HL7 Pilot Program Provides Key Intellectual Property Free of Charge

MAY 2012

HL7 Pilot Program Provides Key Intellectual Property Free of Charge HL7 recently announced a pilot program to provide some of its key intellectual property free of charge. “HL7 is keeping its promise to lower the barriers to adoption of electronic health records by making portions of our valuable intellectual property freely available to our stakeholders,” said Charles Jaffe, MD, PhD, CEO of HL7. “We believe that care givers, academic centers and vendors will greatly benefit from this significant enhancement for access to valuable HL7 material.”

In the pilot project, HL7 will enable no-cost licensing of its domain analysis models (DAMs) and functional profiles. This offer, a first for HL7, was announced at the 2012 HIMSS Annual Conference and Exhibition, one of the largest health information technology conferences in the United States.

The DAM is a set of requirements that explore and analyze the business of a particular clinical “domain.” Domain analysis is the first step in creating HL7 standards for a specific care or research environment. The domain analysis process produces documentation describing the stakeholders, activities, interactions, and information for a particular domain and serves as the source of requirements used in the design of HL7 standards.

Stand-alone DAMs will be made available at no cost during the one-year pilot, including: • HL7 Version 3 DAM: Cardiology; Acute Coronary Syndrome • HL7 Version 3 DAM: Clinical Trials Registration and Results • HL7 Version 3 DAM: Analysis Model: Vital Records

Functional profiles for the HL7 Electronic Health Record System Functional Model (EHR-S FM) will also be available as part of the pilot program. The HL7 EHR-S FM was the industry’s first standard approved by the American National Standards Institute (ANSI) to specify the functional requirements for an electronic health record system. HL7’s functional profiles outline the important features and functions of an EHR system, including criteria to support functions such as medication history, clinical decision support, and privacy and security. Profiles that are available to support specific uses across the continuum of care include: • Child health • Behavioral health • Long-term care • Clinical research • Records management and evidentiary support

“HL7 standards are the most widely used in the industry,” said Don Mon, PhD, chair, HL7 Board of Directors. “These standards will be especially useful to physicians, nurses and other health care professionals, as well as health information management/technology (HIM/HIT) professionals. Making these standards available at no cost will further our mission to enhance the exchange, integration, sharing, and retrieval of electronic health information around the world.”

The HL7 DAMs and functional profiles can be accessed at the HL7 online store or through the HL7. org home page. Users must complete a click-through license registration process to participate.

® Health Level Seven and HL7 are registered trademarks of Health Level Seven International, registered in the US Trademark Office In This Issue... ® Adoption of HL7 CDA HL7 Pilot Program Provides Key Intellectual Property Free of Charge...... 1 to Connect Clinical Trial Data, EHRs:

Adoption of HL7 CDA® to Connect Clinical Trial Data...... 2 Technology to Support Patient Care, Meaningful Use Stage 2 Standards Speed Process from “Bench to Bedside” Proposed Rule Selects Additional HL7 Standards...... 3

Update From Headquarters...... 4-5 HL7 recently announced a collaborative directly to the point of care and facilitate effort with the National Cancer Institute data analysis. Physicians will have a more Demo at HIMSS12 Showcased Benefits of Consolidated CDA...... 6 (NCI) to use the HL7 Clinical Document complete picture of the care provided to Implementations of the HL7 Architecture (CDA®) in a unique way that their patients during clinical trials, and the Context-Aware Knowledge Retrieval (“Infobutton”) Standard...... 7 solves the problem of connecting clini- project will also help facilitate data analysis

Clinical Genomics: Determined to Stay cal trial data to patients’ electronic health that may speed the availability of new treat- Ahead of Game-Changing Technologies 8-9 records (EHRs). ments to patients. News from the PMO and Project Services Work Group...... 10-11

Interoperability throughout a Corporate “This is a significant advance in HIT con- According to John Speakman, chief program Integration Platform Using HL7 nectivity because it brings clinical trial data officer for the NCI’s Center for Biomedical Standards...... 11-13 directly to patients’ personal physicians, Informatics and Information Technology, the News from the PBS Metrics Team...... 14 which means we can improve patient care program will lower the barriers for systems LCAM: Local Clinical Alarm Manager for COPD’s Chronic Patients from by speeding the process of moving medi- to interoperate in the service of biomedical the Belearic Islands...... 15 cal advances from bench to bedside,” said research and, ultimately, precision medicine. Andalusia Health Services: A New SOA and HL7 Strategy...... 16-17 Bob Dolin, MD, FACP, vice chair of the HL7 To reach these goals, the use of HHS-en-

Electronic Surveillance of Healthcare- Board of Directors and co-editor of the CDA. dorsed industry standards such as HL7 CDA Associated Infections Using HL7’s “Studies have shown that right now it can must be part of the picture, he said. Arden Syntax...... 18-20 take seven years or more for new research Upcoming International Events...... 20 advances to be put into clinical practice. The HL7 CDA addresses universal require- HL7 International Project Supports the US Office of Personnel Management’s We can make that process much quicker by ments for the exchange and management of Blue Button® Requirements...... 21 improving physician access to clinical trial structured clinical documents. It supports Certification Exam Congratulations 22-23 data, and by expressing clinical trial data us- the exchange of clinical documents between One Step Closer to Secure EHRs and mHealth...... 24 ing meaningful use EHR standards.” those involved in the care of patients and

