Affiliates Council Members

HL7 Working Group Meeting San Antonio, TX International Council Meeting Sunday, January 15, 2017

Wireless Network: HL7JAN2017 Password: healthlevel7

Agenda

Opening Session (9:00 am – 10:30am) 1. Opening Announcements & Call to Order (5 min) Welcome new Affiliates Welcome new Affiliate Chairs HL7 New Zealand – Peter Jordan HL7 Australia – Jason Steen Thank you to David Hay and Nat Wong for their contributions to the International Council Introductions Round Table (10 min) Confirm Proxies & Quorum

Fernando Campos HL7 Argentina Diego Kaminker Marivan Abrahao HL7 Brazil Alexander Mense Stefan Sabutsch HL7 Austria HL7 Beat Heggli Marco Demarmels Switzerland Juha Mykkanen HL7 Finland Line Saele Lene Alsbaek Nielsen HL7 Denmark Melva Peters (Sunday) Byoung-Kee Yi HL7 Korea Michio Kimura (Thursday) Kai Heitmann Sylvia Thun HL7 Germany Rik Smithies Philip Scott HL7 UK Peter Jordan Jason Steen HL7 Australia Michael Tan (Sunday) HL7 Bert Kabbes Kai Heitmann Netherlands (Thursday) Round table introductions Current Membership = 32 Lapsed members: Quorum for Decisions (40%=13), Directions (33%=11), Financial Decisions (51%=17) Statement of Quorum – 18 Chairs in attendance (in person and by proxy) Quorate for financial decisions 2. Secretary Report (5 min) Review Agenda Melva Peters Reminder to put Affiliate presentation in Dropbox or email Agenda – International Council – San Antonio, TX – January 2017 1 3. HL7 International Board Report & Welcome (10 min) Welcome New Board members – Melva Peters and Nancy Orvis Questionnaire – Internationalization Task Force – please review and respond. New questions have been added. Important to get IC input as we work to become a global organization. Will be discussed further at Thursday’s meeting. Pat van Dyke Leadership Task Force – more information will be provided this week. Have heard what has been said and adjustments have been made Financials Internationalization Task Force – will be pulling information gathered so far together. Make HL7 a global organization to meet the needs of the global community. 4. CEO Report to the IC (10 min) Welcome to San Antonio HL7 Outreach Partners in Interoperability – emerged from Advisory Council in 2015. 1. HL7 FHIR Foundation 2. HL7 FHIR Roundtable – next one is at Duke – March 8-9, 2017 3. Payer Summit Implementing FHIR – July 11-12, 2016 and January 16 ,2017 4. HL7 FHIR Clinical Connectathon 5. HL7 FHIR Connectathon for Translational Science – joint meeting with AMIA – March 26, 2017 6. Clinical Information Interoperability Council – planning an update for Summer 2017 7. HL7 International Genomics Summits – late Summer 2017 8. HL7 North American Developer Days – planned for Summer 2017 – in collaboration with Furore Collaboration Chuck Jaffe JASON Task Force and the Argonauts SMART on FHIR – SMART is a 6-year project at Boston’s Children’s Hospital, funded by the ONC CDS Hooks – clinical decision support using SMART and FHIR – augments CDS solutions embedded in the EHR. Hook can provide information or trigger an app Sync for Science – joint project of ONC, Harvard Medical School, EHR vendors and NIH ONC-funded FHIR programs – profiles for patient care, clinical research, quality measures, decision support, medications and genomics openFDA Initiative – open APIs and more seamless access to research data and decisions on safety of drugs CMS (Medicare) – coordinating a diverse ecosystem of developers for creation of the Blue Button on FHIR Public health reporting – using FHIR for a host of new programs including biosurveillance Clinical Professional Societies – requesting the help of IC in bringing in professional societies from other countries International BioPharma leveraging HL7 FHIR – discussions with EMA, Japanese equivalent

