CDA.

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HL7 NEWS Sjan 14 COVER.indd 1 1/3/14 11:03:16 AM In This Issue... HL7 Takes Leadership Position, continued from page 1

HL7 Takes A Leadership Position in This header template is generalized to be used The transformation of our healthcare system the Era of Patient Empowerment.. 1-2 with any type of patient generated document into a learning health system requires new The HL7 Help Desk...... 2 which exists today, or may be specified in and updated standards. In order to achieve the future. Codes from the LOINC Document transformation change, interoperable informa- Nutrition Standards...... 3 Ontology denote a patient authored document tion is a necessity. It is needed not only across Update from Headquarters...... 4-6 when the Method axis is Patient and the Scale systems, but also across the patient-centered Winners of the 2012-2013 axis is Doc or Nar. For example, LOINC code care teams which includes care professionals, Tooling Challenge...... 7 5815-8 indicates a patient note that is gener- patients, their families and their communities. ated by a patient. A document of this type HL7, as a standards development organiza- The 2013 Consolidated CDA Update...... 8-9 includes sections and entries which conform tion, is shaping the way healthcare tech- to templates defined in C-CDA. To date, sev- nologies will meet the needs of all end users. PBS Metrics Update...... 10-12 eral other types of patient authored notes have Going forward, the end users for health infor- Member Spotlight on Mollie been defined in the Document Ontology, such mation will include consumers as well as the Ullman-Cullere...... 12 as a medical history screening form and sev- many other stakeholders using HIT systems. Update from the Process eral types of consent documents. Going for- In the new era of patient and consumer en- Improvement Committee...... 13 ward, the Patient Generated Document Header gagement in healthcare, HL7 is again leading Early History of HL7, Part 1: template establishes standard implementation the way toward greater interoperability for all. University of California at San guidance for populating the header of all types Francisco Level 7 Protocol.. 14-15, 17 of patient generated CDA documents. Crossing Paradigms, Part 1- The Information Dimension: A Practical Approach for Information Exchange Across Paradigms...... 16-17

News from the PMO...... 18 The HL7 Help Desk:

The 2013 W. Ed Hammond Is healthcare interoperability implementation stressing you out? Volunteer of the Year Awards...... 19 HL7 is here to help. Congratulations on Passing the HL7 Certification Exams...... 20 Introducing the HL7 Help Desk. Exclusively for HL7 members, this 24/7 resource helps Upcoming International Events.... 21 you get quick answers to your questions, with help from peers and expert professionals. Resources include: Save the Date for HIMSS 2014...... 21 • Detailed FAQs (frequently asked questions) HL7 Benefactors...... 22

HL7 Welcomes New Staff Member... 22 • Knowledge base of exclusive reference materials, including over 50 articles on CDA® and C-CDA (Clinical Document Architecture and Consolidated Clinical HL7 Organizational Members... 23-25 Document Architecture) 2014 Technical Steering • Moderated Q&A discussion forum Committee Members ...... 26

Steering Divisions...... 26 Resolve tough implementation challenges—and save time and money. Implementing healthcare interoperability isn’t always easy. Struggling with implementa- HL7 Work Group Co-Chairs...... 27-29 tion challenges can slow down projects and drive up development costs. HL7 Facilitators...... 30-31 Staffed by professionals, the HL7 Help Desk gives you the resources you need to resolve Affiliate Contacts...... 32 roadblocks—and get your project back on track.

HL7 Staff Members...... 33 This service is an exclusive benefit for HL7 members only. To get answers to your burning questions, visit the HL7 Help Desk on the HL7 website at www.HL7.org. 2014 Board of Directors...... 34

Upcoming Implementation Workshop...... 35

Upcoming Working Group Meetings...... 36 is the official publication of: Health Level Seven International 3300 Washtenaw Avenue, Suite 227, Ann Arbor, MI • 48104-4261 USA Phone: +1 (734) 677-7777 • Fax: +1 (734) 677-6622 • www.HL7.org

2 Mark McDougall, Publisher • Andrea Ribick, Managing Editor • Karen Van Hentenryck, Technical Editor

HL7 NEWS Sjan 14 COVER.indd 2 1/3/14 11:03:19 AM Nutrition Standards: A Recipe for Clinician Involvement

By Margaret Dittloff, MS, RD, Product Manager, CBORD; Chair – Nutrition Informatics Sub-Committee, Interoperability & Standards, Academy of Nutrition and Dietetics

If you are actively involved in HL7 work groups, chances like to thank everyone at HL7 who are you have heard someone mention including diet and has helped make this possible. Of nutrition in the context of ballot reconciliation, harmo- course, the point of standards is to nization or new standards projects. Nutrition plays an use them, so we are actively work- integral role in individual and population health and yet ing on how to test these orders and HIT standards related to nutrition data are rather “de- welcome anyone interested to join ficient.” As part of a multipronged approach, nutrition us. Please contact us and submit professionals representing the Academy of Nutrition and your comments on our DSTU nutri- Dietetics (formerly the American Dietetic Association) tion standards (http://www.HL7. Margaret Dittloff, became involved with HL7 just three short years ago to org/dstucomments/). MS, RD advocate and help define universal standards related to the exchange of diet and nutrition information across the continuum of care.

The HL7 jargon and process can be challenging for clinicians, but we need their knowledge and expertise to drive standards that improve patient care and ef- ficiencies for the entire healthcare team. Our approach worked well. We brought forth a specific need and kept the project scope narrow enough to ensure that with each cycle we could reasonably accomplish our Ingredients for Success objectives. We started with a Domain Analysis Model • Nutrition Subject Matter Experts(SME), and recruited subject matter experts in nutrition from Dozen ++ various clinical settings and specialty areas of practice, including pediatrics and nutrition support teams. Then, • Experienced HL7 Modelers, 2 of the best we submitted a separate project to create the Version 3 • Domain Analysis Model, 2 ballot cycles messaging model derived from the DAM. Throughout the process, we worked to collaborate across multiple • Harmonization, shake & stir work groups, primarily with Orders and Observations, Pharmacy and Patient Care under the guidance of • Clinical Models & RMIM, 2 ballot cycles experienced HL7 leaders and facilitators. As a result, we were able to publish two draft standards for trial Organize your SMEs around real-world clini- cal scenarios and translate those into story- use (DSTUs) since submitting our first project scope boards and use cases. Derive your models statement in Sydney in January 2011: HL7 Version 3 from those, then ballot, reconcile and publish. Domain Analysis Model: Diet and Nutrition Orders, Release 2 (DSTU) as well as HL7 Version 3 Standard: Orders; Diet and Nutrition, Release 1 (DSTU). We’d

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HL7 NEWS jan 14 INTERIOR.indd 1 1/3/14 11:09:22 AM Update from Headquarters Time Flies and Two Goodbyes Mark McDougall By Mark McDougall, Executive Director, HL7

A lot has changed throughout my 22 Highlights include: Director, Health IT Programs, years with HL7. Heck, I remember National Partnership for Women one day when Wes Rishel came to Keynote Speakers: & Families our offices to help us understand • The Next Generation of Interop- how HL7 would use the internet, erability by John Halamka, MD, Meeting Sponsors email and a website. A couple tidbits MS, Chief Information Officer of We are pleased to recognize all of of HL7 operations during the pre- the Beth Israel Deaconess Medi- the organizations that sponsored digital age include: cal Center; Chief Information Of- key components of our 27th Annual • Remember that we used to pub- ficer and Dean for Technology at Plenary & Working Group Meeting lish HL7 standards on paper in Harvard Medical School; Chair of in Cambridge: 3-ring binders? the ONC Standards Committee. • Remember the thick membership • Evidence-Based Standards Devel- • AEGIS – Lodging room keys for directory of HL7 members that opment for Care Coordination, attendees we used to publish each year? by Larry Garber, MD, Principal • Beeler Consulting, LLC – Facilita- • During our working group meet- Investigator, IMPACT; Medical tor’s Roundtable Dinner/Meeting ings (WGMs) when the work Director for Informatics, Reliant • Eastern Informatics – Saturday groups would need hard copies of Medical Group breakfast for FHIR Connectathon their chapters, we would make a • Furore – Saturday lunch for FHIR lot of photocopies of the stan- Panel Session on Care Connectathon dards chapters that were under Coordination Challenges in • Gordon Point Informatics– development. And I do mean a the Aftermath of Disaster, Wednesday cookie break lot – about 100,000 photocopies such as: • Hi3 – Monday cookie break at EACH WGM. • 2011 Tohoku Earthquake and Tsu- • iNTERFACEWARE – Lanyards you remember when we put • Do nami Tragedy, by Michio Kimura, • JP Systems – Tuesday cookie all of the meeting minutes from MD, HL7 Japan, break the dozens of committees and • 2011 Christchurch Earthquake, • SPARX Systems – Tooling special interest groups (not yet by David Hay, MD, HL7 New challenge award work groups) on floppy discs? Zealand We then burned copies of the • Lessons floppy discs and distributed them Learned from to our members. the Boston Marathon Wow, we were going high tech then! Bombing for Back then the concept of video con- IT, by Jim ferencing seemed unrealistic. Today, Noga, CIO, we can video conference with our Partners family and friends by hitting one but- Healthcare ton on our phones. Yes, times have • Consumer changed. Priorities for Health & Care 27th Plenary Meeting Planning in an This year’s plenary meeting focused Electronic En- on the timely topic of Care Coordina- vironment, by tion and HL7’s role in it. The slate Erin Mackay, The 27th Annual Plenary & Working Group Meeting Sponsors of speakers and topics being covered Associate with HL7 CEO Dr. Charles Jaffe was quite impressive.

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HL7 NEWS jan 14 INTERIOR.indd 2 1/3/14 11:09:24 AM The additional sponsorship support provided by these organizations contributes heavily to HL7’s meeting budget and is much appreciated. Benefactors and Supporters We are thrilled to continue to attract impressive numbers of HL7 benefac- tors and supporters, who are listed on page 22. Their support of HL7 is very much needed and sincerely appreciated. Representatives from these organizations are pictured on this page. A special thank you is extended to those firms that repre- The 2013 HL7 Benefactors with HL7 CEO Dr. Charles Jaffe sent our 2013 HL7 benefactors and Photo courtesy of Kai Heitmann, MD supporters. • Director: Pat Van Dyke, Delta HL7 Fellows Class of 2013 Organizational Dental Plans Association The HL7 Fellowship program recog- Member Firms • Director: Austin Kreisler, SAIC nizes individuals with outstanding As listed on pages 23-25, HL7 is • Affiliate Director: Diego commitment and sustained contri- pleased to report that there are 684 Kaminker, HL7 Argentina bution to HL7 with at least 15 years organizational member companies. of HL7 membership. Contributions We sincerely appreciate their ongo- It is also noteworthy that with to HL7 may be reflected through ing support of HL7 via their organi- Calvin’s election to the Treasurer serving as a work group or com- zational membership dues. position, a vacancy occurred for mittee co-chair, serving on the HL7 Calvin’s second year as Director on Board of Directors, receiving the W. Board Election Results the board. Following the process Ed Hammond Volunteer of the Year During HL7’s annual business meet- described in the GOM, Board Chair Award, serving as an HL7 Ambas- ing in Cambridge, we announced Don Mon, PhD, appointed Hans sador, making presentations about the results of the recent elections for Buitendijk of Siemens Healthcare, to HL7, publishing a paper about HL7, the following HL7 Board of Director fill the 2014 year of Calvin’s Director or other visible activity. position on the HL7 Board. positions who will all serve a 2014- 2015 term on the Board. During HL7’s 27th Plenary meeting, We are pleased to congratulate these HL7 honored the following five well- individuals for their valued service • Treasurer: Calvin Beebe, Techni- deserving members with distinction to HL7 as members of the HL7 cal Specialist, The Mayo Clinic as HL7 Fellows in the Class of 2013: Board of Directors. • Irma Jongeneel-de Haas, HL7 The Netherlands • Vassil Peytchev, Epic • Dan Pollock, MD, Centers for Disease Control and Prevention • Dave Shaver, Corepoint Health • Robert Stegwee, PhD, HL7 The Netherlands Volunteers of the Year We also were pleased to recognize two valuable volunteers for their dedicated service to HL7. This year marks the 17th year that we have recognized such individuals via the W. Ed Hammond, PhD HL7 Volunteer of the Year Awards. The The 2013 HL7 Fellows, from Left to Right: Bert Kabbes (accepting for Robert Steg- recipients of the 2013 HL7 Volunteer wee, PhD), Dave Shaver, Irma Jongeneel-de Haas, Vassil Peytchev, and HL7 CEO of the Year Awards included: Dr. Charles Jaffe. Missing from photo: Robert Stegwee, PhD and Dan Pollock, MD. continued on next page JANUARY 2014 5

HL7 NEWS jan 14 INTERIOR.indd 3 1/3/14 11:09:28 AM Jane Curry • Ken Rubin, Healthcare Architect, Norman Daoust EDS Civilian Government & DoD Gary Dickinson Healthcare Portfolio, Hewlett- Albert Edwards Packard Enterprise Services Danny Farley • Andy Stechishin, Chief Consul- Michael Fitzmaurice, tant, CANA Software & Services PhD Ltd. Donald Gross Ed Hammond, PhD* We are honored to recognize Andy Ed Jenkins and Ken as dedicated individuals Bert Kabbes who have made significant contri- Ted Klein butions on many fronts, including Virginia Lorenzi in specific HL7 work groups and Rodney Louk throughout the larger HL7 global or- Clement McDonald, The 2013 Volunteer of the Year Award Recipients Ken Rubin ganization. Their efforts and contri- MD* (left) and Andy Stechishin (right) with HL7 CEO Dr. Charles butions are sincerely appreciated and Chuck Meyer Jaffe (center). Photo courtesy of Kai Heitmann, MD. this recognition is certainly well-de- Douglass Pratt Michigan Medical Center in Ann served. Please see the article on page John Quinn* Arbor. Most recently diagnosed with 19 to read more about the impressive Larry Reis hemophagocytic lymphohistiocyto- contributions that these dedicated Wes Rishel* sis, Diana had courageously battled volunteers have made to HL7. Mark Shafarman leukemia for several years. AbdulMalik Shakir Long-Term Members Stu Solomon We will certainly miss Diana and Individuals with at least 10 years Richard Stockell Sam. Their passing also reminds me of membership in HL7 were recog- Andrew Ury, MD how important the HL7 community nized during slide shows occurring D. Mead Walker has become to all of us who have each morning and during lunches. been involved with HL7 a long time. HL7 has the following number of In Closing individuals who have been HL7 I would also like to acknowledge You have become our extended fam- members for these number of years: two HL7 family members who have ily and we sincerely appreciate your recently passed away. role in sustaining HL7 and moving At least 10 years but less than 15 our organization forward. As simple years: 163 members Samuel Schultz, II, PhD, served as as this sentence is, I’d like to say to At least 15 years but less than 20 HL7’s founding Chairman of the each person who has ever been in- years: 70 members HL7 Board of Directors in 1987. volved in HL7 and who has touched Sam helped lead the charge to form my life… thank you!! At least 20 years but less than 25 HL7 and to evangelize HL7 at every years: 29 members opportunity. Sam passed away on With the holidays quickly ap- September 18, 2013, at his home in proaching and on behalf of the At least 25 years: 5 members (Ed Greer, South Carolina. Sam grew up HL7 staff, we extend to you and Hammond, Clem McDonald, John and lived much of his life in Michi- your loved ones best wishes for a Quinn, Wes Rishel and Mark Sha- gan where his funeral occurred. holiday season and new year filled farman)* I’ve known Sam a long time, but I with good health, lots of hugs and was impressed to learn during his much laughter. The list of individuals who have funeral service that he had built a been HL7 members for at least 20 linear particle accelerator as a high years is as follows: school science project.