Health IT Standards – What Went allows for the re-use of clinical data for Wrong?...... 25-26 The new project demonstrates that clinical public health reporting, quality monitoring, HL7 Benefactors...... 26 trial data can be packaged using the same patient safety and clinical trials. Organizational Members...... 27-29 HL7 standards that are incorporated into 2012 Technical Steering EHRs that meet the Stage 1 meaningful use The program will be launched as a pilot Committee Members ...... 30 criteria of the US Office of the National Co- program later this year. Steering Divisions...... 30 ordinator (ONC) to bring clinical trial data HL7 Work Group Co-Chairs...... 31-33

HL7 Facilitators...... 34-35

Affiliate Contacts...... 36

HL7 Staff Members...... 37

2012 Board of Directors...... 38

Upcoming Working Group Meetings...... 39 Educational Summits...... 40 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 Meaningful Use Stage 2 Standards Proposed Rule Selects Additional HL7 Standards

By Keith Boone, Director, HL7 Board of Directors; and Standards Architect, GE Healthcare; and Austin Kreisler, Chair, HL7 Technical Steering Committee and Technical Fellow, SAIC

The Meaningful Use Stage 2 Standards Under the Meaningful Use regulation, a clinical sum- and Certification Rule was published mary must include patient demographics, provider in- in the Federal Register March 7, 2012. formation, date and location of the visit, reason for the The long awaited changes to the visit, problem, medication and allergy lists, procedures Meaningful Use regulations now in- performed, immunizations or medications administered Keith Boone clude three additional HL7 standards during the visit, vital signs, test results and pending and implementation guides, including tests, care plan, referrals, and smoking status. the IHE Health Story CDA® Consoli- dation Implementation Guide Draft The availability of new document types under Meaning- Standard for Trial Use (DSTU), the ful Use means that providers can use the appropriate HL7 2.5.1 S&I Framework Lab Results type of document to record information about the visit, Interface Informative Document, and and supply that record to the patient as a clinical sum- the HL7 Context Aware Knowledge mary. This was one of the key goals of the IHE Health Story Consolidation project. Retrieval (InfoButton) standard. The US Health IT (HIT) Standards Com- Lab Results Interface mittee also recommended that only Austin Kreisler The HL7 2.5.1 Lab Results Interface Implementation one standard be used for Electronic Guide is the result of collaborative efforts between HL7 Laboratory, Immunizations, and Syndromic Surveil- and the Health and Human Services Standards and lance reporting to Public Health. Under Stage 1, the HL7 Interoperability Framework Laboratory Results Inter- Version 2.3.1 and 2.5.1 standards were available for face Initiative. This guide addresses the challenges of those purposes, but now only HL7 Version 2.5.1 is being reporting lab results to ambulatory providers, harmo- proposed. They also selected HL7 2.5.1 implementation nizes previous HL7 efforts on laboratory reporting, and guides for each of those purposes, although no guide addresses regulatory requirements under the Clinical was selected for Syndromic Surveillance from ambula- Laboratory Improvement Act (CLIA). It provides clear tory environments (that work is currently in progress conformance requirements for implementing laboratory in the International Society for Disease Surveillance results interfaces in the ambulatory setting. The new (ISDS)). guide generated hundreds of ballot comments in its initial round of balloting, has been substantially revised IHE Health Story CDA Consolidation based on reconciliation of those comments, and will Implementation Guide go through an additional round of balloting in the near The IHE Health Story Consolidation Draft Standard for future with the goal of achieving draft standard status Trial Use was developed jointly by members of HL7, later this summer. IHE, Health Story and the ONC Standards and Interoper- ability Framework team. The new guide includes nine InfoButton document templates: While most of what appeared in Meaningful Use Stage 2 was quite predictable, as ONC closely followed the HIT • Continuity of Care Document (Version 1.1) Standards Committee Recommendations, there was one • Consultation Note surprise in the rule for some readers. The HL7 Context • Diagnostic Imaging Report Aware Knowledge Retrieval Standard, otherwise known • Discharge Summary as InfoButton, was selected as part of the required set of • History and Physical (H&P) Note standards to support Clinical Decision support for two • Operative Note separate cases. It is required to be supported by EHRs to enable clinician access to reference information on • Procedure Note problems, medications, allergies, lab results and other • Progress Note structured content of the medical record, and also en- • Unstructured Document ables access to patient-specific education materials.

MAY 2012 3 Update from Headquarters By Mark McDougall, Executive Director, HL7

Mark McDougall

January Meeting Bob will continue to serve on the James Ferguson of Kaiser Perma- More than 400 attendees participated board as the vice chair. nente, Edward Tripp with Edward in our January Working Group Meet- S. Tripp and Associates, and Diego ing held in San Antonio, Texas, Janu- We also recognized three outgoing Kaminker from HL7 Argentina. Fol- ary 15-20, 2012. Over 40 HL7 work board members who served terms on lowing terms as the affiliate director groups met in San Antonio, of which the HL7 Board of Directors: Bill Braith- on the board, Michael van Campen 29 work groups conducted co-chair waite, MD, PhD; Hans Buitendijk; of Gordon Point Informatics was also elections for 42 positions. Attendees and Dennis Giokas. All three contrib- elected to serve as the treasurer of also took advantage of 30 tutorials uted heavily to important and valu- the board. We look forward to work- that week. able roles for the HL7 organization ing with all of these individuals along throughout their many years of service with the entire 2012 HL7 Board of Di- Board Changes to HL7. Sincere thanks also goes to rectors that are listed on page 38. On The New Year brought a change at Bill and Hans for their years of service behalf of the entire HL7 organization, the helm of the HL7 Board of Direc- on the HL7 Finance Committee. I thank each member of the board for tors. We welcomed Don Mon, PhD their ongoing leadership and contributions to HL7.