2 5. CTO Report specific to Affiliates (10 min) 2016 CTO Themes V3 Future – meetings this week Simplify –re-organization of Work Groups Process FHIR – implementation registry is up on FHIR.org BioPharma Tooling priorities Triaging current tools from inventory – maintain, enhance/replace, retire Wayne Kubrick Address new strategic needs Currently under evaluation – EHR Functional Profile tooling, FHIR Registry (RFI will be posted soon), Confluence/JIRA vs MediaWiki, Tracker Tooling for new Vocab Harmonization process Standard Group Chat Getting conferencing in order – Free Conference Call.com – free and international numbers in 60 countries and VOIP and screen sharing – will be rolled out in phases over the next few months SNOMED Portal – allows downloads for value sets – http://www.hl7.org/portal/index.cfm from Home Page: Resources/Tools & Resources/Vocabulary Resources Survey to IC Affiliates – level and adoption of FHIR – please respond when you receive it 6. Technical Steering Committee Report (10 min) TSC Update Simplification Developing requirements for logging issues/recommendations for standards – will be putting out the requirements for logging Action: looking for input from the International Council Ken McCaslin Clarified the withdrawal of a standard process Continue to hold of the forming of new work groups – at least through May 2017 WGM Working through the process to have a place to find decisions made by the TSC Comment: Suggestion that there should be mentoring for Co-Chairs Will explore opportunities 7. Regional Reports HL7 Europe (10 min) - Giorgio What is Europe? Healthcare is a national/regional responsibility There is a European healthcare eHDSI – future infrastructure to support European healthcare for cross-border – patient summary and e- Prescriptions and e-Dispensations services operational by 2020 European Commission – responsible for CORE Services Member states – responsible for GENERIC services 3 waves through to 2020 Most of the EU communities will be active in at least 1 service How will HL7 contribute to these processes? Project statuses: AccessCT – ended in July 2016 – final recommendations published OpenMedicine – ended December 2016 – final review in Feb 2017 eStandards – ends September 2017 – 5 month extension New Trillium II – January 2017 to June 2019 – patient summary at a global level

Agenda – International Council – San Antonio, TX – January 2017 3 8. Madrid WGM Support During a session at previous years, discussed possibility of commitment of sponsorship in Madrid Currently have support from Switzerland, France, Italy, Germany and Argentina – THANK YOU! Meeting – Wednesday Q2 – Madrid WGM planning – Affiliate Chairs are welcome to participate Discussions of events during the WGM Some changes to WGM to reduce costs – box lunches on some days and buffet meals on other days 9. Thursday Agenda Topics (5 min) May 2017 WGM (Madrid) – 10 minutes Nomination Committee reps – 10 minutes International Patient Summary Project Update – 10 min eVotes – 10 min Process pHealth budget request New agenda items: Help to affiliates to bring new members together and support – Affiliates working as a group instead of separately (Ed) FHIR artefacts IHIC 2017 update 10. Affiliate governance of local FHIR artefacts (20 minutes) General discussion on governance of locally produced FHIR artefacts Issues (“self-germinating” FHIR projects) URL domain names Trademark policy Extensions and identifiers (naming systems) Profiles and implementation guides (International FHIR Registry) Validation and compliance testing (AEGIS Touchstone, Crucible) Individual certification (FHIR™ Certified Implementer) Line in the sand (DSTU1-2 encourage adoption STU3 governance implementation)? Balloting process Discussion: Ed: HL7 International – lots of effort on linking FHIR to HL7 International Francois (HL7 France) – are in the same situation – local projects building their own extensions. At the same point of building governance at the national level. Interested in having an international registry Kai (HL7 Germany) – need transparency. Doubt there will be a single international profile registry – needs to be federated and support sharing registries. Need to have a way to announce profiles. Melva (HL7 Canada) – have had implementers asking what to do – want to do the right thing but haven’t been ready. Need to move quickly otherwise we will miss the opportunity John Ritter – similar issue with EHR and PHR functional model and tooling – Please respond to survey: https: Epic – implementer perspective – running in to issues with localizations. Should not let this happen with FHIR Alexander (HL7 Austria) – have been encouraging member to come to Affiliate to publish Kai (HL7 Germany) – focus on transparency and ability to compare artefacts and keep proper relationship between things we are doing. Encourage everyone to share! Break (10:30am-11am)