Landen Bain Diana Stephens joined HL7 in Janu- Woody Beeler, PhD ary 2001 as our Director of Member- * Denotes a founding member of HL7 Bernd Blobel, MD ship Services. Diana passed away Hans Buitendijk on August 27, at the University of

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HL7 NEWS jan 14 INTERIOR.indd 4 1/3/14 11:09:29 AM HL7 and Sparx Systems Announce the Winners of the 2012-2013 Tooling Challenge New implementation tool will enable commercial UML modeling tools to work with HL7 static models

HL7 and Sparx Systems, a leading vendor of modeling tools based on open standards, announced the winners of the 2012-2013 Tooling Challenge during the September Plenary & Working Group Meeting in Cambridge, MA. The challenge was to produce a Unified Model- ing Language (UML) profile for HL7’s Model Interchange Format (MIF) static models using Sparx Systems’ Enterprise Architect that will enable commercial UML modeling tools to work with HL7 static models, which have features that extend the standard UML expressions. From Left to right: Antonio Villega (tooling challenge winner), HL7 CEO Dr. Charles Jaffe, Sparx Systems representative JD Baker, and Professor Antoni Olivé (tooling challenge winner). The 2012-2013 HL7 Tooling Chal- Photo courtesy of Kai Heitmann, MD. lenge winners are Antoni Olivé, professor of information systems • Assessment of the extensibility of the profile and its and Antonio Villegas, PhD student in computing, both agility with regard to changes in the methodology of the Universitat Politècnica de Catalunya Barcelona Tech in Barcelona, Spain. They were awarded the $4,000 HL7 CTO John Quinn stated, “The industry is in need of prize at HL7’s September Working Group Meeting in tooling solutions that will facilitate the implementation and Cambridge, MA. adoption of standards and this challenge has successfully spurred the development of such solutions. We hope that The Tooling Challenge, sponsored by Sparx Systems, re- future challenges will continue to address this need and quired submitters to meet the following qualifications: provide developers with the ability to use more off-the- • Create a UML profile using Enterprise Architect that shelf tools.” correctly describes MIF static models to the extent al- lowed by the UML language “Sparx Systems was pleased to sponsor the HL7 Tooling • Document parts of MIF static models that were not or Challenge, which has helped paved the way for future could not be expressed in UML Profile Language solutions and has set a best practice benchmark for HL7,” • Use the submitted UML profile to adapt Sparx Systems’ said Ken Harkin, Business Development Manager for Sparx Enterprise Architect to express a proper HL7 static Systems. “This kind of collaboration opens opportuni- model as a proof of concept ties for stakeholders within the global health sector and beyond. Sparx Systems looks forward to sponsoring future Criteria used to determine the winning submission awards and new solutions to the challenges faced by the included: HL7 community and the global UML community as well as • Assessment of the profile as a valid UML profile as the healthcare industry overall.” defined by the Object Management Group (OMG) • Assessment of the validity and degree with which the HL7 and Sparx Systems plan to announce the next tooling profile represents MIF static model constructs challenge in early 2014. The goal of the upcoming chal- • The ability to utilize the profile in Enterprise Architect lenge will be to define the requirements and approach to construct valid HL7 static models as defined in MIF for the development of a tooling project for HL7 for static • The thoroughness of the profile documentation and models and the support of HL7-specialized diagramming the ability for HL7 Version 3 newcomers to understand syntax, moving away from the Visio-based modeling. and apply it JANUARY 2014 7

HL7 NEWS jan 14 INTERIOR.indd 5 1/3/14 11:09:32 AM Bridging the Healthcare Safety Chasm: The 2013 Consolidated Terrence O’Malley, MD CDA Update By Terrence O’Malley, MD, Medical Director, Non-Acute Care Services, Partners HealthCare System, Inc.; Larry Garber, MD, Medical Director for Informatics, Reliant Medical Group; and Russell Leftwich, MD, Chair of HL7 Professional Engagement and Chief Medical Officer, Office of eHealth Initiatives

Patients are at highest risk for many transfers from any site to the Emer- of multiple transi- types of adverse events at the time of gency Department (ED). tions of care, the a transition of care from one site or complexity of clinical care team to another. Quality, After hospital discharge, an esti- their care plans Larry Garber, MD safety and efficiency of care suffer if mated 1.5 million preventable adverse and follow-up care the receiving team does not have all events occur annually in the US when also puts them of the information it needs, in a time- discharge treatment plans are not at risk for poorly ly fashion, in a convenient format, exchanged or followed (Forster, et al., coordinated and and through an efficient process. For 2003). In another study, important incomplete care patients that receive care at multiple information about the patient’s care even without fre- sites, the issues of poor transitions following a hospital discharge was quent transitions. are compounded by the absence of a missing 78% of the time (van Wal- Poor care coordi- common care plan in place across all raven, et al., 2002). Many of these nation increases sites, and the failure to communicate failures contribute to the high prevent- the chance that a Russell Leftwich, MD existing care plans to the receiving able Medicare readmission rate in the patient will suffer site. The 2013 update of the Con- US which costs $26B annually. from a medication solidated CDA (HL7 Implementation error or other health care mistake by 140% (Lu, et al., 2011). Commu- Guide for CDA® Release 2: Con- In one study (Patient Safety Institute, nication failures between providers solidated CDA Templates for Clinical 2003), 14% of unplanned hospital admissions originating in the ED contribute to nearly 70% of medical Notes (US Realm) Draft Standard for could have been avoided if the ED errors and adverse healthcare events Trial Use Release 2) based on the HL7 had outpatient information. For (Gandhi, et al., 2000). One study es- Care Plan Domain Analysis Model patients seen in the ED, important timated that 150,000 preventable ad- (DAM) and the HL7 Long-Term Post- or critical information was missing verse drug events (ADEs) occur at the Acute Care (LTPAC) Summary lays nearly one third of the time (Stiell, et time of admission due to inadequate the foundation for safer and more al., 2003). These omissions particu- knowledge of outpatient medication robust transitions of care and for the larly impact the care of the 14% of history (Gandhi et al., 2003), costing exchange of a longitudinal care plan. Medicare beneficiaries who have six $8 Billion in the US each year. This is or more chronic conditions. 70% of a population that requires both tight Incomplete information often leads them have one or more ED visits per transitions and overall coordination to delays or omissions of required year, 63% have one or more hospital of care. care, initiation of inappropriate care, admissions, and 41% go on to receive avoidable duplication of tests and care in LTPAC sites. They account for Prior to the 2013 Consolidated Clini- procedures, and failure to initi- 46% of all Medicare spending and cal Document Architecture (C-CDA) ate appropriate follow-up care. As 70% of all Medicare 30-day readmis- update, there were significant gaps examples, significant problems have sions (2012 Medicare Chart Book). that made it difficult to provide been identified with two high volume receiving clinicians at acute care and transitions of care: at discharge from Not only are these 14% of Medicare LTPAC sites with complete, standard- the hospital to any site of care, and beneficiaries exposed to the risks ized and interoperable clinical data

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HL7 NEWS jan 14 INTERIOR.indd 6 1/3/14 11:09:33 AM at the time of a transition of care. ing goals; barriers, nutrition assess- discharge summary availability The absence of templates and the ment and diet orders; more granular during post-discharge visits on means to adequately represent critical codification of all of the longitudinal hospital readmission. J Gen In- concepts such as goals of care, mile- care team members; representation tern Med, Volume 17, pp. 186-92. stones, barriers and risks, prevented of patient and provider priorities for 3. Patient Safety Institute, 2003 the exchange of a multi-disciplinary health concerns; interventions and 4. Stiell, et al., 2003 Stiell A, For- longitudinal care plan within and goals; a mechanism to demonstrate ster AJ, Stiell IG, van Walraven between provider teams. the “many-to-many” relationships C. Prevalence of information that exist among and between these gaps in the emergency depart- In 2013, with the Consolidated CDA new components; and the ability to ment and the effect on patient update, most of these gaps have been digitally sign a CDA document. outcomes. CMAJ. 2003 Nov eliminated and will provide new US 11;169(10):1023-8. HL7 standards for transitions of care Ballot reconciliation of over 1,000 5. 2012 Medicare Chart Book Cen- and care plans. The changes in the ballot comments is well underway ters for Medicare and Medicaid update are extensive. They include with the expectation of publication Services. Chronic Conditions the following: in early 2014. More work remains to among Medicare Beneficiaries, be done to further constrain vocabu- Chartbook, 2012 Edition. Balti- Three new document types: laries and value sets before seam- more, MD. 2012. • Referral Note (including referral less interoperability will be realized. 6. Lu, et al., 2011 Lu, C. Y. and E. to the ED) However, with the new standards Roughead. “Determinants of • Transfer Summary (for use in the 2013 update in place, the Patient-Reported Medication whenever there is a permanent foundation has been laid for the ef- Errors: A Comparison Among transfer of care-taking responsi- ficient exchange of essential clinical Seven Countries.” International bility from one site to another or information at the time of a transi- Journal of Clinical Practice from one care team to another.) tion of care to and from all acute, (April 6, 2011): 65: 733–740. doi: • Care Plan with Digital Signa- behavioral health and LTPAC sites, 10.1111/j.1742-1241.2011.02671. ture (including support for the as well the standards to exchange a x. http://onlinelibrary.wiley. Home Health Plan of Care, AKA longitudinal care plan. The Office of com/doi/10.1111/j.1742- CMS-485) the National Coordinator (ONC) has 1241.2011.02671.x/pdf. issued a call for sites to pilot these 7. Gandhi, et al., 2000 Gandhi, Te- Six new Section-Level templates: new standards. Information can be jal K., Sitting, Dean F., Franklin, • Physical Findings of Skin Section found at http://wiki.siframework. Michael, Sussman, Andrew J., • Mental Status Section org/LCC+Pilots+WG. Fairchild, David G., and David • Health Concerns Section W. Bates. “Communication • Health Status Evaluations/Out- Improved transitions of care and the Breakdown in the Outpatient Re- comes Section exchange of a longitudinal care plan ferral Process.” Society of Gener- • Nutrition Section as a result of the HL7 2013 Consoli- al Internal Medicine (September • Goals Section dated CDA Update create the bridge 2000): 226- 231. doi:10.1046/ across the quality and safety chasm. j.1525-1497.2000.91119.x. Thirty new Entry-Level templates, 8. Gandhi et al., 2003 Tejal K. including: Gandhi, M.D., M.P.H., Saul N. • Characteristics of Home References Weingart, M.D., Ph.D., Joshua Environment Borus, B.A., Andrew C. Seger, • Cultural and Religious 1. Forster, et al., 2003 Forster AJ, R.Ph., Josh Peterson, M.D., Observation Murff HJ, Peterson JF, Gandhi Elisabeth Burdick, M.S., Diane L. • Patient Priority Preference TK, Bates DW. The Incidence and Seger, R.Ph., Kirstin Shu, B.A., • Provider Priority Preference Severity of Adverse Events Affect- Frank Federico, R.Ph., Lucian ing Patients after Discharge from L. Leape, M.D., and David W. In collaboration with the HL7 Patient the Hospital. Annals of Internal Bates, M.D. “Adverse Drug Care Work Group’s Care Plan DAM, Medicine 138: 161-167. 2003. Events in Ambulatory Care.” new constructs exist for: health risks 2. van Walraven, et al., 2002 Van N Engl J Med 2003; 348:1556- and safety concerns; non-prescription Walraven, C., Seth, R., Austin, 1564April 17, 2003DOI: 10.1056/ interventions; patients’ overarch- P. & Laupacis, A., 2002. Effect of NEJMsa020703

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HL7 NEWS jan 14 INTERIOR.indd 7 1/3/14 11:09:34 AM PBS Metrics Update By the PBS Metrics Team composed of HL7 International Staff Members Dave Hamill, Director, Project Management Office; Lynn Laakso, TSC Project Manager; Don Lloyd, PhD, Director of Technical Dave Hamill Publications; and Karen Van Hentenryck, Associate Executive Director

Ballot Process Changes Stemming from the Project Initiation and Approval ANSI Audit Step 1 – Completion of a New Project As a result of the ANSI audit, there have been some modifi- Scope Statement (PSS) for Work Group cations to the procedures for managing ballot projects: Approval The HL7 Project Scope Statement • Consensus group sign up – Voters can now sign up for template is located at Resources > consensus groups from the time of ballot announcement Templates > Project Scope State- through the end of the day prior to ballot opening. Previ- ment and Project Approval Process ously, voters could join the consensus group up until the or http://www.HL7.org/permalink/ Lynn Laakso week before the ballot closed. ANSI now requires us to ?ProjectScopeStatement. close the sign up before the ballot opens so that we can adequately check for balance of interest. Step 2 – PSS Form Submission Submit the WG-approved PSS to your • Elimination of proxy voting – While ANSI does not WG’s steering division (SD) co-chairs prohibit proxy voting, it requires that we maintain a and the director of the HL7 Project Man- written statement from each voter which identifies the agement Office via email: person to whom they are assigning their proxy for a [email protected]. particular ballot. The Governance and Operations Com- mittee, along with staff, have tried to think of methods Step 3 – Submission Acknowledgement to enable proxy voting that can be applied uniformly The director of the PMO will assign Don Lloyd, PhD across all organizations and which does not introduce a new Project ID to the project, enter undue administrative burden for our members and the project into Project Insight (online staff. Until we find a process that meets these criteria, resource) and communicate project proxy voting is not an option for us. The best work- information to the director of technical around for proxy voting at this time is for work groups publications. to complete their ballot reconciliation as quickly after the ballot period as possible. Step 4 – Steering Division Approval of • Notification to TSC of taking an existing project to the PSS normative ballot – Some documents, even those that are The project facilitator attends the SD Con- balloted as draft standards for trial use (DSTUs), will ference Call which has the PSS review never go to normative ballot. This change allows us to on its agenda so as to answer any ques- Karen Van ballot those items without being penalized by ANSI for tions/concerns. The SD will review and Hentenryck not submitted the PINs form at the time the project was either approve the PSS, or return it to the started. Once a work group alerts us that a document is WG with direction or considerations. Upon SD approval, the going to be normative (until that time, the project is not TSC project manager will provide the TSC the SD-Approved considered one in which ANSI would have an interest), PSS we will file the appropriate paperwork with ANSI and the work group has an 18 month window to pass their Step 5 – Technical Steering Division Approval of PSS ballot. Once balloted, the Work Group has 12 months to The project facilitator attends the TSC conference call complete reconciliation and publish the standard. which has the PSS review on its agenda so as to answer any questions/concerns. The TSC will review and either Ballot Project Lifecycle approve the PSS, or return it to the SD and WG with direc- The following is extracted from a recently published docu- tion or considerations. ment which summarizes the lifecycle of ballot projects. It is intended to provide work group (WG) co-chairs with a Step 6 – Project Approvals high-level view of the major stages and waypoints involved The director of the PMO will update the SD and TSC approv- in balloting any document or standard with the goal of al dates appropriately in Project Insight as they occur. The publishing that document or standard. The full document is TSC project manager will announce the project’s approval in available at HL7.org > Resources > Tools and Resources> the weekly “Update from the TSC”. Project Management and Tracking Tools. 10 JANUARY 2014