Meeting Sponsors I am also pleased to recognize the following organizations that sponsored key components of our recent Janu- ary Working Group Meeting in San Antonio:

• LINKMED Bob Dolin, MD Bill Braithwaite Hans Buitendijk Dennis Giokas • iNTERFACEWARE MD, PhD • Gordon Point Informatics to the start of • Beeler Consulting LLC his two-year term • SPARX as board chair. We also recognized the The additional sponsorship support many contributions provided by these organizations of outgoing board heavily contributes to HL7’s meeting chair, Bob Dolin, budget and is much appreciated. MD. It has been a treat to work with HIMSS Bob during his For over 20 years, HL7 has exhibited term as chair James Ferguson Edward Tripp Diego Kaminker each year at the annual conference of and we thank the Healthcare Information and Man- him for his brilliance and ongo- As previously announced, we are agement Systems Society (HIMSS). ing calmness which he consistently pleased to welcome three new Direc- This year’s HIMSS conference con- brought to any situation we faced. tors on the HL7 Board of Directors: vened in Las Vegas, Nevada dur-

4 MAY 2012 Benefactors and Supporters We are thrilled to have attracted the all time highest number of HL7 benefactors and supporters, who are listed on page 27. Their support of HL7 is very much needed and sincerely appreciated. We are pleased to recognize our benefactors in all of our HL7 newsletters, on the HL7 website, in our HL7 press releases, and at all of our HL7 working group meetings. A special thank you is extended to the list of firms that represent our 2012 HL7 benefactors and supporters.

Organizational Member Firms As listed on pages 27-29, HL7 is proud to report that the number of HL7 organizational member companies is at an all time high of 758 companies. We sincerely appreciate their ongoing support of HL7 via their organizational membership dues.

In Closing HL7 Vice Chair, Bob Dolin, MD, gives a presentation at the HL7 Booth at HIMSS12 As I write this article, two of my favorite events are occurring this ing the week of February 20, 2012. Bob Dolin, MD weekend: St. Patrick’s Day and the HIMSS12 reportedly attracted over John Gutai 37,000 people. annual basketball tournament in Freida Hall the US that involves teams from 64 Chuck Jaffe, MD, PhD HL7’s Director of Communications, universities participating in “the Andrea Ribick, oversaw the produc- Mark Janczewski dance” or “March Madness.” May tion of 27 thirty minute presenta- Thom Kuhn you and your loved ones be blessed tions on HL7 standards and relevant Ken McCaslin with a winning season and plenty of fun dancing. topics. Many of the presentations at- Don Mon, PhD tracted crowds that filled the theater Galen Mulrooney area and were standing room only. John Quinn I also wish to express our sincere Ken Rubin thanks to the many individuals who volunteered to staff our booth and/or Scott Robertson, PharmD make presentations in our booth, Dave Shaver including: Jim St. Clair Sandy Stuart Calvin Beebe Michael van Campen Woody Beeler, PhD Grant Wood Alan Brookstone, MD Jim Case, MD

MAY 2012 5 Health Story Demo at HIMSS12 Showcased Benefits of Consolidated CDA® By Liora Alschuler, HL7 Health Story Project Liaison; Health Story Project Executive Liora Alschuler Committee Member; Co-Editor of the HL7 CDA; and CEO, Lantana Consulting Group

HL7 associate organization, the Health date them into one implementation Story Project, demonstrated use of the guide along with the HL7 Continu- HL7 Implementation Guide for CDA ity of Care Document standard. Release 2: IHE Health Story Consolida- Consolidated CDA offers a national tion, Release 1 – US Realm for the first foundation for exchange of infor- time at the HIMSS12 Interoperability mation collected in clinical docu- Showcase with a use case provided by ments and is a huge step forward the American College of Physicians. for health information interoper- The demonstration highlighted how 12 ability in the US. vendors used Consolidated CDA to maximize information available throughout a transition of care using all avail- Health Story members featured in the HIMSS12 demon- able channels—from unstructured, scanned documents to stration included: Apixio, Canon U.S.A, ChartLogic, Fujit- dictated notes enriched with abstractor, computer-assisted su, Inofile, Lantana Consulting Group, M*Modal, Nuance, and NLP coding—while maintaining the patient story. Optum and Verizon. Health Story is discussing plans with its members for the HIMSS13 demonstration. Interested On the last day of the showcase, the national coordina- vendors should contact Joy Kuhl at joy@optimalaccords. tor for HIT, Farzad Mostashari, MD, challenged partici- com. Visit www.healthstory.com for more information pants to demonstrate readiness for integration by securely about the project, and http://www.hl7.org/implement/ exchanging information with an unrelated partner on the standards/product_brief.cfm?product_id=258 for more floor within one hour. The Health Story Project partici- information about Consolidated CDA. pated in the challenge and was successful in exchanging a clinical document within the deadline with two separate demonstration partners. A History & Physical was sent by way of the Verizon Medical Data Exchange to the STEM Transition of Care Pilot and to EHR vendor, OnBase, using Consolidated CDA. The exchange reveals the effectiveness of Consolidated CDA for exchange of health data at a moment’s notice.