Q2 (11:00am – 12:30pm)

4 11. FHIR Update (5 min) Focus is on publication – have plans to publish STU3 mid-March. Content deadlines start in February Connectathon – 206 people (record) – continue to grow each meeting Certification process continues to move forward – should be available this quarter. Finalizing the test example in next couple of weeks Looking to moving some materials to normative Lloyd McKenzie Next ballot – tentatively scheduled for January 2018 Kai: how many participants from Connectathon will stay for the rest of the week? In general, it has been about 10%. Confirm with Lillian There are activities occurring throughout the week – should encourage them to stay Peter: Which version is certification based on. STU3 12. Reports from HL7 Affiliates (60 minutes) see presentations posted on IC website HL7 Argentina Unexpected growth in membership – 50% in 2016 Outreach – 1-2 day workshops Most of the provinces are including some level of standards in RFPs Translating CDA R2 – expected to become a national standard in Argentina for clinical documents by mid 2017 MAIS – FHIR for e-claims HL7 Fundamentals – going down but FHIR Fundamentals is going up HL7 Austria Celebrating 10th anniversary in 2017 as an Affiliate ELGA – live operation since December 2015. All regions with hospitals online. Millions of CDA documents in repositories. 3% opt out. Piloting – e-Medication. National activities about telecommunications Stable membership numbers New FHIR Technical Committee HL7 Canada

HL7 France HL7 V2.5.1 and higher – adoption driven by IHE for hospital workflow CDA R2 – national records (PHR, pharmaceutical) and lab reports FHIR – non-controlled grazing Set up of a permanent working group to build national profiles Need an international registry of profiles and IGs HL7 Germany Membership growing – approximately 270 HL7 Italy Risk areas Low attendance at technical projects Decrease in membership income No leadership renewal Corrective areas Identification of customers’ expectations New mechanisms to facilitate member engagement What’s next? Emergency encounter report has been proposed – will be developed in Art Décor ™ Biweekly calls to openly discuss all subjects of interest

Agenda – International Council – San Antonio, TX – January 2017 5 HL7 Netherlands Stable membership – about 2015 Looking at new opportunities for find new members in other healthcare sectors Joint agreements with HL7 NL, Nictiz, OIZ, Mental Health, etc – on validated national HL7 FHIR-NL FHIR profiles 25-year jubilee of HL7 Netherlands! HL7 NL website migrated and renewed Information exchange between hospitals and social care sectors Participating on Interpas and EU Mental Helath project HL7 NL WGM – held in November HL7 V3 used in National Switchpoint (LSP) 66% of population connected (opt-in); 95% GPs and pharmacies connected; 85% hospitals connected; 800,00 messages per week on medication and 190,000 patient summaries per week Redesign of medication process – shift of focus towards therapeutic information – split from logistics MEDMIJ project – will be using FHIR – patient centered environments HL7 New Zealand New Chair – Peter Jordan David Hay – now Chair Emeritus New Zealand United – building health systems capabilities from existing investment NZHealthInc Single electronic health record – working on a business case HL7 NZ Activity SNOMED CT Expo Health Informatics NZ Conference Focus for 2017 – FHIR Governance, Organizational Membership; FHIR Profiling Workshops; Promoting EHR- system Functional Models; Continuing collaboration with HL7 Australia HL7 Norway EHR Functional Model – has been translated to Norwegian (parts of the specification) – now recommended to be used as a functional model in Norway Will be used for new platform for health for middle part of Norway – 5 vendors have qualified Planned activities More tutorials – FHIR Simplifier – tools to present and ballot profiles on FHIR Kai – HL7 Germany has negotiated an agreement with Furore to use. Other Affiliates can consider HL7 Spain Membership – decreased in 43% between 2013 and 2016 Evangelism – 3 seminars in different parts of Spain. Use of HL7 is mandatory in IT public tenders Education – more than 600 HL7 certified people – another 50 in 2016 Translation of new education materials (v2.8) – need support for translation Need new materials such as FHIR Future Increase members with new offerings. Madrid WGM will be a good opportunity Madrid 2017 WGM – May 6-12, 2017 HL7 Switzerland Stable – 50 org and 25 personal members TC meeting – 3 meetings – 20 participants; Update work on Swiss EHR; FHIR Workgroup National eHealth Strategy – report with recommendation on mHealth Current projects – Radiology report - CDA document based on Swiss standard – expecting final results next week TC meeting – 24 Jan 2017 – Radiology report; FHIR Workgroup; EHR Workgroup