HL7 NEWS jan 14 INTERIOR.indd 8 1/3/14 11:09:36 AM Ballot Initiation

Step 1 – Ballot Cycle Initiation Step 2 – Final Submission and/or Review of Ballot New PSS for the next ballot cycle submitted to PMO by dead- Materials line. Existing projects anticipating normative ballot submit A co-chair will indicate to the director of technical publica- scope update to TSC. The director of technical publications tions that the posted ballot materials are ready for ballot releases an email to the co-chairs list providing a calendar of opening. the upcoming ballot cycle and indicates that the Notifications of Intent to Ballot form is available. Step 3 – Announcement of Ballot Opening The director of technical publications will release the ballot Step 2 – Notification of Intent to Ballot (NIB) opening announcement indicating the formal beginning of A WG co-chair completes NIB form for each of the WG-ap- the ballot period. There will be no changes to ballot materi- proved ballot project items the WG expects to take to ballot als after this point unless the WG petitions the Publishing during the upcoming ballot cycle. Please note that several of WG for corrections to material and a patch release. the fields on this form are used in the completion of the bal- lot announcement, so a clear description of the ballot item Step 4 – Ballot Close and Release of Ballot Results (its intent and the expected contents, as well as any revisions At ballot close, the director of technical publications will from previous ballots) should be prepared beforehand. review the ballot results (ensuring, for instance, that quorum has been met) and package and release the ballot results to Step 3 – Preparation of Draft Formation of Ballot Pools the co-chairs. Announcement The director of technical publications will prepare a draft of Ballot Reconciliation the formation of ballot pools announcement using informa- tion provided in the NIB form and provide this to the co- Step 1 – Review of Ballot Comments chair list serve for review by the WGs. A WG co-chair will consolidate the ballot comments for each WG ballot item in preparations for reconciliation. Step 4 – Review of Formation of Ballot Pools Announcement Step 2 – Preparation of Reconciliation Spreadsheet At least one co-chair will review the ballot entries for that During reconciliation, the WG will use the amalgamated WG and reply back with any revisions or confirm that the comments spreadsheet to track WG decisions regarding the entries for that WG are correct. ballot comments. When completed, a WG co-chair will post this final reconciliation spreadsheet to the ballot summary Step 5 – TSC Approval of Ballot Items page on the Ballot Desktop. Many aspects of the ballot process, such as ballot level and item name, are subject to approval by the TSC. At some Step 3 – Notification to Negative Balloters point between the release of the formation of ballot pools Once the final reconciliation spreadsheet has been posted to announcement and the opening of the ballot the TSC will the ballot summary page on the Ballot Desktop, a WG co- approve those items and the names of the items permitted chair will send out the withdrawal request to negative voters to ballot. using the email functionality on the Ballot Desktop.

Step 6 – Formal Release of Ballot Announcement Step 4 – Achievement of Ballot Approval Level At least 30 days prior to the scheduled ballot opening, the Following the posting of the final ballot reconciliation director of technical publications will release the Formation spreadsheet and the notification to negative voters, it should of Ballot Pool Openings. After this time, any change in the become clear that the ballot has either achieved the neces- status of any ballot item should immediately be communi- sary approval level, or will fail to achieve this level. cated by the WG to the director of technical publications. Should the ballot achieve the necessary approval level, it is Ballot Process expected that the WG will move forward to publish the item. Normative publication must be completed within 12 months Step 1 – Preparation of Ballot Materials of the ballot to be eligible as an ANSI standard. If ten months The WG’s publishing facilitator will submit all ballot mate- has passed and the ballot has not published, the WG may rials requiring HQ preparation (i.e., Version 3 (V3)-related request an extension from the associate executive director materials) to the director of technical publications according ([email protected]). to the deadlines indicated in the V3 Ballot Countdown and review the posted materials for completeness and correct- If the ballot item is at the normative level and still has one or ness. For non-V3 submissions, the materials will be prepared more outstanding negatives, it is expected that the WG will according to the WG’s schedule and supplied to the director request a two-week recirculation ballot using the template of technical publications on the agreed upon date before the located at Resources > Templates > Recirculation Request ballot opening. Template, and pending a successful conclusion to this ballot, move forward to publish the item.

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HL7 NEWS jan 14 INTERIOR.indd 9 1/3/14 11:09:36 AM Member Spotlight on Mollie Ullman-Cullere

Mollie Ullman-Cullere has been a member of HL7 Institute of Technology for eight years creating geneti- since 2006. She is a co-chair of the HL7 Clinical Ge- cally engineered mouse models for human diseases, nomics Work Group and serves as one of their subject Mollie became interested in software databases and matter experts for genetics/genomics/fam- standard terminologies. Wanting to move out ily history in clinical and translational of research and closer to patient care, she medicine. In this role, she has co- joined the Partners Center for Person- authored several standards/imple- alized Genetic Medicine (also known mentation guides, including the as Harvard-Partners). As a senior HL7 Version 2.5.1 fully LOINC information architect supporting a qualified IG’s for reporting clinical genetic testing laboratory structured clinical genetic test for Partners Healthcare, Mol- results and interpretation, as lie needed to learn healthcare well as cytogenetic report- IT data standards and became ing; Version 3 implementation involved with HL7 and the guide for family history/pedi- extended community of health- gree; and the Version 3 CDA- care IT experts. In 2010, she based genetic test report. Mollie made the decision to move even also serves as an HL7 liaison to closer to clinical care, supporting outside organizations working on a hospital pathology laboratory, so clinical genetic/genomic standards, she transferred to the Dana-Farber/ including past senior advisor to the Brigham and Women’s Cancer Center HHS/ONC personalized healthcare work- to help in their efforts to enable the Center ing group, the Human Variome Project, the for Advance Molecular Diagnostics to develop College of American Pathologists Cancer Biomarker genome sequencing tests (and healthcare IT report- Reporting Committee, and the Federally mediated ing) for care of cancer patients. workgroup for the development of clinical-grade ge- nomic data file formats (GVF and VCF). Mollie has increasingly come to understand the im- portance of business innovation both within a large Mollie has worked in genetics her entire life. Raised academic medical center and HL7 and is currently en- on a farm on Maui, she experimented with subsis- rolled in an evening MBA program at Babson College. tence farming in the tropics. She earned an under- She is married to a scientist from Barcelona, Spain, graduate degree in animal science at the University who also works in genetics although at the molecular of Massachusetts at Amherst and masters in animal function level in cells and animal models. They have science with a minor developmental biology from two boys, now in college studying biomedical engi- Cornell University. After working at Massachusetts neering and engineering.

PBS Metrics Update continued from page 11

Should the ballot NOT achieve the necessary approval form located at Resources > Templates > Publication level, it is expected that the WG assess the content and its Request Template or http://www.HL7.org/permalink/ likeli-hood of passing a future ballot, and then either revise ?PublicationRequestTemplate, and submit it to the TSC and resubmit the item to a future ballot, or withdraw the project manager who will place it on the TSC agenda item from consideration by indicating the withdrawal of for approval. the project using the template located at Resources > Templates > Notice of Withdrawal of Proposed ANS Step 2 – TSC Approval of Publication Request Template to the director of the PMO. The TSC will review the publication request and either approve the request or return the request with direction or comments. Publishing Final Document Step 3 – Document Publication Step 1 – Submission of Publishing Request Form The director of technical publications will prepare the item A WG co-chair will complete the publication request for publishing, working with the co-chairs and/or publish- ing facilitator as needed to confirm the correct content and

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HL7 NEWS jan 14 INTERIOR.indd 10 1/3/14 11:09:38 AM Update from the Process Improvement Committee Karen Van Hentenryck By Karen Van Hentenryck, HL7 Associate Executive Director

The HL7 Process Improvement Com- improve our interactions with them. • Updating the ballot comment mittee (PIC) is the focal point within spreadsheet – PIC has added this HL7 to identify, collect, track, and New PIC Projects as a recurring three-year project. resolve issues pertaining to organi- PIC is working on several new pro- It has been several years since zational process improvement. The jects that have been suggested by the the ballot comment spreadsheet committee serves as an open venue membership, including: has been updated, so it is due for allowing HL7 members to voice ideas a review. You can submit your pertaining to improvement in orga- • Updating the Decision Making suggested updates to the spread- nizational process or policy, and is Practices (DMPs) – Specifically, sheet at: http://wiki.hl7.org/in- the steward for issues pertaining to we’ve had a request to stan- dex.php?title=PIC:BCSM. process improvement. Additionally, dardize the process that work the Process Improvement Commit- groups use to select the candi- PIC Project being Closed tee maintains primary responsibility date for whom they place their Occasionally, a PIC project that to duly consider issues raised in an vote for steering division chair. sounded like a great idea doesn’t open, public forum; to mature those This was initially suggested as receive traction by the membership. ideas into formal, actionable propos- an update to the Governance The wiki job match site falls into als; and to host and champion those and Operations Manual (GOM), this category. This site was originally proposals to the HL7 Technical Steer- but the Governance and Opera- created to match volunteers with ing Committee and/or the HL7 Board tions Committee, the commit- work groups needing assistance. Vol- of Directors, as appropriate. tee responsible for updated the unteers were able to create a profile GOM, referred the item to PIC. In of their skills and availability and Recurring Projects the past, the process was out- work groups were able to complete After each working group meeting lined in the announcements that a “job posting” to advertise their (WGM), PIC reviews the Post WGM are distributed to the co-chairs needs. Unfortunately, no volunteers Effectiveness Survey responses to when announcing the nomina- or work groups used the site in over- determine if there are any issues tions/election of steering division the 12 months it was open. Many preventing work groups from meet- co-chairs. PIC is in the process people indicated that use of the site ing their goals at the WGMs and if of moving that process to the was not easy or intuitive, so we will so, discuss how we might address DMPs. To that end, we’ve created no longer be promoting or working them, and to recognize any trends. a wiki site where other changes on that site. If HL7 members decide One of the trends PIC has noticed to the DMPs can be suggested. that they would still like some sort over time is that work groups spend Please use the following link to of job matching site, PIC will consid- less time at the WGMs engaged in submit your suggested changes er other ways to make this available ballot reconciliation and more time to the DMPs to the membership. providing updates on existing proj- http://wiki.hl7.org/index. ects and discussing new ones. Also, php?title=PIC:DMP Monthly Calls and WGM the number of joint meetings be- • Creating a check list for balloting Meeting tween two or more work groups has – Several co-chairs have ex- PIC invites all HL7 members who increased significantly since PIC has pressed a desire for a checklist of have ideas or a process they would started tracking the results of the Post tasks needed to take a document like to see improved to join PIC on WGM Effectiveness Survey. Another from project proposal through its monthly calls. Typically, we meet project that PIC routinely undertakes publication. Many new co-chairs, the last Monday of each month. is a review of comments/evaluations for example, don’t realize that a Refer to the HL7 Conference Calling from the first-time meeting attendees publication request form must be Center for specific dates and dial in to determine how we are meeting submitted in order for a docu- information. PIC also typically meets the needs and expectations of that ment that has successfully been during Q1 on Thursdays at the Work- audience. We’ve made several tweaks balloted to be published. PIC will ing Group Meeting (check the onsite to the first-time attendee program be bringing that checklist for- guide for meeting room). based on feedback we have received ward for peer review in the very and are always looking for ways to near future.

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HL7 NEWS jan 14 INTERIOR.indd 11 1/3/14 11:09:39 AM The Early History of HL7, Part1: University of California at San Francisco Level 7 Protocol

By Rene Spronk, Senior Consultant and Trainer, Ringholm; Co-Chair, HL7 Application Implementation Rene Spronk and Design Work Group

HL7 was founded in 1987; the HL7 protocol does, how- Project at UCSF ever, date back to the mid-1970s when its precursor was Efforts at the UCSF Medical Center—under the direction developed at University of California at San Francisco of Donald W. Simborg (CIO of UCSF), who worked with (UCSF) Medical Center and first implemented in produc- Steve Tolchin of Johns Hopkins University Applied Phys- tion in 1981. HL7 Version 1 (V1) and Version 2 (V2) are ics Laboratory (APL), led to the development of the first essentially refinements of the UCSF protocol. application-level data interchange protocol in healthcare in 1976. Introduction Mainframe based medical information systems were When Don arrived at UCSF in 1976, the hospital did its initially used in the early 1960s. In the 1970s as clini- billing systems on a mainframe computer owned by the cal support subsystems (minicomputers) evolved for University. Patient identification, ADT, and outpatient the clinical laboratory, radiology, and for other clinical registration were paper-based processes. There was services, most developed their own separate databases. a clinical laboratory minicomputer, but paper forms These created problems for hospitals which used main- were sent to the laboratory for entry of patient informa- frame technology for their financial and registration tion and clinical laboratory orders and results from the systems and, to a small extent, for order entry, results laboratory were printed on paper and sent to the various reporting, and some other clinical functions. The solu- clinical areas. There were no other computer systems for tion at that time was to connect a terminal from the clinical activities. nursing unit to each of the systems so that a user could use all of the systems by going from terminal device to Don Simborg, about the initial stages of the project terminal device. (1976-1979):

Around 1979, the International Standards Organization “In order to have a network up and running a lot (ISO) developed the Open Systems Interconnect (OSI) mod- of things had to happen. First, the basic decision to el and reference base for network systems that specified deviate from the ‘single-vendor’ mainframe-com- seven layers for the exchange of data between computers. puter-based model had to have been conceived and In 1976, TCP/IP was already established at the Department discussed widely within the administration as this of Defense, where work on the ARPANET (the precursor certainly represented a very risky approach. Then, the to the Internet) had begun in 1969. Microprocessors were concept of integration somehow had to be conceived, introduced around 1975. which led to the notion of using a LAN and a level 7 protocol— again a risky approach given the fact Data integration standards were in their infancy at the that no hospital was using a LAN this way. Then we time: a few high level protocols were used in the context of had to ensure the initial departments were on board the ARPANET, and ANSI X12 (used in finance and logis- with being the guinea pigs, find the vendors for those tics) was developed in 1979. The American College of Radi- systems, help develop the specifications for the ap- ology-National Electrical Manufacturers Association (ACR- plications, acquire the systems, and implement them NEMA) began its work on its standard for digital imaging in the departments.” and communications in medicine (DICOM) in 1983.