The mission of the Health Story Project is to unlock the valuable data in clinical notes and make possible an unrestricted flow of this narrative-source data into EMR and other systems for use within healthcare enterprises and health information exchanges. Over the previous four years Health Story supported development of eight HL7 implementation guides for common clinical documents as well as last year’s effort with HL7, IHE and the Susan Lucci, AHIMA Liaison to Health Story and Linda Brady, ONC Standards & Interoperability Framework to consoli- Acting CEO, AHDI and CDIA 6 MAY 2012 Implementations of the HL7 Context-Aware Knowledge Retrieval (“Infobutton”) Standard

By Guilherme Del Fiol, MD, PhD, Co-Chair, HL7 Clinical Decision Support Work Group and Department of Biomedical Informatics, University of Utah; and Howard Strasberg, MD, MS, Co-Chair, HL7 Clinical Decision Support Work Group and Wolters Kluwer Health

The high frequency To enable scalable and effective Infobutton Standard, we interviewed of clinicians’ pa- integration between EHR/PHR representatives of 17 organizations tient care informa- systems and knowledge resources, that implemented the standard, tion needs that go the HL7 Clinical Decision Support including EHR vendors, health- unanswered is a (CDS) Work Group developed the care organizations, and knowledge well-known prob- Context-Aware Knowledge Re- publishers. An article presenting Guilherme Del Fiol MD, PhD lem. Estimates trieval (“Infobutton”) standard. The the results of this study has been vary from 0.2 to 3 Infobutton standard consists of a published in a special issue of the information needs per patient seen set of specifications that include Journal of Biomedical Informatics and about half of these needs are a normative specification and two dedicated to standards in practice.5 not met.1 Online health knowledge implementation guides. The norma- The analysis identified 20 recur- resources have answers to most tive specification (http://www.hl7. rent themes. Overall, interviewees of these questions, but important org/implement/standards/prod- underscored the benefits, simplic- barriers limit their use at the point uct_brief.cfm?product_id=208) ity, and flexibility of the Infobutton of care.2 An increasingly popular ap- has been recently included in the Standard. On the other hand, par- proach to help clinicians and patients draft EHR Meaningful Use Stage 2 ticipants requested easier access to meet their information needs is to Standards and Certification Cri- standard specifications and guidance enable context-specific access to teria. This specification defines a to novice implementers who are knowledge resources within EHR and shared context information model not familiar with HL7. Participants PHR systems via Infobuttons.3 Based to be implemented by EHR/PHR also requested easier access to HL7 on the clinical context in an EHR/ systems and knowledge resources. terminology assets that are used PHR (e.g., patient data, task, user The first implementation guide, in the Infobutton Standard. Imple- attributes, care setting attributes), URL-Based Implementations of the menters expect that the Infobut- Infobuttons anticipate clinicians’ Context-Aware Information Retrieval ton Standard will be widely or at and patients’ information needs and Domain (http://www.hl7.org/imple- least fairly well adopted. However, provide automated links to relevant ment/standards/product_brief. uptake will depend especially on the knowledge resources. For example, cfm?product_id=22), specifies adoption by EHR systems, which from a problem list of a 73 year old Infobutton implementations using should be significantly accelerated female, an Infobutton may provide simple URLs. The second imple- by the requirement to implement access to specific inpatient treatment mentation guide is a draft standard the Infobutton Standard defined in guidelines of community acquired for trial use (DSTU) called Context- the EHR Meaningful Use Stage 2 pneumonia in this age group. In Aware Knowledge Retrieval, Service- Standards and Certification Criteria. addition, the same Infobutton could Oriented Architecture (SOA). The Widespread adoption of the Infobut- provide access to patient education SOA implementation guide specifies ton standard has the potential to material on community acquired SOAP and RESTful Infobutton imple- bring contextually relevant clinical pneumonia to be given to the patient mentations. In addition, this docu- decision support content into the upon the patient’s discharge. Stud- ment specifies a standard knowledge healthcare provider workflow as ies have shown that clinicians who response payload based on the IETF well as to educate patients about accessed Infobuttons were able to Atom Standard. their health care and treatment op- meet their information needs in 86% tions, enabling patient engagement of the Infobutton sessions, reporting To assess the perceived adoption, and patient-centered care. enhancement of patient care deci- benefits, challenges, and lessons sions in 62% of these sessions.4 learned of implementers of the HL7

1. Smith R. What clinical information do doctors need? Bmj. 1996;313(7064):1062-8. Epub 1996/10/26. 2. Ely JW, Osheroff JA, Chambliss ML, Ebell MH, Rosenbaum ME. Answering physicians’ clinical questions: obstacles and potential solutions. Journal of the American Medical Informatics Association : JAMIA. 2005;12(2):217-24. Epub 2004/11/25. 3. Cimino JJ, Elhanan G, Zeng Q. Supporting infobuttons with terminological knowledge. Proceedings : a conference of the American Medical Informatics Association / AMIA Annual Fall Symposium AMIA Fall Symposium. 1997:528-32. Epub 1997/01/01. 4. Del Fiol G, Haug PJ, Cimino JJ, Narus SP, Norlin C, Mitchell JA. Effectiveness of topic-specific infobuttons: a randomized controlled trial. Journal of the American Medical Informatics Association : JAMIA. 2008;15(6):752-9. Epub 2008/08/30. 5. Del Fiol G, Huser V, Strasberg HR, Maviglia SM, Curtis C, Cimino JJ. Implementations of the HL7 Context-Aware Knowledge Retrieval (“Infobutton”) Standard: Challenges, strengths, limitations, and uptake. Journal of biomedical informatics. 2012. Epub 2012/01/10. MAY 2012 7 Clinical Genomics Determined to Stay Ahead of Game-Changing Technologies Mollie Ullman-Cullere