6 HL7 UK Recent activities State of FHIR in UK – joint with British Computer Society INTEROPen – UK initiative arising from industry Inspired by Argonaut to address gap between FHIR excitement and implementation Key aim ito bring more resources for UK FHIR profiles, etc Competitor to HL7 UK but relations are good Partners in Interop Summit 2017 – 2 day event March 2-3 to be held in London – DeepMind Health offices SNOMED CT Interoperability Forum – November 2016 Will be implemented across GP settings by April 2018 – systems must adopt SNOMED CT as the clinical terminology within, in place of Read codes Secondary care, acute care, mental health, community systems, dentistry and other systems – April 1, 2020 UK holding educational FHIR connectathon simultaneous with Clinical Connectathon this Friday Membership – decreasing more severely – starting to affect finances – may impact attendance at HL7 International WGM Planning a FHIR (informative) HL7 UK ballot this quarter HL7 USA US Realm – 127 projects – active or archived – 57 are V3; 19 EHR; 11 DAMS; 17 V2; ? CDA Change in government leadership – don’t know the impact Major initiatives haven’t changed 21st Century Cures Act Congress approved December 7, 2016 Signed into law on December 13th Purpose to accelerate “discovery, development and delivery” of medical therapies by encouraging biomedical research investment and facilitation innovations and approval processes Promote innovation Streamline regulatory approval process Increase use of EHRs and telehealth Health Information Exchange Privacy of health information Access to Care 13. Closing Remarks (5 min) Reminders Madrid WGM Planning – Wed Q2 – Rio Grande Center Melva Peters Send agenda items Proxy if you will not be able to attend on Thursday Lunch (12:30 – 1:30pm)

Meeting Adjourned @ 12:40

Thank you for attending the meeting. Have a successful week.

Agenda – International Council – San Antonio, TX – January 2017 7 Affiliates Council Members:

Affiliate / Role Attendance Record Co-Chair Melva Peters Co-Chair Diego Kaminker Co-Chair Line Saele HL7 Board of Directors Beat Heggli IC Representatives Frank Oemig Members of the Council HL7 Argentina Fernando Campos Yes (by proxy) HL7 Australia Jason Steen Yes (by proxy) HL7 Austria Stefan Sabutsch Yes (by proxy) HL7 Bosnia and Herzegovina Samir Dedovic HL7 Brazil Marivan Abrahão Yes (by proxy) HL7 Canada Melva Peters Yes HL7 China Li Baoluo HL7 Croatia Miroslav Koncar HL7 Czech Republic Libor Seidl HL7 Denmark Lene Alsbæk Nielsen Yes (by proxy) HL7 Finland Juha Mykkanen Yes (by proxy) HL7 France Francois Macary HL7 Germany Sylvia Thun Yes (by proxy) HL7 Greece Alexander Berler HL7 Hong Kong Chung Ping Ho HL7 India Dr. Chandil Kumar Gunashekara HL7 Italy Giorgio Cangioli HL7 Japan Michio Kimura Hl7 Korea Byoung-Kee Yi Yes (by proxy) HL7 Netherlands Bert Kabbes Yes (by proxy) HL7 New Zealand Peter Jordan HL7 Norway Line Saele HL7 Russia Sergey Shvyrev HL7 Serbia Filip Toskovic HL7 Singapore Adam Chee HL7 Spain Francisco Perez HL7 Sweden Mikael Wintell HL7 Switzerland Marco Demarmels Yes (by proxy) HL7 Taiwan Yu-Ting Yeh HL7 UK Philip Scott Yes (by proxy) HL7 Uruguay Julio Leivas HL7 USA Ed Hammond Lapsed or Unpaid Affiliates