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HL7 NEWS jan 14 INTERIOR.indd 12 1/3/14 11:09:40 AM of patient admission-discharge-transfer information, orders from clinical areas, and the display of textual results to the clinical areas.

Don Simborg, on the creation of the Level 7 protocol:

“My team specified the Level 7 protocol, which con- sisted of a broadcast message for ADT/Registration synchronization, and various query-response mes- sages for order entry and results display (text results with the continuation protocol). The specifications included data level definitions and error control. This was the first Level 7 protocol ever used in healthcare to my knowledge. We continued to add computers to the UCSF network and refined the protocol over the years. Clinical uses of the network began during the second year of the project (1982).”

Mark Shafarman, who joined UCSF in 1980, describes the Level 7 protocol: “Throughout all of this we had to conceive of the messages that we wanted to have flowing to and from “They were text-oriented transmission, of something these systems, detail their content, trigger events, error that looked not too different from what would later control, etc. (i.e. the Level 7 protocol). After securing evolve into HL7. Essentially the computer would re- funding for the projects we had to negotiate with each ceive what we now call a text message, process it, and of the vendor’s agreements to implement the protocols. create a type of acknowledgement. The UCSF protocol Then we had to test them, modify them as needed, was a delimited format; the delimiters were different and re-test them. We had initial tests going as early as from those ultimately used by HL7 Version 2. “ 1979. The working network took testing, re-working, re-testing, and re-design. More importantly, the Level “The basic transactions look similar to those that can 7 protocol wasn’t somehow just delivered to UCSF by nowadays be found in HL7 V2, such as patient reg- APL or anyone else. We had to decide what we needed istration, acknowledgements, and report. From 1983 to accomplish in order to integrate these distributed onward, structured reports were sent to a newly de- functions in order for the hospital to function. That veloped patient record system. Problems, results and took some years of design and specification.” labs were the main reports, and from those we would assemble a patient record.” In 1981, four minicomputers were connected to the net- work to exchange transactions between the UCSF regis- In the initial year (1981), the network was used to tration systems, clinical laboratory, outpatient pharmacy synchronize key patient identification information and and radiology systems – all built by different manufac- registration information among the four systems. Two turers. The UCSF project consisted of two key parts: types of transactions were used: a query/response trans- action for demographic and registration information, and 1. A fiber-optic Local Area Communications Network a broadcast to the network of demographic and registra- (LACN) developed by APL. The project used micro- tion information. Network support for these transactions processor-based network-integrating units (NIU) to included error checking, flow control, time-outs, match- perform the conversions of communications codes ing of responses to queries, and other functions. Clinical needed to exchange data. uses of the network began during the second year of the 2. An OSI Level 7 protocol developed by Don Simborg project (1982/1983). and his team at UCSF. The computers exchanged several core messages, including the synchronization continued on page 17

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HL7 NEWS jan 14 INTERIOR.indd 13 1/3/14 11:09:41 AM Crossing Paradigms: Part I – The Information Dimension: Alean Kirnak A Practical Approach for Information Exchange across Paradigms

By Alean Kirnak, Software Partners LLC; Ken Lord, SemantX, Inc, Object Management Group; Stefano Lotti, Invitalia, HL7 Italy; and Zoran Milosevic, Deontik Pty Ltd, Australia Ken Lord

Summary: The HL7 Cross Paradigm Interoperability Im- The X-Paradigm project is scoped to plementation Guide for Immunizations (X-Paradigm) proj- produce an implementation guide ect, sponsored by the Service Oriented Architecture Work based upon HL7’s Services-Aware Group, has been employing a Services Aware Interoper- Interoperability Framework (SAIF). ability Framework (SAIF)-based approach to interoperabil- The project’s goal is to assist organi- ity in a complex environment of heterogeneous systems. zations in achieving interoperability As a product of its initial research, the X-Paradigm group in an environment comprising mul- has incorporated the OMG Model Driven Message Interop- tiple different data exchange para- Stefano Lotti erability (MDMI) standard as a means of cross-referencing digms – messages, documents and the data models of the multiple standards that are in play services. X-Paradigm will provide in the environment. The MDMI approach achieves this specific implementation guidance for by empowering domain experts to develop mappings that the scoped immunizations domain yield machine computable semantic assets. This contrasts and concrete methods for develop- with what today is largely a hand-coding process requir- ing cross paradigm guides for other ing a software development team and paper based specifi- domains beyond immunizations. cations. Resulting benefits include easier implementation, The first draft of the X Paradigm reduced complexity, long-term system sustainability, and document went to HL7 Ballot in enhanced standards compliance. September 2012. In addressing the Zoran Milosevic SAIF Information Dimension, data HL7 standards are produced for the real world, where elements of relevant standards were mapped. The initial interfaces conform to various HL7 versions and flavors, mapping cross referenced data elements in HL7 Version as well as non-HL7 standards and local and proprietary 2, HL7 Version 3 Continuity of Care Documents (CCD), models. The challenge facing many organizations is and Immunization Content as profiled by Integrating the that the real-world situation is complex, resulting from Healthcare Enterprise (IHE). To accomplish this, a brute investment in different products over time. Implementers force spreadsheet approach was used. face a myriad of standards which are themselves often incompatible across implementations and versions. We The spreadsheet approach became unwieldy and was should accept that the coexistence of different para- difficult to maintain even in our small example. Based digms is, and will be, a reality. A concrete and practical upon the comments received on the initial HL7 Ballot, standardization solution should address this fact. What the work group elected to test the OMG’s Model Driven is needed is a mechanism to normalize, manage and Message Interoperability (MDMI) standard to replace the automate the integration among the various standard spreadsheet approach. and non-standard paradigms.

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HL7 NEWS jan 14 INTERIOR.indd 14 1/3/14 11:09:42 AM The Use of MDMI the OMG that has produced such healthcare specifications The MDMI standard allows semantic mapping of the data as RLUS (Record Locate Update Service), CTS2 (Common elements of one HL7 standard to another version by means Terminology Service), and hData Record Format. of a Referent Index. The MDMI Referent Index leverages, and is compatible with, the RIM and HL7 vocabulary con- Next Steps cepts, and enables the separation of the semantics from Currently, the X-Paradigm information model is being syntax for each paradigm. updated to reflect developments in key targeted paradigms, specifically, the certification process for Meaningful Use The MDMI standard is a UML model that can generate Stage II immunization messages and the immunization computable artifacts and is extensible for any paradigm. For FHIR resource included in the September 2013 ballot cycle. example, a single HL7 Version 3 MDMI map can exchange The transformation of paradigms using MDMI is also being data with a HL7 Version 2 map, a Clinical Document Archi- further tested to a greater level of detail. Encouraged by tecture (CDA®) based map, or a Fast Healthcare Interoperabil- the application of MDMI to the information dimension, the ity Resources (FHIR®) map. Thus the X-Paradigm guide will X Paradigm group is investigating the application of other be able to support varied versions of immunization messages standards to address mapping at the behavioral dimension. and services. Moreover, the pattern is applicable to other domains as appropriate. Once successfully vetted and proven, Conclusion it is hoped that MDMI will offer guidance on at least one way So far, use of MDMI appears to both greatly improve the to apply the Information Dimension of SAIF to real-world mapping methodology (“Information Dimension”), and to deployments. provide more rigorous traceability among the SAIF per- spectives (Conceptual, Logical, and Implementable). The Another benefit of MDMI is that open source tooling has promise of MDMI is in translating the data elements of been built (See the Open Health Tools Model Driven Health one message, document or service to another; and it helps Tools/MDMI Project) to make it easy to develop MDMI maps. in connecting requirements, models, and implementable Demonstrations of this approach were presented in May 2013 standards in a rigorous way according to SAIF, ultimately at the Atlanta Working Group Meeting. producing machine-readable artifacts that can be used in an implementation as well. X-Paradigm also represents the fruit of collaboration between OMG and HL7. Such collaboration is not new; Further information, including the Project Scope State- the OMG Unified Modeling Language (UML) standard was ment, can be found at: http://hssp.wikispaces.com/Cross used to develop HL7 Version 3. The Healthcare Services +Paradigm+Interoperability+Implementation+Guide+ Specification Program (HSSP) is a joint effort of HL7 and for+Immunization.

The Early History of HL7 continued from page 15 Don Simborg, on his subsequent activities at Simborg commercial success there needed to be a non-proprietary Systems: standard for the Level 7 protocol. So in 1985, our board agreed to allow the StatLAN protocol to be somehow put “In 1984, I approached Ralph Ungermann, the CEO of in the public domain.” Ungermann-Bass to see if they would sponsor further research at UCSF. At the time, Ungermann-Bass was one That decision led to the initial HL7 meeting in March 1987, of the most prominent commercial network companies and to the creation of HL7 on March 29-31, 1987. based in Silicon Valley. Instead of funding research at UCSF, Ralph convinced me to start a company to try This is the first part of a series of articles about the early to commercialize what we had done at UCSF and he history of HL7. This article is an abridged version of a helped fund the company. This was the start of Simborg creative commons article available at http://bit.ly/1e7KScz Systems, which marketed StatLAN, a network-based hos- – you are referred to the full article for references. Please let pital information system. The StatLAN protocol was very us know should you have additional information about the similar to the UCSF protocol. We were a struggling start- UCSF/StatLAN protocols. up company and it became clear that in order to have

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HL7 NEWS jan 14 INTERIOR.indd 15 1/3/14 11:09:43 AM News from the PMO

and Project Services Work Group Dave Hamill By Dave Hamill, Director, HL7 Project Management Office; Rick Haddorff and Freida Hall, Co-Chairs Project Services Work Group

The Long and Winding Road of Updated Project Scope Project Management at HL7 Statement Template for 2013 At the May Working Group Meeting in Atlanta, Project The HL7 Project Management Office Services was delighted to report that Project Number and the Project Services Work Group 1,000 was created within Project Insight. While not the released the 2014 version of the Proj- Rick Haddorf most momentous milestone in HL7 lore, it does indicate ect Scope Statement (PSS) template; tremendous progress of project management within HL7. a result of their annual updates to the template. As usual, our goal is to HL7 first utilized Project Insight in September 2006. streamline and simplify the template After a year working with the various transition teams, so that it’s easier to use by HL7 mem- the PMO began using it in earnest when the revised bers and provides the most useful Technical Steering Committee (TSC) was put in place data to the membership. in January 2008. For the past six years, HL7 has refined its project submission and review processes in order to Changes include: Freida Hall raise awareness and communication of the project work • Align PSS project risk with the being done at HL7, avoid duplication of work, and track TSC’s risk approach history and progress of HL7 projects. • Indicate that any PSS planning to go to ballot in the same cycle must have a publishing facilitator identi- Our work going forward will focus on feedback gathered fied from this past year’s survey, which asked the member- • Add a field to document a standard’s ‘common name’ ship to evaluate project management practices at HL7. • Add a ‘lineage’ field which allows explanation that if The PMO has increased its presence during the steering the project is a Release 2 or higher, is it supplanting, division review process to ensure that work groups have replacing, or coexisting with a previous release the bandwidth to take on new projects and to catch any • Add a field indicating that the TSC has received projects that may have slipped past the PMO’s desk. The a Copyright/Distribution Agreement and that it’s survey responses indicated a desire for more and bet- signed by both parties or that the TSC has been pro- ter communication and education of HL7 project man- vided the verbiage that is outlined in the SOU agement processes and tools. Therefore, in the future, • Add a field to document external schedules that expect to see multiple ‘mini webinars’ focusing on HL7 drive the project but are not readily known outside Project Management tools, tips, tricks and processes. of the project team • Add a field for co-sponsor approval date The PMO and Project Services co-chairs would like • Add a field to address project that contain content to thank all the HL7 members in helping make proj- which is already partially developed; these projects ect management at HL7 a success. Here’s to the next should be reviewed by the ArB 1,000 projects.

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HL7 NEWS jan 14 INTERIOR.indd 16 1/3/14 11:09:44 AM The 2013 W. Ed Hammond Volunteer of the Year Awards

HL7 honored two members with the 17th annual W. The 2013 recipients include: Edward Hammond, PhD Volunteer of the Year Award. • Ken Rubin, Healthcare Architect, EDS Civilian Established in 1997, the award is named after Dr. Ed Ham- Government & DoD Healthcare Portfolio, Hewlett- mond, one of HL7’s most active volunteers and a founding Packard Enterprise Services member as well as past Board chair. The award recognizes • Andy Stechishin, Chief Consultant, CANA Software & individuals who have made significant contributions to Services Ltd. HL7’s success.

About the Recipients

Ken Rubin has been a member of HL7 since 1994 and forum advocate for HL7 work groups. He is also a profes- has worked diligently over the years to promote and sup- sional photographer and has donated the photos he has port standards adoption. He has served as a co-chair of the taken at HL7 meetings free of charge. Services Oriented Architecture (SOA) Work Group since its inception and was instrumental in introducing service ori- Andy Stechishin has been a member of HL7 since ented thinking and processes to HL7. In addition, he facili- 2008 and is very active in standards development. He cur- tated the formation of the Healthcare Services Specification rently serves in several leadership roles, including as the Project (HSSP), a co-chair for four HL7 standards devel- work groups: Pub- opment effort lishing (since 2009), to create health Tooling (since 2009), industry SOA Implementable Tech- standards jointly nology Specification sponsored by both (since 2010) and Ap- HL7 and the Object plication Implemen- Management tation and Design Group (OMG). (AID), formerly He continues to known as RIMBAA provide mentor- (since 2012). In ad- ing and leadership dition, Andy serves on services across as a co-chair of a number of HL7 the Technical and work groups. Ken Support Services also served as one Steering Division of of the inaugural the Technical Steer- chairs of the HL7 ing Committee, the Process Improve- group responsible ment Committee for overseeing the (PIC) and helped execution of stan- establish PIC as a dards development trusted and open within HL7.