By Mollie Ullman-Cullere, Co-Chair, HL7 Clinical Genomics Work Group and Senior BioMedical Informaticist, Dana-Farber Cancer Institute, Partners HealthCare System, Inc; Amnon Shabo, PhD, Co-Chair, HL7 Clinical Genomics Work Group and Head of the Healthcare and Life Sciences Standards Program, IBM; Grant Wood, HL7 Clinical Genomics Publishing Facilitator and Senior IT Strategist, Intermountain Healthcare; and Bob Milius, Senior Data Analyst, Bioinformatics Research, National Marrow Donor Program

The world of clinical genomics has changed rapidly since options for these patients, clinical tri- the genetics-themed plenary session held in Boston in als of whole-genome sequencing for Amnon Shabo, PhD October of 2010. Speakers discussed family health history this disease began in 2010. Based on and genetic data flowing into the electronic health record. mutations uncovered by sequencing, They talked about the ever expanding research with physicians ordered treatment proto- newly available and significantly larger genomic data sets. cols for either existing drugs, or new Yet with the healthcare industry talking about personal- agents being evaluated in pharma- ized medicine, data models and transmission standards sponsored clinical trials. have been slow in adoption and implementation. A major challenge in whole genome The earth-shattering news now is that research from the sequencing is the interpretation of the Grant Wood National Human Genome Research Institute shows sequenc- genetic data for use in diagnostic and ing costs dropping like a rock falling from the sky. In fact, treatment decisions. Many vendors they are outstripping the exponential curves of Moore’s Law. are developing software that will help Whole genome sequencing has fallen at a record-setting rate clinicians interpret and understand of $100 million 10 years ago to just $1,000 today. The first genetic data for clinical application. radically steep drop appeared in 2008 with the introduction Collaborations between vendors, of next generation sequencing technologies. academic research, and healthcare providers are beginning to identify best

We should be able to perform ever larger studies to cor- practices for diagnostic development Bob Milius relate genes with medical histories due to the falling and gene discovery as a model for ge- sequencing prices. Disruptive technologies have set the nome sequencing in a clinical setting. stage for an accelerated revolution in both research and clinical genetics. Clinical Genomics Roadmap Previous work done by the Clinical Genomics (CG) Work Next Generation Sequencing Impacting Group helps support these new technologies. The Pedi- Clinical Care gree (family health history) Model passed normative Research publications, news stories, and scientific confer- ballot in 2007, and the CCD® was extended to support ences are already focusing on the use of whole genome transmission of family history summations. Yet efforts are or exome sequencing in the clinic. As an example, triple still required to gain wider adoption of the standard. Hope negative breast tumors, which make up nearly 20 per- increased dramatically when capturing family history us- cent of breast cancers, do not respond to treatment with ing coded data was announced as part of Meaningful Use targeted therapies such as Herceptin. To investigate new Stage 2 proposed standards.

8 MAY 2012 Two Version 2 implementation guides which extend the the National Marrow Donor Program (NMDP). This pilot 2.5.1 Laboratory Reporting Guide to support structured/ includes developing use cases and storyboards, which codified reporting of cytogenetic and genetic variation will be used to guide structured document design and test results passed informative ballot in January and will model refinement, as well as exchanging data using HL7 be published this spring. As the second release of the containers and payloads. genetic variation guide, this included support for additional use cases based on early adopter feedback and HL7 Multi-Workgroup Collaboration improved structuring of interpretation and links to public Critical for Success knowledgebases. Work is continuing on gene expression The CG Work Group actively collaborates with a number profiling and a CDA® implementation guide for genetic of other HL7 work groups, including Orders and Observa- test reports. An OMICS domain analysis model (DAM) tions (O&O), Anatomic Pathology (AP), Clinical Decision will be created and aligned with a life science DAM and Support (CDS), Image Integration (II), Regulated Clinical the BRIDG model. Research Information Management (RCRIM), Clinical Interoperability (CIC), and Marketing. Two new projects Moving Forward with Projects and Pilots began this spring: CG is working with II, CDS, AP, and Recently, the CG Work Group has launched several new Lab on O&O’s specimen CMET release 2 and clinical projects: reaffirming family health history, expanding it sequencing will look to Lab, O&O, AP, and SD for mes- with a release 2, clinical sequencing, and an implementa- saging components within the overall clinical sequencing tion guide for CDA genetic test results, as well as partici- workflow. CG and CDS have a long-term collaborative pation in release 2 of the specimen CMET. effort around family history and the pedigree model. CG is working with CIC on overall strategy for development Last year the work group began a project reaching out of the OMICS DAM, examining strategy which supports to stakeholders involved in next generation sequencing cross organization collaboration of aligned DAMs which technologies. The issues to be addressed are: (1) what support a wide variety of stakeholders from research to are the compelling initial use cases for full sequencing, clinical trial to clinical environments. (2) what are the requirements for scaling out from research use to robust clinical applications, (3) who are the Happening faster than anyone predicted, we will have an likely early adopters and how will we engage them in the understanding of our genomes such that getting everyone standards process, and (4) what are the likely systems sequenced will make both medical and economic sense. architectures that will evolve in order to accommodate We need to keep in mind, however, that falling prices are genetic sequences. simply the first step. Clinical interpretations are still coming slowly – for now any way. And the Clinical Genomics Work The CG Work Group is also exploring the use of HL7 Group will continue its efforts to stay ahead of the curve. standards for messaging and structured documents to address the challenge for recording and reporting HLA typing results. The matching of stem cell donor (bone marrow, peripheral blood or umbilical cord blood) to a recipient is determined by comparing their tissue types, and is known as Human Leucocyte Antigen (HLA) types. The CDA implementation guide for genetic testing reports (CDA GTR) will be further constrained and specialized for use in HLA typing reports. A pilot is being developed to exchange HLA typing results within HL7 messages and documents between two clinical groups (Hadassah Medical Organization and Northwestern University) and