Photos courtesy of Kai Heitmann, MD

JANUARY 2014 19

HL7 NEWS jan 14 INTERIOR.indd 17 1/3/14 11:09:46 AM Congratulations ttttttttttttttttttttt To the following people who passed the HL7 Certification Exams

Certified HL7 Bhavna Ramani Sreejesh Niduvali Maxim Abramsky Version 2.x Chapter Kandavel Sethumadhavan Minakshee Pandey Lauretta Carroll Spardha Smriti 2 Control Specialist September 21, 2013 Anuradha Swamy Computer Based Testing Mohd. Ismail Ansari Peter Jordan July 11, 2013 Raviteja Annadanam HL7 Taiwan Mark Shortt Ken K. Chen Suchitra K Bagalkoti Jeff Greenland Divyen Bari August 10, 2013 HL7 India Saraswathi T. Gowda Ritesh Vijay Bhatkar Hsu Chih-Wei Kevin Hill Mrunmayee Chogale Shih-Hao Ku September 21, 2013 Anand Raghavan Ketaki Chopde Sei-Peng-Corey Tu Jyoti Hemraj Moryani Scott C. Snow Anwesha Das Arpa Mukhopadhyay Cheryl L. Sullivan Chapel D’cunha October 24, 2013 Vidya Nadar Sara L. Stewart Neha H.Gogte Ming Chung Pooja Nair Shabbir Suterwala Jithin Jain Hung-Wen Lin Mr. Harshad D. Patil Prashant Deepak Kadam Vance Yiu Cheong Lau Pratyush Sharma September 26, 2013 Madhavi B. Karekar Anupriya Laxman Lori Dieterle Dipika Kewalramani Shiwarkar Anne Hegarty Shilpa Kharatmol Certified HL7 CDA Viral Solani Rajeev Krishnapillai Rohini Khopar Specialist Parikshit Krishna HL7 Spain November 7, 2013 Vikesh Kundar July 1, 2013 Jazmin Estrada Smita Mani Dwight D. Blubaugh July 26, 2013 Hari Joshi Pranali Matal Junqiao Chen David Corrales Sánchez Sukriti Nandy Mazumdar Maria T. Esquela November 8, 2013 Neha Navale Jeffery L. Garner James H. Crout Harshal Nawale Michelle L. Hinterberg Certified HL7 Rodney E. Jenkins Prashant Nayak Amir Hosinipur Jennifer B. Lovvorn-Harris Arundhati Pawaskar Anna L. Langhans Version 3 RIM Yahna D. Perry Pratik Rane Tiffany M. Livengood Specialist Angela E. Wheatley Ritika Rawlani Meredith E. Maddux Bhooshan Anand Sapre Kishore Metla July 11, 2013 Computer Based Testing Rahul Sharma Brenda Wood Baskar Ramamoorthy Amardeep D Singh September 26, 2013 Bhargava Reddy Kunal K Wadhwa Jennifer Bessette September 26, 2013 Venkata Krishna C Derek Bush Jeff Brown Yarlagadda October 5, 2013 Lauretta Carroll Naga venkata s pudi Shabina Abdul Kareem Phil Cartagena Thuppahi S De Silva Kavya Ambigapathy Ken Chen Computer Based Testing Mamatha Atte Lars-Gunnar Hartveit Preetha Balachandran HL7 Canada Shivakumar Deetur Erin Holt Dr. Rekha Dhonde Matthew Johnson HL7 India July 9, 2013 Ramandeep Garg Thomas Ricciardi Milagros Lopez Bincy George Beatriz Rocha September 21, 2013 Mahaboob Khan J Priyaranjan Tokachichu HL7 India Shantha Kumar K N Ajay Nanubhai Parsana Prashant Kulkarni November 7, 2013 Madhusudana Putta June 22, 2013 Anuradha Swamy Rebecca Angeles Shardul M. Rane Vinayak Hegde Shinu Kurian Chakri V Abburi Disha K. Vasant Priya Mohan Bharan Muppala Patrick Huber

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20 JANUARY 2014

HL7 NEWS jan 14 INTERIOR.indd 18 1/3/14 11:09:47 AM Upcoming INTERNATIONAL EVENTS

HIMSS14 For more information, please visit eHealth 2014 (Canada) Orlando, FL http://www.cdisc.org/interchange Vancouver, BC, Canada February 23–27, 2014 June 1–4, 2014 For more information, please visit European Federation For more information, please visit http://www.himssconference.org for Medical Informatics http://www.e-healthconference.com/ Special Topics Conference HealthINF 2014 – 7th (EFMI STC 2014) International Conference Budapest, Hungary 12th International on Health Informatics April 26–29, 2014 Congress on Nursing Eseo, Angers, Loire Valley, France For more information, please visit Informatics (NI2014) March 3–6, 2014 http://www.stc2014.org/ Taipei, Taiwan For more information, please visit June 21–25, 2014 http://www.healthinf.biostec.org/ HL7 May Working Group Meeting For more information, please visit http://www.e-healthconference.com/ eHealth Week 2014 Phoenix, AZ Nice, France May 4–9, 2014 April 3–4, 2014 For more information, please visit http://www.HL7.org/events/work- MIE 2014 For more information, please visit Istanbul, Turkey groupmeetings.cfm http://worldofhealthit.org/2014/ August 31–September 3, 2014 eHealth 2014 (Austria) For more information, please visit CDISC Europe Interchange http://www.mie2014.org/ 2014 Vienna, Austria Paris, France May 22–23, 2014 April 7–11, 2014 For more information, please visit http://www.ehealth2014.at

SAVE THE DATE FOR HIMSS 2014 February 23 – 27, 2014 Orlando, FL Join us in the HL7 Booth (#1265) at the HIMSS 2014 Exhibit

HL7 will once again offer a variety of education sessions covering HL7 standards and current industry topics such as Meaningful Use. Visit our booth to learn more about how HL7 and HL7 standards contribute to meaningful use and are HL7 CEO Dr. Charles Jaffe presents helping change the face of healthcare IT. at the HL7 HIMSS exhibit.

www.himssconference.org JANUARY 2014 21

HL7 NEWS jan 14 INTERIOR.indd 19 1/3/14 11:09:49 AM HL7 Benefactors as of November 26, 2013

Centers for Disease Control and Prevention

Office of the National Coordinator for Health IT

HL7 Welcomes New Staff Member Pete Swanson, Web Developer

Pete joined the HL7 staff in October 2013 as the web developer. He has a var- ied background in web development, with a skill set that includes ColdFusion, SQL Server, and front end tools such as HTML, CSS, and Adobe Photoshop. He looks forward to using his design and functionality skills towards the enhancement and maintenance of the HL7 website.

Pete currently lives in Gilroy, CA. In his spare time, he enjoys sports, particularly running, hiking, and soccer.

22 JANUARY 2014

HL7 NEWS jan 14 INTERIOR.indd 20 1/3/14 11:09:56 AM HL7 ORGANIZATIONAL MEMBERS Benefactors CDA PRO American Immunization Registry Association NAACCR Accenture CentriHealth (AIRA) National Association of Dental Plans Allscripts Clinical Intelligence Consulting, Inc American Medical Association National Cancer Institute Booz Allen Hamilton Dapasoft Inc. American Psychiatric Association National Center for Health Statistics/CDC Centers for Disease Control and Prevention/ Dent Technical Consulting Services American Society of Clinical Oncology National Centre for Health Information CDC Eastern Informatics, Inc. Arizona Department of Health Services Systems Duke Translational Medicine Institute Edifecs, Inc. Arkansas Department of Health National Council for Prescription Drug Epic Edmond Scientific Company Blue Cross Blue Shield Association Programs Food and Drug Administration EnableCare LLC CA Department of Public Health National eHealth Transition Authority GE Healthcare ESAC Inc Cabinet for Health and Family Services (NEHTA) GlaxoSmithKline FEI.com California Correctional Health Services National Institute of Standards and IBM Frank McKinney Group LLC California Department of Health Care Technology Gartner Intel Corporation, Digital Health Group Services National Library of Medicine General Dynamics Information Technology InterSystems California HealthCare Foundation National Marrow Donor Program Genoa Healthcare Clinical Laboratory Kaiser Permanente CalOptima NCQA Goodmark Medical (International) Ltd McKesson Provider Technologies CDISC New Mexico Department of Health Haas Consulting Microsoft Corporation Centers for Disease Control and Prevention/ New York State Department of Health Health Konnekt NICTIZ Nat.ICT.Inst.Healthc.Netherlands CDC NICTIZ Nat.ICT.Inst.Healthc.Netherlands Healthcare Data Assets Office of the National Coordinator for Centers for Medicare & Medicaid Services NIH/CC Healthcare Integration Technologies City of Houston NIH/Department of Clinical Research Health IT Healthcentric Advisors College of American Pathologists Informatics Oracle Corporation - Healthcare HLN Consulting, LLC College of Healthcare Information Mgmt. North Carolina Health Information Exchange Partners HealthCare System, Inc. Hubbert Systems Consulting Executives OA-ITSD - Department of Mental Health Philips Healthcare iEHR.eu Colorado Regional Health Information Office of the National Coordinator for Quest Diagnostics, Incorporated Just Associates, Inc. Organization Health IT Siemens Healthcare Lantana Consulting Group Columbia University OFMQ U.S. Department of Defense, Military Health Logimethods Community Mental Health Center of Oklahoma State Department of Health System LOTS, LLC U.S. Department of Veterans Affairs M*Modal, Inc. Crawford County Oregon Public Health Division Matricis Informatique Inc. Comprehensive Medical and Dental Program Pharmaceuticals & Medical Devices Agency Gold MCNA Dental Connecticut Department of Public Health Phast 7 Delta, Inc. Michael Keevican, LLC Contra Costa County Health Services Primary Care Information Project, NYC Dept AEGIS.net, Inc. newMentor Council of Cooperative Health Insurance Health American Health Information Management Ockham Information Services LLC Danish National eHealth Authority Radiological Society of North America Association OMKT LLC Delaware Division of Public Health Ramsey County Public Health Asseco Poland S.A. OTech, Inc. Delta Dental Plans Association Region Sjaelland Beeler Consulting LLC Professional Laboratory Management, Inc. Department of Developmental Services Region Syddanmark Corepoint Health RedGranite, LLC Department of Health RTI International Credible Wireless Riki Merrick DGS, Commonwealth of Virginia SAMHSA Daintel River Rock Associates Duke Translational Medicine Institute SC Dept. of Health & Environmental Control Etnomedijos intercentras Rob Savage Consulting ECRI Institute HS Fresenius Vial Shafarman Consulting Electronic Transactions Development Agency Social Security Administration Gamma-Dynacare Medical Laboratories SLI Global Solutions Emory University, Research and Health Software and Technology Vendors healthbridge Stat! Tech-Time, Inc. Sciences IT Association (SATVA Holston Medical Group The Audigy Group, LLC European Medicines Agency Technological University of Panama, CIDITIC Info World The SIMI Group, Inc. Food and Drug Administration Telligen Inofile Travers Consulting Georgia Medical Care Foundation Tennessee Department of Health iNTERFACEWARE, Inc. United Laboratory Network IPA, LLC Health Sciences South Carolina Texas Department of State Health Services Liaison Technologies Inc., Virginia Riehl HIMSS Texas Health Services Authority Michiana Computer and Technology Westat ICCBBA, Inc. The Joint Commission Notable Solutions IFPMA (as trustee for ICH) The MITRE Corporation Pitney Bowes Software General Interest Indian Health Service The National Council for BehavioralHealth Rochester RHIO ASIP SANTE Indiana Health Information Exchange UC Davis School of Medicine Shimadzu Scientific Instruments, Inc. Academy of Nutrition & Dietetics International Training & Education Center University HealthSystem Consortium Sparx Systems ACLA for Health University of AL at Birmingham Standing Stone, Inc. Advanced Medical Technology Association Iowa Department of Public Health University of Kansas Medical Center Varian Medical Systems (AdvaMed) Japan Pharmaceutical Manufacturers University of Minnesota WellPoint, Inc. Agency for Healthcare Research and Quality Association University of Szeged, Institute of Informatics Alabama Department of Public Health L.A. County Dept of Public Health University of Texas Medical Branch at Consultants American Assoc. of Veterinary Lab Louisiana Public Health Institute Galveston Accenture Diagnosticians Michigan Health Connect University of Utah Pediatric Critical Care/ AHIS - St. John Providence Health American College of Physicians Michigan Health Information Network IICRC Blackbird Solutions, Inc. American College of Radiology Ministry of Health - Slovenia UT Austin Health Information Technology Booz Allen Hamilton American Dental Association Minnesota Department of Health Program Canon Information & Imaging Solutions, American Health Information Management Missouri Department of Health & Senior Utah Health Information Network Inc. Association Services Virginia Department of Health JANUARY 2014 23

HL7 NEWS jan 14 INTERIOR.indd 21 1/3/14 11:09:57 AM HL7 ORGANIZATIONAL MEMBERS, continued

Virginia Information Technologies Agency Enloe Medical Center UT M.D. Anderson Cancer Center Clinical Software Solutions Washington State Department of Health Geisinger Health System Vanguard Health Systems Clinicomp, Intl Wisconsin State Laboratory of Hygiene Hendricks Regional Health VUMC ClinicTree WNY HEALTHeLINK Heritage Provider Network West Virginia University Hospitals CMG Technologies Sdn Bhd WorldVistA Hill Physicians Medical Group Winchester Hospital CNIPS, LLC HSE - Health Service Executive CNSI Payers Huron Valley Physicians Association Vendors Cognitive Medical Systems Blue Cross and Blue Shield of Alabama Institut Jules Bordet 1MEDiX Cognosante, LLC Blue Cross Blue Shield of Arizona Intermountain Healthcare 3M Health Information Systems ColdLight Solutions, LLC Blue Cross Blue Shield of South Carolina Interpath Laboratory 7 Delta, Inc. ComChart Medical Software CareMore Medical Enterprises Johns Hopkins Hospital ABELSoft Inc. Community Computer Service, Inc. CIGNA Kaiser Permanente Accent on Integration Compania de Informatica Aplicata Community Health Group Kernodle Clinic, Inc. Accountable Care Associates Computrition, Inc. Florida Blue Laboratory Corporation of America Acumen Physician Solutions Conducive Consulting, inc. Health Care Service Corporation Loyola University Health System ADP AdvancedMD, Inc. Corepoint Health Healthspring Lucile Packard Children’s Hospital ADS Technologies, Inc. Credible Wireless Meridian Health Plan Mayo Clinic AEGIS.net, Inc. CSC Healthcare MetLife, Inc. McFarland Clinic PC Agilex Technologies Curaspan Healthgroup, Inc. National Government Services Medicover Alert Life Sciences Computing, Inc. Cyberpulse L.L.C. Neighborhood Health Plan Meridian Health AllMeds Inc Cyrus-XP LLC Premera Blue Cross Milton S. Hershey Medical Center Allscripts Daintel UnitedHealth Group MinuteClinic AlphaCM, Inc Dansk Medicinsk Datacenter ApS Valence Health New York-Presbyterian Hospital Altos Solutions, Inc Darena Solutions LLC Wisconsin Physicians Service Ins. Corp. North Carolina Baptist Hospitals, Inc. Altova GmbH Data Direct NYC Health and Hospital Corporation American Data Data Innovations, LLC Pharmacy Partners HealthCare System, Inc. American Data Network Data Strategies, Inc. Bristol-Myers Squibb Pathologists’ Regional Laboratory Amtelco Datuit, LLC GlaxoSmithKline Pathology Associates Medical Apelon, Inc. Daverci, LLC Merck & Co. Inc. Laboratories Aprima Medical Software Dawning Technologies, Inc. Sanofi-Aventis R&D Patient First Argility Healthcare Deer Creek Pharmacy Services Pocono Medical Center Asseco Poland S.A. Dell-Boomi Providers Quest Diagnostics, Incorporated AT&T mHealth Delta Health Technologies, LLC Advanced Biological Laboratories (ABL) Rady Children’s Hospital athenahealth DiagnosisOne, Inc. SA Regenstrief Institute, Inc. Atirix Medical Systems DoctorsPartner LLC COMPUGROUP MEDICAL POSLKA SP.Z Region Midt, It-udvikling, arkitektur og Austco Document Storage Systems, Inc. O.O. design Availity, LLC DocuTrac, Inc. Akron General Medical Center Regional Medical Laboratory, Inc Aversan Inc Dolbey & Company Alaska Native Tribal Health Consortium Rheumatology and Dermatology Beckman Coulter, Inc. EBM Technologies Inc. Albany Medical Center Associates PC Beeler Consulting LLC eCareSoft Inc. Albany Medical Center Hospital Rockingham Memorial Hospital Biocartis NV echoBase ARUP Laboratories, Inc. SA Tartu University Clinics Biswas Information Technology Solutions eClinicalWorks Ascension Health Information Services Saudi Aramco - Healthcare Applications Inc. eHealth Data Solutions, LLC Athens Regional Health Services, Inc. Division Bizmatics, Inc. eHealthCare Systems, Inc. Avalon Health Care Scottsdale Health Bostech Corporation EHRCare LLC Barnabas Health Seneca Family of Agencies CAL2CAL Corporation Electronic Medical Exchange Holdings Blessing Hospital Sharp HealthCare Information Systems Cal-Med LLC Blount Memorial Hospital Sound Physicians CANON INDIA PVT LTD ELEKTA Boston Children’s Hospital South Bend Medical Foundation, Inc. Care Data Systems EMD Wizard Inc Butler Healthcare Providers Spectrum Health Care Everywhere, LLC Emdeon, LLC Carilion Services, Inc. St. Joseph Health CareCam Innovations emedpractice Cedars-Sinai Medical Center St. Joseph’s Hospital Health Center CareCloud Emerging Systems Center for Life Management Summa Health System Carestream Health, Inc. EmpowerSystems CHI Texas Health Resources CareTech Solutions, Inc. Epic Childrens Mercy Hospitals and Clinics The Children’s Hospital of Philadelphia Casmaco Ltd. ESO Solutions Children’s of Alabama Theranos, Inc. CCITI NY eSpoc Cincinnati Children’s Hospital Tuomey Healthcare System Cedaron Medical, Inc. ESRI City of Hope National Medical Center U.S. Department of Defense, Military Center for Clinical Innovation Etnomedijos intercentras Cleveland Clinic Health System Health System Center of Informational Technology Evolvent Technologies Corporacion IPS Universitaria de caldas U.S. Department of Veterans Affairs DAMU Explorys Cottage Health System UK HealthCare Certify Data Systems EyeMD EMR Healthcare Systems, Inc. Deaconess Health System University of Louisville Physicians ChartWise Medical Systems, Inc. ezEMRx DESC University of Nebraska Medical Center ChoiceOne EHR Inc. e-Zest Solutions Ltd. Diagnostic Laboratory Services University of Pittsburgh Medical Center ClaimTrak Systems, Inc Foothold Technology Dignity Health University of Utah Health Care Clear EMR Forte Holdings Emory Healthcare University Physicians, Inc. Clinical Architecture LLC Fortelinea Software Systems, LLC. 24 JANUARY 2014

HL7 NEWS jan 14 INTERIOR.indd 22 1/3/14 11:09:57 AM HL7 ORGANIZATIONAL MEMBERS, continued

Fresenius Vial Isoprime Corporation NaviNet Softek Solutions, Inc. Futures Group J&H Inc. NeoSoft LLC Software AG USA, Inc. Gamma-Dynacare Medical Laboratories J4Care GmbH New England Survey Systems Inc Software Partners LLC GEMMS Jaime Torres C y Cia S.A. NexJ Systems Inc SonoSite, Inc Geriatric Practice Management KAMSOFT S.A. NextGen Healthcare Information Systems, SOUTHERN LIFE SYSTEMS, INC Get Real Health Kanick And Company Inc. Southwestern Provider Services, Inc Global Health Products, Inc Keane, Inc. Notable Solutions Sparx Systems GlobalSubmit Keiser Computers Inc. NxTec Corporation Sphere3 Haemonetics Corporation Kestral Computing Pty Ltd OA Systems, Inc. SRSsoft, Inc. Harris Corporation Knowtion Omnicell, Inc. Standing Stone, Inc. HD Clinical Lab Warehouse, Inc. OMNICOM srl StatRad, LLC Health Care Software, Inc. Last Bajt Onco, Inc. STI Computer Services, Inc. Health Companion, Inc. Lavender & Wyatt Systems, Inc. Optima Healthcare Solutions Stockell Healthcare Systems, Inc. Health Intersections Pty Ltd Liaison Technologies Inc., Optimus EMR, Inc. Strategic Solutions Group, LLC Health Services Advisory Group LINK Medical Computing, Inc. OptiScan Biomedical Corporation SuccessEHS Healthbox Liquent, Inc. OptumInsight Summit Healthcare Services, Inc. HealthBridge Logibec Oracle Corporation - Healthcare Summit Imaging, Inc. healthbridge Logical Images Inc. Oral Health Solutions Sunquest Information Systems Healthcare Management Systems, Inc. LORENZ Life Sciences Group Orchard Software Surescripts HEALTHeSTATE M.S. Group Software, LLC Orion Health Surgical Information Systems Healthland M2comsys OZ Systems Swearingen Software, Inc. HealthTrio, LLC ManagementPlus P&NP Computer Services, Inc. Syncordant HealthUnity Corp Marin Health Network Patient Resource Systematic Group Healthwise, Inc. Marshfield Clinic PCE Systems T System Inc heartbase, inc. McKesson Provider Technologies Pervasive Health, Inc. The CBORD Group Inc. Hewlett-Packard Enterprises Services MDLand Philips Healthcare The Echo Group Hi3Solutions MDP Systems, LLC PHmHealth The SSI Group, Inc. Hill Associates MDT Technical Services, Inc. Physicians Medical Group of Santa Cruz Therap Services, LLC Hi-Tech Software, Inc. Med Informatix, Inc County Tiatros Inc. Holston Medical Group MedConnect, Inc. PilotFish Technology TIBCO Software Inc. HospiServe Healthcare Services Pty) Ltd. MedEvolve, Inc. Pitney Bowes Software Tietronix Software Inc. Hyland Software, Inc. Medflow, Inc. PointCross Life Sciences Timeless Medical Systems Inc. i2i Systems MEDfx Corporation Politechnika Poznanska UBM Medica Iatric Systems Medical Informatics Engineering Polyglot Systems, Inc. Unibased Systems Architecture, Inc. IBM Medical Messenger Holdings LLC Practice Fusion Uniform Data System for Medical ICE Health Systems Inc. Medical Systems Co. Ltd - medisys PresiNET Healthcare Rehabilitation ICLOPS Medical Web Technologies, LLC QS/1 Data Systems, Inc. Unlimited Systems Ignis Systems Corporation Medicalistics, LLC QuadraMed Corporation Valant Medical Solutions Inc. iMDsoft MedicBright Technologies Qvera Valley Hope Association - IMCSS iMedics Inc Medicity, Inc. RazorInsights Varian Medical Systems InDxLogic Medicomp Systems, Inc. RCx Rules Versaworks, Inc. Info World MediPortal LLC Real Seven, LLC VIP Medicine, LLC Infor MediServe Information Systems, Inc. Recondo Technology, Inc. Virtify Information Builders MEDITECH, Inc Reed Technology and Information Services Visbion Ltd Information Management Associates Mediture Inc. Walgreens Innovative Workflow Technologies Medlinesoft Remote Harbor, Inc WebMD Health Services Inofile MedMagic Roche Diagnostics International Ltd. WellPoint, Inc. Inovalon Medocity Rochester RHIO Wells Applied Systems Insight Software, LLC Medsphere Systems Corporation Rosch Visionary Systems Wellsoft Corporation Integrated Practice Solutions MEDTRON Software Intelligence RTZ Associates, Inc Wolters Kluwer Health Integrity Digital Soultions, LLC Corporation Rural Wisconsin Health Cooperative WorkAround Software, Inc. Intel Corporation, Digital Health Group Medtronic Sabiamed Corporation Xerox State Healthcare, LLC Intellica Corporation MedUnison LLC SAIC - Science Applications International XIFIN, Inc. Intelligent Health Systems MedVirginia Corp XSUNT Corporation Intelligent Medical Objects (IMO) Megics Corporation Sandlot Solutions, Inc. Zoho Corp. INTELLIGENT RECORDS SYSTEMS & MGRID Sargas Pharmaceutical Adherence & ZOLL SERVICES Michiana Computer and Technology Compliance Int’l Zynx Health Interactivation Health Networks, LLC Micro-Med, Inc Seeburger AG Interbit Data, Inc. Microsoft Corporation Shimadzu Scientific Instruments, Inc. Interface People, LP MioSoft Corporation Siemens Healthcare iNTERFACEWARE, Inc. Mirth Corporation Simavita Pty Ltd Interfix, LLC ModuleMD LLC Skylight Healthcare Systems, Inc. InterSystems MPN Software Systems, Inc. SMART Management, Inc. iPatientCare, Inc. MuleSoft SNAPS, Inc. iSALUS Healthcare MZI HealthCare SOAPware, Inc. JANUARY 2014 25

HL7 NEWS jan 14 INTERIOR.indd 23 1/3/14 11:09:58 AM 2014 TECHNICAL STEERING COMMITTEE MEMBERS

CHAIR Jean Duteau STRUCTURE & SEMANTIC DESIGN Ken McCaslin Duteau Design Inc. CO-CHAIRS Quest Diagnostics, Incorporated Phone: 780-328-6395 Calvin Beebe Phone: 610-650-6692 Email: [email protected] Mayo Clinic Email: Phone: 507-284-3827 kenneth.h.mccaslin @questdiagnostics. com DOMAIN EXPERTS CO-CHAIRS Email: [email protected] Melva Peters CHIEF TECHNICAL OFFICER Jenaker Consulting Patricia Van Dyke, RN John Quinn Phone: 604-515-0339 Delta Dental Plans Association HL7 International Email: [email protected] Phone: 503-243-4492 Email: [email protected] Phone: 216-409-1330 Email: [email protected] John Roberts TECHNICAL & SUPPORT SERVICES

Tennessee Department of Health CO-CHAIRS ArB CO-CHAIRS Phone: 615-741-3702 Frieda Hall Lorraine Constable Email: [email protected] Quest Diagnostics, Incorporated HL7 Canada Phone: 610-650-6794 Phone: +1 780-951-4853 FOUNDATION & TECHNOLOGY Email: [email protected] Email: [email protected] CO-CHAIRS George (Woody) Beeler, Jr., PhD Andy Stechishin Anthony Julian Beeler Consulting, LLC CANA Software & Services Ltd. Mayo Clinic Phone: 507-254-4810 Phone: 780-903-0885 Phone: 507-266-0958 Email: [email protected] Email: [email protected] Email: [email protected] Paul Knapp (Interim) INTERNATIONAL REPRESENTATIVES Knapp Consulting, Inc. Giorgio Cangioli Phone: 604-987-3313 HL7 Italiy Email: [email protected] Phone: +39 3357584479 Email: [email protected] STEERING DIVISIONS

DOMAIN EXPERTS FOUNDATION & TECHNOLOGY STRUCTURE & SEMANTIC DESIGN Anatomic Pathology Application Implementation & Design Arden Syntax Anesthesiology Conformance & Guidance for Clinical Decision Support Attachments Implementation/Testing Clinical Statement Implementable Technology Specifications Child Health Electronic Health Record Infrastructure & Messaging Financial Management Clinical Genomics Modeling & Methodology Imaging Integration Clinical Interoperability Council Security Clinical Quality Information Service Oriented Architecture Mobile Health Community Based Collaborative Care Templates Orders & Observations Emergency Care Vocabulary Patient Administration Health Care Devices Structured Documents Patient Care TECHNICAL & SUPPORT SERVICES Pharmacy Education Public Health & Emergency Response Electronic Services Regulated Clinical Research International Mentoring Committee Process Improvement Committee Information Management Project Services Publishing Tooling