MAY 2012 9 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

SAIF Pilot Project Services is happy to be working The forum is Coordination Project on this effort to help move HL7 toward open. Please come Project Services is leading this project, the adoption of the SAIF architecture. forward with any which is sponsored by the Techni- We appreciate and welcome the contri- project questions, cal Steering Committee. The primary butions from all those involved in the concern or idea. deliverable of the SAIF Pilot Coordina- SAIF AP projects. We’d love to have tion project will be to create concrete you join us! examples of artifacts that can be used Guidance for Steering Divi- Freida Hall in a future version of an HL7 SAIF sion Co-Chairs: Using PBS Webinar Re- implementation guide. Metrics to Evaluate WG cording: HL7 Capacity to Undertake Project Man- SAIF Pilot Coordination will assist in New Efforts agement Tool the documentation of processes en- Project Services has created a new Overview for countered throughout the development document offering suggestions and HL7 Project of projects under the SAIF AP (Archi- guidance for steering division co-chairs Facilitators tecture Program) umbrella that require on using the PBS (Projects Ballots and In case you didn’t input from more than one work group. Standards) Metrics to evaluate work know, the HL7 group capacity when they are under- PMO recorded The team has used RASCI charts to taking new projects. a webinar that Rick Haddorff capture the roles and responsibili- provides an overview of the various ties of groups in these efforts. The In addition to referencing the PBS Re- HL7 Project Management tools. To first use of this tool was to capture ports link located on the work group’s view the 38 minute webinar recording, the interactions between groups as a HL7.org page and the PBS Metrics go to www.HL7.org > Resources > modeling tool was selected for use in Excel report located in GForge, the Webinar Recordings. the Orders and Observations Compos- document contains a list of potential ite Order project. The team has also issues and questions which steering This session, targeted for co-chairs and used Project Insight to help model the division co-chairs can pose to the those leading HL7 projects (i.e. project dependencies between the SAIF pilot work groups. facilitators), demonstrates HL7 project projects’ activities. tools including Project Insight (HL7’s The document is located at www. primary project repository), the HL7 Additionally, the team has begun to HL7.org > Resources > Tools & Searchable Project Database, GForge, use a concept mapping tool to present Resources > Project Tracking Tools as well as review HL7 project process- the dependencies diagrammatically. (http://www.hl7.org/documentcen- es and methodologies. This is the work we will be focusing ter/public/wg/projectServices/PBS- on in the next several months. MetricGuidanceforSDCoChairsFinal. If you would like the PMO to pres- doc). ent this webinar at one of your Overall, the Project will document Steering Division or Work Group coordination conducted by over 12 Come Join Us for the Project conference calls, please contact HL7 work groups as they proceed Management Roundtable Dave Hamill at [email protected] to through over 9 projects under the SAIF Every working group meeting, Project schedule a day and time. AP umbrella. From this coordina- Services hosts an informal gathering tion, suggested contributions to SAIF at lunchtime on Wednesday called HL7 Project Tracking Tools Governance documents will be created the Project Management Roundtable. All of HL7’s project tools, including the as well as modifications to the HL7 Look for the tent card with “Project Searchable Project Database, GForge Project Life Cycle for Product Develop- Managers” on it in the general session/ and Project Insight, are available on ment (PLCPD). lunch ballroom. www.HL7.org via Participate > Tools & Resources > Project Tracking Tools. 10 MAY 2012 Interoperability throughout a Corporate Integration Platform Carlos Tellería Orriols Using HL7 Standards

By Carlos Tellería Orriols, Integration Manager, SALUD

The Public Healthcare Provider of the Aragón Autono- In June 2007, the first interfaces went into production, and mous Community of Spain (SALUD) is responsible for Rhapsody has operated continuously since then. Today, the healthcare delivery to 1.34 million inhabitants in the Rhapsody provides the basis for integration between the Aragón region in northern Spain. With an annual budget different information systems of the Department of Health of 1.8 billion in 2012, SALUD covers a geographical area of of Aragón. There are currently nine instances of Rhapsody 47,719 km. in production, one for each territorial sector of Aragón, as well as the central node. SALUD, through its hospitals, primary health centers and other specialty facilities, offers a comprehensive portfolio of The HL7 Version 2.5 standard was adopted at the begin- services to citizens, including: ning of the project for every message passing through the • Primary care integration engine. An implementation guide for Aragón is • Acute care currently being compiled and is expected to be published • Chronically dependent care (skilled nursing) this year. • Mental health • Emergency The deployment of Rhapsody in Aragón is being led by the • Public health Center for Integrated Management of Corporate Projects • Pharmaceutical benefits, orthoprosthetic, dietary (CGIPC) of SALUD. The development and maintenance team products and health transport is composed entirely of C2C Consulting TSIS consultants.