26 JANUARY 2014

HL7 NEWS jan 14 INTERIOR.indd 24 1/3/14 11:09:59 AM HL7 WORK GROUP CO-CHAIRS

Anatomic Pathology Mitra Rocca Conformance & Guidance Jim McKinley Food and Drug Administration for Implementation/ Victor Brodsky, MD Blue Cross and Blue Shield of Phone: 301-796-2175 College of American Pathologists Alabama Email: [email protected] Testing Phone: 646-322-4648 Phone: 205-220-5960 Wendy Huang Email: [email protected] Anita Walden Child Health Canada Health Infoway Inc. Duke Translational Medicine John David Nolen Phone: 416-595-3449 Cerner Corporation Gaye Dolin, MSN Institute Email: Phone: 816-446-1530 Lantana Consulting Group Phone: 919-668-8256 [email protected] Email: [email protected] Phone: 714-744-4152 Email: [email protected] Email: Frank Oemig Anesthesia [email protected] Clinical Quality HL7 Germany Information Phone: 49-208-781194 Martin Hurrell, PhD Michael Padula, MD, MBI Email: [email protected] Phone: 44-7711-669-522 The Children’s Hospital of Email: [email protected] Philadelphia Patricia Craig The Joint Commission Ioana Singureanu Phone: 215-590-1653 Eversolve, LLC John Walsh, MD Email: [email protected] Phone: 630-792-5546 Partners Healthcare Email: [email protected] Phone: 603-870-9739 Phone: 617-726-2067 Feliciano Yu, MD Email: [email protected] Email: [email protected] St. Louis Children’s Hospital Floyd Eisenberg Robert Snelick Phone: 314-454-2808 iParsimony LLC Application Email: [email protected] National Institute of Standards & Phone: 202-643-6350 Technology Implementation & Design Clinical Decision Support Email: [email protected] Phone: 301-975-5924 Email: [email protected] Peter Hendler, MD Crystal Kallem, RHIA Kaiser Permanente Guilherme Del Fiol, MD, PhD University of Utah Health Care Lantana Consulting Group Education Phone: 510-248-3055 Phone: 515-992-3616 Email: [email protected] Phone: 919-213-4129 Email: [email protected] Email: crystal.kallem@lantana- Diego Kaminker Rene Spronk group.com HL7 Argentina HL7 The Netherlands Robert Jenders, MD Phone: 54-11-4781-2898 Phone: 33-318-553812 Phone: 310-761-4700 Christopher Millet Email: diego.kaminker@kern- Email: [email protected] Email: [email protected] Email: [email protected] it.com.ar Kensaku Kawamoto, MD, PhD Andy Stechishin Walter Suarez, MD, MPH Patrick Loyd CANA Software & Services Ltd. University of Utah Health Care ICode Solutions Phone: 780-903-0855 Phone: 801-587-8001 Kaiser Permanente Phone: 301-801-3207 Phone: 415-209-0544 Email: [email protected] Email: Email: [email protected] [email protected] Email: [email protected] Architectural review Board Melva Peters Howard Strasberg Clinical Statement Jenaker Consulting Lorraine Constable Wolters Kluwer Health HL7 Canada Phone: 604-515-0339 Phone: 858-481-4249 Hans Buitendijk Email: [email protected] Phone: +1 780-951-4853 Email: howard.strasberg@wolter- Siemens Healthcare Email: [email protected] skluwer.com Phone: 610-219-2087 Electronic Health Records Anthony Julian Clinical Genomics Email: Mayo Clinic [email protected] Gary Dickinson Phone: 507-266-0958 Yan Heras, PhD CentriHealth Email: [email protected] Lantana Consulting Group Rik Smithies Phone: 951-536-7010 Phone: 801-663-9209 NProgram Ltd. Email: gary.dickinson@ehr-stan- John Quinn Email: [email protected] Phone: 44-7720-290967 dards.com Health Level Seven International Email: [email protected] Phone: 216-409-1330 Amnon Shabo, PhD Mark Janczewski, MD, MPH Email: [email protected] IBM Community Based Medical Networks, LLC Phone: 972-544-714070 Phone: 703-994-7637 Arden Syntax Email: [email protected] Collaborative Care Email: [email protected] Peter Haug, MD Suzanne Gonzales-Webb Intermountain Healthcare Mollie Ullman-Cullere Don Mon, PhD Phone: 801-442-6240 Partners HealthCare System, Inc. US Department of Veterans Affairs RTI International Email: [email protected] Phone: 617-582-7249 Phone: 619-972-9047 Phone: 312-777-5228 Email: Email: Email: [email protected] [email protected] Robert Jenders, MD [email protected] Phone: 301-761-4700 John Ritter Email: [email protected] Clinical Interoperability Phone: 412-372-5783 Council Richard Thoreson Email: [email protected] Attachments SAMHSA W. Edward Hammond, PhD Phone: 240-276-2827 Helen Stevens Love Durwin Day Duke Translational Medicine Email: Hl7 Canada Health Care Service Corporation Institute [email protected] Phone: 250-598-0312 Phone: 312-653-5948 Phone: 919-383-3555 Email: [email protected] Email: [email protected] Email: [email protected] Max Walker Patricia Van Dyke, RN Craig Gabron Department of Health Dianne Reeves Delta Dental Plans Association Blue Cross Blue Shield of South National Cancer Institute Phone: 61-3-9096-1471 Carolina Phone: 503-243-4492 Phone: 240-276-5130 Email: Phone: 803-763-1790 Email: patricia.vandyke@moda- Email: [email protected] Email: [email protected] [email protected] health.com

JANUARY 2014 27

HL7 NEWS jan 14 INTERIOR.indd 25 1/3/14 11:10:00 AM HL7 Work Group Co-Chairs, continued

Electronic Services Imaging Integration Marketing Council Robert Hausam, MD Hausam Consulting Jeff Brown Helmut Koenig, MD Rene Spronk Phone: 801-949-1556 Kernodle Clinic Siemens Healthcare HL7 Netherlands Email: [email protected] Phone: 336-538-1234 Phone: 49-9131-84-3480 Phone: 31-318-553812 Email: [email protected] Email: [email protected] Email: [email protected] Patrick Loyd ICode Solutions Lorraine Constable Harry Solomon Edward Tripp Phone: 415-209-0544 HL7 Canada GE Healthcare Edward S. Tripp and Associates, Inc. Email: [email protected] Phone: 780-951-4853 Phone: 847-277-5096 Phone: 224-234-9769 Email: [email protected] Email: [email protected] Email: [email protected] Ken McCaslin Quest Diagnostics, Incorporated Ken McCaslin Implementable Grant Wood Phone: 610-650-6692 Quest Diagnostics, Incorporated Technology Specifications Intermountain Healthcare Email: kenneth.h.mccaslin@ Phone: USA +1 610-650-6692 Phone: 801-408-8153 questdiagnostics.com Email: kenneth.h.mccaslin Paul Knapp Email: [email protected] @questdiagnostics.com Knapp Consulting Inc. Organizational Relations Phone: 604-987-3313 Mobile Health Committee Nat Wong Email: [email protected] HL7 Australia Gora Datta Scott Robertson, PharmD Email: [email protected] Dale Nelson CAL2CAL Corporation Phone: 949-955-3443 Kaiser Permanente Lantana Consulting Group Phone: 310-200-0231 Emergency Care Phone: 916-367-1458 Email: [email protected] Email: dale.nelson@squaretrends. Email: [email protected] Laura Heermann Langford com Matthew Graham Intermountain Healthcare Mayo Clinic Outreach Committee For Phone: 801-507-9254 Andy Stechishin Phone: 507-284-3028 Email: [email protected] CANA Software & Services Ltd. Email: [email protected] Clinical Research Phone: 780-903-0885 Donald Kamens, MD Email: [email protected] Nadine Manjaro Ed Helton, PhD XPress Technologies Tech Mahindra National Cancer Institute Phone: 904-296-1189 Infrastructure & Phone: 913-948-1246 Phone: 919-465-4473 Email: [email protected] Messaging Email: [email protected] Email: [email protected] James McClay, MD Harry Rhodes Patient Adminstration University of Nebraska Anthony Julian American Health Information Mayo Clinic Medical Center Management Association Alexander deLeon Phone: 402-559-3587 Phone: 507-266-0958 Phone: 312-233-1119 Email: [email protected] Kaiser Permanente Email: [email protected] Email: [email protected] Phone: 626-381-4141 Email: [email protected] Peter Park David Shaver Corepoint Health Modeling And US Department of Defense, Irma Jongeneel-de Haas Military Health System Phone: 214-618-7000 Methodology Email: dave.shaver@corepointhealth. HL7 The Netherlands Phone: 202-762-0926 George (Woody) Beeler Jr., PhD Phone: +31 681153857 Email: [email protected] com Beeler Consulting, LLC Email: [email protected] Financial Management Sandra Stuart Phone: 507-254-4810 Kaiser Permanente Email: [email protected] Line Saele Kathleen Connor Phone: 925-924-7473 Helse Vest IKT Email: [email protected] Jean Duteau Phone: 47-55976494 Edmond Scientific Company Duteau Design Inc. Email: [email protected] Email: [email protected] International Council Phone: 780-328-6395 Email: [email protected] Beat Heggli Patient Care HL7 Switzerland Philip Scott, PhD— HL7 International Liaison Grahame Grieve Elaine Ayres Phone: 41-44-297-5737 Health Intersections Pty Ltd Email: [email protected] HL7 UK NIH/CC Phone: 44-8700-112-866 Phone: 61-3-9844-5796 Phone: 301-594-3019 Email: [email protected] Email: grahame@ Paul Knapp healthintersections.com.au Email: [email protected] Knapp Consulting Helen Stevens Love, MBA— Phone: 604-987-3313 Lloyd McKenzie Stephen Chu, MD Email: [email protected] Secretary National eHealth Transition HL7 Canada HL7 Canada Authority (NEHTA) Health Care Devices Phone: 250-598-0312 Email: [email protected] Email: [email protected] Phone: 61-730238448 AbdulMalik Shakir Email: [email protected] Todd Cooper City of Hope National Medical Center for Medical Interoperability Michael van Campen—Affiliate Liaison Center Kevin Coonan, MD Phone: 858-442-9200 Phone: 626-644-4491 Email: [email protected] Email: [email protected] Gordon Point Informatics Ltd. Phone: 250-881-4568 Email: Email: michael.vancampen@gpinfor- [email protected] Russell Leftwich, MD John Garguilo Office of eHealth Initiatives National Institute of Standards matics.com Email: [email protected] Orders/Observations Phone: 615-507-6465 International Mentoring Email: [email protected] Hans Buitendijk Allen Hobbs, PhD Committee Siemens Healthcare Kaiser Permanente Hugh Leslie, MD Phone: 610-219-2087 Ocean Informatics Phone: 510-267-5031 Diego Kaminker Email: Email: [email protected] HL7 Argentina Email: hugh.leslie@oceaninforma- Phone: 54-11-4781-2898 [email protected] tics.com John Rhoads, PhD Email: [email protected] Philips Healthcare Lorraine Constable Michael Tan Phone: 978-659-3024 John Ritter HL7 Canada NICTIZ Email: [email protected] Phone: 412-372-5783 Phone: 780-951-4853 Phone: 31-7031-73450 Email: [email protected] Email: [email protected] Email: [email protected] 28 JANUARY 2014

HL7 NEWS jan 14 INTERIOR.indd 26 1/3/14 11:10:01 AM HL7 Work Group Co-Chairs, continued

Pharmacy Jane Daus-V2 Services Oriented Tooling Committee McKesson Provider Technologies Architecture Hugh Glover Phone: 847-495-1289 Dennis Cheung Blue Wave Informatics Email: [email protected] Don Jorgenson Canadian Institute for Health Phone: 44-07889407113 Phone: 970-472-1441 Email: hugh_glover@bluewavein- Information (CIHI) Peter Gilbert formatics.co.uk Email: [email protected] Email: [email protected] Covisint Melva Peters Phone: 734-604-0255 Stefano Lotti Andy Stechishin Jenaker Consulting Email: [email protected] HL7 Italy CANA Software & Services Ltd. Phone: 604-515-0339 Phone: 39-06-421-60685 Phone: 780-903-0855 Email: [email protected] Email: [email protected] Brian Pech-V2 Email: [email protected] Kaiser Permanente John Hatem Phone: 678-245-1762 Vince McCauley Oracle Corporation - Healthcare Michael Van der Zel Email: [email protected] Medical Software Industry Phone: 415-269-7170 Association HL7 The Netherlands Email: [email protected] Phone: 61-298-186493 Phone: +31 503619876 Andrew Stechishin-V3 Email: [email protected] Email: [email protected] Scott Robertson, PharmD CANA Software & Services Ltd. Kaiser Permanent Phone: 780-903-0855 Ken Rubin Vocabulary Phone: 310-200-0231 Email: [email protected] Email: [email protected] Hewlett-Packard Enterprises Regulated Clinical Services Jim Case, MS, DVM, PhD Process Improvement Phone: 703-845-3277 National Library of Medicine Research Information Committee Email: [email protected] Phone: 530-219-4203 Management Email: [email protected] Sandra Stuart Structured Documents Ed Helton, PhD Kaiser Permanente Heather Grain Phone: 925-924-7473 National Cancer Institute Calvin Beebe Standards Australia, eHealth Email: [email protected] Phone: 919-465-4473 Mayo Clinic Education Email: [email protected] Phone: 507-284-3827 Phone: 613-956-99443 Project Services Email: [email protected] Email: [email protected] Rick Haddorff Donald Jaccard, MPA Food & Drug Administration Diana Behling Mayo Clinic Russell Hamm Phone: 301-796-1996 Iatric Systems Phone: 978-296-1462 Lantana Consulting Group Email: [email protected] Email: Phone: 978-805-3159 Phone: 507-271-0227 [email protected] Email: [email protected] Freida Hall Email: russ.hamm@lantanagroup. Quest Diagnostics, Inc. com Edward Tripp Austin Kreisler Phone: 610-650-6794 Leidos, Inc. Edward S. Tripp & Associates, Inc. Email: Phone: 706-525-1181 Robert Hausam, MD Phone: 224-234-9769 [email protected] Email: [email protected] Hausam Consulting Email: [email protected] Public Health Phone: 801-949-1556 Patrick Loyd Email: [email protected] Emergency Response Security ICode Solutions Phone: 415-209-0544 William T. Klein Joginder Madra Bernd Blobel, PhD Gordon Point Informatics Ltd. Email: [email protected] Klein Consulting, Inc. HL7 Germany; University of Phone: 780-717-4295 Phone: 631-924-6922 Regensburg Medical Center Email: Brett Marquard Email: [email protected] [email protected] Phone: 49-941-944-6767 River Rock Associates LLC Email: [email protected] Email: Ken Pool, MD regensburg.de [email protected] OZ Systems Phone: 214-631-6161 Mike Davis Templates Email: [email protected] US Department of Veterans Affairs Kai Heitmann, MD John Roberts Phone: 760-632-0294 HL7 Germany Tennessee Department of Health Email: [email protected] Phone: 49-172-2660814 Phone: 615-741-3702 Email: [email protected] Email: [email protected] John Moehrke GE Healthcare John Roberts Rob Savage Phone: 920-912-8451 Rob Savage Consulting Tennessee Department of Health Email: [email protected] Email: [email protected] Phone: 615-741-3702 Email: [email protected] Publishing Committee Patricia Williams Hl7 Australia Mark Shafarman George (Woody) Beeler Jr., PhD-V3 Phone: 61-863045039 Shafarman Consulting Beeler Consulting, LLC Email: [email protected] Phone: 510-593-3483 Phone: 507-254-4810 Email: Email: [email protected] [email protected]

JANUARY 2014 29

HL7 NEWS jan 14 INTERIOR.indd 27 1/3/14 11:10:02 AM HL7 FACILITATORS Modeling and Alexander Henket AbdulMalik Shakir Peter Gilbert Methodology Facilitators HL7 Netherlands City of Hope National Medical Covisint Patient Administration Center Structured Documents George (Woody) Beeler, Jr., PhD Email: [email protected] Clinical Interoperability Council; Phone: 734-604-0255 Beeler Consulting LLC Modeling & Methodology Email: [email protected] Facilitator-at-Large William “Ted” Klein Phone: 626-644-4491 Phone: 507-254-4810 Klein Consulting, Inc. Email: abdulmalik@shakirconsult- Robert Hallowell ing.com Email: [email protected] Vocabulary Siemens Healthcare Phone: 631-924-6922 Medication; Pharmacy Ioana Singureanu Charlie Bishop Email: [email protected] Phone: 610-219-5612 Eversolve, LLC iSoft Email: CBCC; Health Care Devices Clinical Statement Austin Kreisler [email protected] Phone: 603-870-9739 Phone: 44-7989-705-395 Leidos Email: Email: [email protected] Structured Documents Alexander Henket [email protected] Phone: 706-525-1181 HL7 Netherlands Email: austin.j.kreisler Patient Administration Bernd Blobel, PhD Corey Spears @leidos.com Email: [email protected] HL7 Germany Medicity Security Electronic Health Records Patrick Loyd Anthony Julian Phone: 49-941-944-6767 Phone: 917-426-7397 ICode Solutions Mayo Clinic Email: bernd.blobel Email: [email protected] @klinik.uni-regensburg.de Orders & Observations Infrastructure & Messaging Phone: 415-209-0544 D. Mead Walker Phone: 507-266-0958 Kathleen Connor Email: [email protected] Mead Walker Consulting Email: [email protected] Edmond Scientific RCRIM Financial Management Joginder Madra Phone: 610-518-6259 Helmut Koenig, MD Email: Gordon Point Informatics Ltd. Email: [email protected] Siemens Healthcare [email protected] Immunization; PHER Imaging Integration Phone: 780-717-4295 Publishing Facilitators Phone: 49-9131-84-3480 Kevin Coonan, MD Email: joginder.madra@ Email: Emergency Care gpinformatics.com Becky Angeles [email protected] Email: [email protected] ESAC Inc. Dale Nelson RCRIM Austin Kreisler Norman Daoust Lantana Consulting Group Phone: 972-437-5001 Leidos Daoust Associates Implementable Technology Email: Orders & Observations Anatomic Pathology Specifications [email protected] Phone: 706-525-1181 Phone: 617-491-7424 Phone: 916-367-1458 Email: Email: Email: Douglas Baird [email protected] [email protected] [email protected] Boston Scientific Corporation Templates Margaret (Peggy) Leizear Jean Duteau Lloyd McKenzie Phone: 651-582-3241 Food and Drug Administration Duteau Design Inc. HL7 Canada; Gordon Point Email: RCRIM [email protected] Patient Care; Pharmacy Informatics Phone: 301-796-8495 Phone: 780-328-6395 Facilitator-at-Large Email: [email protected] Mike Davis Email: [email protected] Email: [email protected] US Department of Veterans Affairs Mary Kay McDaniel Security Hugh Glover Craig Parker, MD Cognosante, LLC Phone: 760-632-0294 Blue Wave Informatics Intermountain Healthcare Financial Management Email: [email protected] Medication Clinical Decision Support Phone: 602-300-4246 Phone: 44-0-7889-407-113 Phone: 801-859-4480 Email: Jean Duteau Email: [email protected] [email protected] Email: hugh_glover@ Duteau Design Inc. bluewaveinformatics.co.uk PHER Amnon Shabo, PhD Dale Nelson Phone: 780-328-6395 IBM Lantana Consulting Group Grahame Grieve Email: [email protected] Health Intersections Pty Ltd Clinical Genomics CMET; Implementable Technology Phone: 972-544-714070 Specifications Infrastructure & Messaging Isobel Frean Phone: 61-3-9844-5796 Email: [email protected] Bupa Group Phone: 916-367-1458 Email: grahame@ Clinical Statement Email: healthintersections.com.au Phone: 44-207-656-2146 [email protected] Email: [email protected]

30 JANUARY 2014

HL7 NEWS jan 14 INTERIOR.indd 28 1/3/14 11:10:04 AM HL7 FACILITATORS, continued Frank Oemig, PhD Kevin Coonan, MD Susan Matney Sandra Stuart HL7 Germany Emergency Care 3M Health Information Systems Kaiser Permanente German Realm Email: [email protected] Patient Care Infrastructure & Messaging Phone: 49-208-781194 Phone: 801-265-4326 Phone: 925-924-7473 Email: [email protected] Guilherme Del Fiol, MD, PhD Email: [email protected] Email: [email protected] University of Utah Health Care Craig Parker, MD Clinical Decision Support Robert McClure, MD Pat Van Dyke, RN Intermountain Healthcare Phone: 919-213-4129 MD Partners, Inc. Delta Dental Plans Association Clinical Decision Support Email: CBCC Electronic Health Records Phone: 801-859-4480 [email protected] Phone: 303-926-6771 Phone: 503-243-4992 Email: [email protected] Email: Email: patricia.vandyke@ Christof Gessner [email protected] modahealth.com John Ritter HL7 Germany Electronic Health Records Health Care Devices Sarah Ryan Tony Weida Phone: 49-172-3994033 Clinical Interoperability Council Phone: 412-372-5783 Apelon Email: [email protected] Email: [email protected] Email: [email protected] Security Email: [email protected] W. Edward Hammond, PhD Harold Solbrig Ioana Singureanu Duke Transitional Medicine Mayo Clinic Eversolve, LLC Institute Modeling & Methodology CBCC Templates Email: [email protected] Phone: 603-870-9739 Phone: 919-383-3555 Email: Email: [email protected] Harry Solomon [email protected] GE Healthcare Monica Harry Imaging Integration Margarita Sordo HL7 Canada Phone: 847-277-5096 Partners HealthCare System, Inc. PHER Email: Gello Email: [email protected] Phone: 781-416-8479 [email protected] Email: [email protected] Robert Hausam, MD Anita Walden Hausam Consulting Duke Translational Medicine Orders & Observations; Institute Structured Documents Clinical Interoperability Council Phone: 801-949-1556 Phone: 919-668-8256 Email: [email protected] Email: [email protected] Joyce Hernandez Grant Wood Merck & Co. Inc. Intermountain Healthcare Clinical Genomics Clinical Genomics Phone: 732-594-1815 Phone: 801-408-8153 Email: Email: [email protected] [email protected]

Vocabulary Facilitators Wendy Huang Canada Health Infoway Inc. Paul Biondich, MD Patient Administration IU School of Medicine Phone: 416-595-3449 Child Health Email: [email protected] Phone: 317-278-3466 Email: [email protected] Julie James Blue Wave Informatics Kathleen Connor Medication; Pharmacy; RCRIM Edmond Scientific Email: julie_james@ Financial Management bluewaveinformatics.co.uk Email: [email protected] William “Ted” Klein Klein Consulting, Inc. Modeling & Methodology Phone: 631-924-6922 Email: [email protected] JANUARY 2014 31

HL7 NEWS jan 14 INTERIOR.indd 29 1/3/14 11:10:05 AM Affiliate Contacts

HL7 Argentina HL7 Czech Republic HL7 Korea HL7 Russia Fernando Campos Libor Seidl Byoung-Kee Yi, PhD Tatyana Zarubina, MD, PhD Phone: +54-11-4781-2898 Phone: +420 605740492 Phone: +82 234101944 Phone: +7-495-434-55-82 Email: fernando.campos Email: [email protected] Email: [email protected] Email: [email protected] @hospitalitaliano.org.ar HL7 Finland HL7 Luxembourg HL7 Singapore HL7 Australia Juha Mykkanen, PhD Stefan Benzschawel Dr. Adam Chee Richard Dixon Hughes Phone: +358-403552824 Phone: +352-425-991-x2889 Email: [email protected] Email: [email protected] Email: [email protected] Email: Phone: 299538544 [email protected] HL7 Spain HL7 Austria HL7 France Carlos Gallego Perez Patricia Williams, PhD, MSc Nicolas Canu HL7 Netherlands Phone: +34-93-693-18-03 Phone: +61 863045039 Phone: +33 02-35-60-41-97 Robert Stegwee, MSc, PhD Email: [email protected] Email: [email protected] Email: [email protected] Phone: +31-30-689-2730 Email: HL7 Sweden HL7 Bosnia and Herzegovina HL7 Germany [email protected] Gustav Alvfeldt Samir Dedovic Christof Gessner Phone: +46 08-123-13-117 Phone: +387 0-33-721-911 Phone: +49 172-3994033 HL7 New Zealand Email: [email protected] Email: [email protected] Email: [email protected] David Hay Phone: +64-9-638-9286 HL7 Switzerland HL7 Brazil HL7 Greece Email: [email protected] Marco Demarmels MD, MBA Marivan Santiago Abrahao, MD Alexander Berler Phone: +41 712791189 Phone: +55-11-3045-3045 Phone: +30-2111001691 HL7 Norway Email: [email protected] Email: [email protected] Email: [email protected] Terje Halvorsen Email: [email protected] HL7 Taiwan HL7 Canada Melva Peters HL7 Hong Kong Chih-Chan (Chad) Yen Phone: +604-515-0339 Dr. Chung Ping Ho HL7 Pakistan Phone: +886-2-2552-6990 Email: Phone: +852 34883762 Maajid Maqbool Email: [email protected] [email protected] Email: [email protected] Phone: +92-51-90852159 Email: maajid.maqbool HL7 Turkey HL7 China HL7 India @seecs.edu.pk Ergin Soysal, MD, PhD Prof. Baoluo Li Lavanian Dorairaj, MBBS, MD Email: [email protected] Phone: +86-010-65815129 Email: [email protected] HL7 Puerto Rico Email: [email protected] Julio Cajigas HL7 UK HL7 Italy Phone: +1 787-447-3713 Philip Scott, PhD HL7 Colombia Stefano Lotti Email: [email protected] Phone: +44 8700-112-866 Dr. Ing. Diego Lopez Phone: +39-06-42160685 Email: [email protected] Phone: +57 3015819362 Email: [email protected] HL7 Romania Email: Florica Moldoveanu, PhD HL7 Uruguay [email protected] HL7 Japan Phone: +40-21-4115781 Julio Leivas, MD HL7 Croatia Michio Kimura, MD, PhD Email: florica.moldoveanu Phone: +598 095229291 Miroslav Koncar Phone: +81-3-3506-8010 @yahoo.com Email: [email protected] Phone: +385-99-321-2253 Email: Email: [email protected] [email protected]

32 JANUARY 2014

HL7 NEWS jan 14 INTERIOR.indd 30 1/3/14 11:10:06 AM 2014 HL7 STAFF Chief Executive Chief Technical Executive Associate Executive Officer Officer Director Director

Charles Jaffe, MD, PhD John Quinn Mark McDougall Karen Van Hentenryck +1-858-720-8200 +1-216-409-1330 +1-734-677-7777 +1-734-677-7777 [email protected] [email protected] [email protected] [email protected] Director of Director of Manager Director of Global Partnerships Meetings of Education Education and Policy

Lillian Bigham Mary Ann Boyle Sharon Chaplock, PhD Ticia Gerber +1-989-736-3703 +1-734-677-7777 +1-414-443-1327 +1-202-486-5236 [email protected] [email protected] [email protected] [email protected] Director of Director, Project Membership & Director of TSC Project Management Office Administrative Services Technical Services Manager

Dave Hamill Linda Jenkins Michael Kingery Lynn Laakso +1-734-677-7777 +1-734-677-7777 +1-919-636-4032 +1-906-361-5966 [email protected] [email protected] [email protected] [email protected]

Director of Technical Director of Web Publications Communications Developer

Pete Swanson Donald Lloyd, PhD Andrea Ribick +1-650-451-8465 +1-734-677-7777 +1-734-677-7777 [email protected] [email protected] [email protected] JANUARY 2014 33

HL7 NEWS jan 14 INTERIOR.indd 31 1/3/14 11:10:10 AM 2014 HL7 Board of Directors Vice Chair Treasurer Chair Emeritus Technical Steering & Secretary Committee Chair

Donald Mon, PhD Calvin Beebe W. Edward Ken McCaslin RTI International Mayo Clinic Hammond, PhD Quest Diagnostics Inc. +1-312-777-5228 +1-507-284-3827 +1-919-383-3555 +1 610-650-6692 [email protected] [email protected] [email protected] kenneth.h.mccaslin@ questdiagnostics.com Appointed Affiliate Directors

James Ferguson Douglas Fridsma, MD, PhD Stanley Huff, MD Diego Kaminker Helen Stevens Love, MBA Kaiser Permanente Office of the National Intermountain Healthcare HL7 Argentina HL7 Canada +1 510-271-5639 Coordinator for Health IT +1-801-442-4885 +54-11-4781-2898 +1-250-598-0312 [email protected] +1-202-205-4408 [email protected] diego.kaminker [email protected] [email protected] Directors-at-Large

Keith Boone Hans J. Buitendijk Austin Kreisler Patricia Van Dyke GE Healthcare Siemens Healthcare Leidos, Inc. Delta Dental Plans +1-617-519-2076 +1 610-219-2087 +1-706-525-1181 Association [email protected] hans.buitendijk austin.j.kreisler +1-503-243-4492 @siemens.com @leidos.com patricia.vandyke @modahealth.com Ex Officio Members Advisory Council Chair

Charles Jaffe, MD, PhD Mark McDougall John Quinn Richard Dixon Hughes HL7 CEO HL7 Exective Director HL7 CTO HL7 Australia / DH4 Pty Limited +1-858-720-8200 +1-734-677-7777 +1-216-409-1330 [email protected] [email protected] [email protected] [email protected] 34 JANUARY 2014

HL7 NEWS jan 14 INTERIOR.indd 32 1/3/14 11:10:13 AM HL7 Implementation Workshop

Gain real-world HL7 knowledge TODAY that you can apply TOMORROW

What is an Implementation Workshop? An HL7 Implementation Workshop is a three-day hands-ons event focused on HL7-specific topics such as Version 2, Clinical Document Architecture (CDA®), and Fast Healthcare Interoperability Resources (FHIR®). It includes a combination of exercises and presentations to help attendees learn how to implement HL7 standards. Why Should I Attend? This is an invaluable educational opportunity for the healthcare IT community as it strives for greater interop- erability among healthcare information systems. Our classes offer a wealth of information designed to benefit Upcoming a wide range of HL7 users, from beginner to advanced. Implementation Among the benefits of attending the HL7 Implementation Workshop Workshop are: • Efficiency Concentrated format provides maximum training with minimal time investment • Learn Today, Apply Tomorrow A focused curriculum featuring real-world HL7 knowledge that you can apply immediately • Quality Education High-quality training in a “small classroom” setting promotes more one-on-one learning • Superior Instructors You’ll get HL7 training straight from the source: Our instructors. They are not only HL7 experts; they are the people who help produce the HL7 standards • Certification Testing March 11–13, 2014 Become HL7 Certified: HL7 is the sole source for HL7 certification testing, now offering testing on Meaningful Use and FHIR Version 2.7, Clinical Document Architecture, Hilton Washington Dulles Airport and Version 3 RIM Washington, DC • Economical A more economical alternative for companies who want the benefits of HL7’s on-site training but have fewer employees to train JANUARY 2014 35

HL7 NEWS Sjan 14 COVER.indd 3 1/3/14 11:03:23 AM Upcoming WORKING GROUP MEETINGS

May 4 – 9, 2014 September 14 – 19, 2014 Working Group Meeting 28th Annual Plenary Pointe Hilton Squaw Peak Resort & Working Group Meeting Phoenix, AZ Hilton Chicago Hotel, Chicago, IL

January 18 – 23, 2015 May 10 – 15, 2015 Working Group Meeting Working Group Meeting Hyatt Regency on the Riverwalk Hyatt Regency Paris – San Antonio, TX Charles de Gaulle Hotel Paris, France

October 4 – 9, 2015 29th Annual Plenary & Working Group Meeting Sheraton Atlanta Hotel Atlanta, GA

HL7 NEWS Sjan 14 COVER.indd 4 1/3/14 11:03:35 AM