The public health system is divided into eight geographi- Case I: Patient Unique Identification at cal sectors, each of of which has a reference hospital. The Corporate Level health district is the basic territorial framework for primary At Aragón Health Service, a unique identifier has been health care, having direct access to the population and with defined for every patient (CIA, Autonomic Identification the ability to provide ongoing support, and includes: Code), in such a way that they are uniquely identified • 124 Primary care centers across all facilities and devices inside the health system. • 990 Primary care physicians This code is automatically created and managed by an • 167 Pediatric physicians Enterprise Master Patient Index (EMPI) system. The normal • 933 Primary care nurses operation of the system comprises two circuits, related to the patient’s entry points to the health system: primary In December 2006, the interoperability project began as the care and emergency services at hospitals. basis for the IT strategy for the public health system. Orion Health Rhapsody was chosen for this purpose, mainly for Clinical systems are permanently synchronized with the de- its simple, efficient, robust manner, independent of vendor- mographic database and EMPI for primary care since specific technology. continued on page 12

MAY 2012 11 Interoperability, continued from page 12

patients have been previously granted their healthcare assurance. When a new patient is created in the assurance database, a notification is sent to an EMPI Web Service, which creates a unique ID (CIA) for that patient and then returns the information to the demographic database. This database broadcasts an ADT A28 message to all primary care systems.

The circuit is more complex with the hospital emergency system. A patient may not exist in the EMPI system, but it is mandatory to provide assistance to him or her in a secure way. In normal conditions, when a patient arrives at emergency, HIS sends an ADT message Case 1: EMPI at Aragon Health Service to EMPI, which identi- fies that patient and broadcasts a merge message A34 to all involved systems in returns his or her unique ID (CIA), creating it if necessary. which the temporary CIA is replaced by a permanent one. Thereafter, HIS keeps that identifier and includes it in This operation allows for the restoration of identifiers and every message sent to third party systems, such as RIS or guarantees that the patient’s healthcare and correct identifi- laboratory. cation are provided at all times.

If a communication problem occurs when a patient hasn’t Case II: Simultaneous management of yet been assigned his or her unique CIA, the EAI bus, laboratory orders and appointments with responsible for communications among systems, detects a HL7 messages SIU or ORM message lacking a CIA and tries to look for it SALUD has an electronic health record tool for primary in the EMPI. If this operation is not possible, EAI assigns a healthcare that allows the generation and sending of labora- temporary unique ID to the patient with the format “PROV” tory orders, but it does not support appointment manage- + Local History Number, and adds a PID.3 element to the ment for analytic tests. Admission staff at the specialty message with this ID. Once communications are restored, facilities usually performs this action. and with the permanent CIA already created in EMPI, EAI SALUD has also developed a custom solution (LabRM,

12 MAY 2012 Laboratory Request Manager) for managing both lab All the logic inside the processes for selecting schedules, orders and patients’ appointments for analytic tests. This finding schedule gaps, trying to fix an appointment (re- solution is multi-lab and multi-requester, and connectiv- cursively if needed), and composing a message that joins ity is defined with a set of HL7 messages for managing order and appointment details, has been developed over orders as well as appointments. OpenESB BPEL engine.

Aiming to facilitate patient appointments, and also with All integration routes and traffic management have been the goal of reducing pressure on admission personnel, a implemented with the Orion Health Rhapsody Engine. route has been developed between primary care systems IT staff at SALUD, in collaboration with C2C consultants, and LabRM. Beginning with the order request, the route is developed the system. as follows: • Registers laboratory orders • Selects the correct extraction point and schedule depend- ing on order type requested • Assigns appointments finding first available gap on that schedule • Links appointment to order • Returns the appointment details to the clinical application

Thus, patients leave their consultation with both the appointment and the lab order simultaneously.

LabRM is also responsible for sending requests to laboratory, and managing results as well as forwarding them to clinical systems. These transactions are delivered using standard OML/ORL and ORU/ACK schemes. Case II: SALUD’s LabRM system

MAY 2012 13 News from the PBS Metrics Team By HL7 International Staff Members Dave Hamill, Director, Project Management Office; Lynn Laakso, TSC Project Manager; Don Lloyd, PhD, Director of Technical Publications; and Karen Van Hentenryck, Associate Executive Director Dave Hamill

PBS Metrics (Projects, Ballots and Standards) through 3 or more ballots Report 4. Expired DSTUs - Expired DS- The PBS Metrics Team would like to thank all the work TUs that have not proceeded to group co-chairs, project facilitators and everyone else that normative or some other ballot had a hand in cleaning up their ‘infractions’ (i.e. red items). level The team continues to enhance reporting, visibility and 5. Unpublished CMETs - CMETs resources to make it as easy as possible for work groups to that are finished (passed by address problem areas. On HL7.org, via Resources > Work numbers and Recon is com- Groups, you can now find forms, templates and process plete) but unpublished (wait- Lynn Laakso documentation to help you address PBS infractions. ing for the CMET clean-up work to be completed by Andy PBS Metrics Work for 2012 Stechishin and Dave Hamill) The PBS Metrics Team will focus on making the PBS infor- 6. Unpublished Ballots - Items mation easier to access and more visible. A link to the PBS that are finished (passed by Metrics Excel report will be added to every work group’s numbers and reconciliation webpage on www.HL7.org as well as the HL7 Search- is complete) but unpublished able Project Database. ‘Interim’ reports will be published (not in Normative Edition or on between working group meetings (WGMs) to provide more HL7 Standards page) timely information. Co-chairs will be provided their Project 7. Projects in Project Insight that Don Lloyd, PhD Insight login credentials prior to WGMs so project clean up are behind more than 120 Days will be easier. PBS Team members will assist in creating 8. Projects in Project Insight with educational material on HL7 balloting, and the Searchable an ‘Unknown’ status Project Database will be modified to indicate if the project 9. Work groups that do not have has a PBS Metrics infraction. any 3-Year Plan Items in Project Insight PBS Metrics Reports and Dashboard The PBS Metrics reporting and dashboards are easily ac- The PBS Metrics Report was created cessible via the Reports link on your work group’s HL7. to support the HL7 strategic initia- org page. This link directs you to GForge, where the report tive to “streamline the HL7 standards development process.” It is intended resides within the TSC’s File area (http://gforge.hl7.org/ Karen Van Hentenryck gf/project/tsc/frs/?action=FrsReleaseBrowse&frs_pack- to be a tool to assist work groups age_id=169). with managing ballots in addition to cleaning up projects and old data. By reviewing the reports, work groups can As a reminder, the PBS reporting and dashboards reflect identify potential issues before they get out of hand as well the following criteria for each work group: as move items through balloting to a final document or standard state. 1. Idle Ballots - Items that haven’t balloted in a year, and are still “open” (haven’t successfully complet- If you have any questions or comments, please direct ed their ballot) them to any PBS Metrics team member: Dave Hamill 2. No Recon Package - Items that have not had a rec- ([email protected]), Lynn Laakso ([email protected]), Don onciliation package posted Lloyd ([email protected]) and Karen Van Hentenryck 3. Non-Advancing Ballots - Items that have gone ([email protected]).

14 MAY 2012 LCAM: Local Clinical Alarm Manager for COPD’s Chronic Patients from the Balearic Islands

By A. Conde Geli, M. Pons Crespí, M. N. Melià Aguiló, J. C. Amer Oliver, F. Tous Llull, Integration Competency Center (http:// cci.ibit.org), Department of Health, Fundació iBit

Abstract Project Aim The present article defines the Local Clinical Alarm • Assistance improvement: support for the clinical Manager (LCAM), an interoperability project of sev- professional upon the monitoring and treatment of eral information systems related to the monitoring and the chronic disease COPD early diagnosis of Chronic Obstructive Pulmonary Dis- • Minimization of COPD infra-diagnosis, easing an ease (COPD), which applies algorithms which reflect early diagnosis of people within EPOC risk the reference clinical practice guides. The project’s scope is defined within the Balearic Islands’ health and Designing a Prototype Solution for COPD sanitary environment. The prototype design had to include a previous synchronization step between the patient that is being LCAM is generic and configurable, and allows profes- queried by the clinical professional and LCAM. This sionals to monitor one or several chronic diseases. The synchronization process is carried out by implementing architecture is based on a Services Oriented Architecture CCOW with LCAM within its client part and the clinical (SOA) model, and the synchronization with the local application used by the clinical professional. The clini- clinical application is carried out using the HL7 Clinical cal application instigates context changes, cascading Context Object Workgroup (CCOW) standard protocol. any change to the rest of applications which share the protocol (in this case LCAM) every time a new patient Introduction query is carried out. Once the clinical professional has Chronic diseases are the epidemics of the twenty-first carried out the patient query the application, a cascade century, especially in countries with a population with will be carried out within the new context, and LCAM a high aging rate. COPD is a cause of high morbidity, will gather information about whether the patient is or mortality and disability in Spain. It is estimated that is not at risk, or if COPD has been diagnosed. between 9% and 10% of the adult population over 40 years of age suffer from COPD, and that over 70% An absolute priority at the technical level, and in order of them remain undiagnosed. Chronic diseases entail to enable a progressive addition of other chronic diseas- costly and complex processes, and represent a big per- es, was to obtain a solution already adapted for re-us- centage of the sanitary costs. ability, flexibility and scalability in the future.

The information system (IS) that supports the Chronic Interoperating Information Diseases Alarm Manager will be referred to as LCAM in In order to enable the information’s interoperability, a this article. means of transport was needed, together with a synchronization standard between the desktop applications. The IS consists of a client part, installed in each pro- The HL7 CCOW and Version 3 standards were chosen. fessional’s personal computer, as well as a server part, which acts as an integration core with the different Future sanitary information systems. The client part is fed by In order to increase the functionalities of LCAM, the ac- the sanitary application which the professional is using tions that need to be carried out for this interoperability at the time—generally any application which uses HL7 project are as follows: CCOW as an integrated communication protocol. CCOW • Monitoring and early diagnosis of vascular risk/ informs the client part of the LCAM about the context diabetes mellitus patient—the patient about whom the clinical profes- • Monitoring of the specific care-giving programs sional is querying the sanitary application—and about which specific chronic diseases the professional is in- Conclusions terested in monitoring. Once this information has been The client LCAM has been set up in fifteen health collected, LCAM’s integration engine informs the client centers and three hospitals within the Balearic Islands. if it is necessary to display alarms which may interest In clinical literature, the most accepted proposal con- the clinical professional related to the patient who is sists of combining the presence of the main risk factor been queried at the time. (smoking habit), the age criteria (as age increases, the continued on page 17

MAY 2012 15 Andalusia Health Services: A New SOA and HL7 Strategy

By José Román Fernández Engo, Charge of Strategy for Interoperability, IT Department, SAS- José Román Andalusia Health Services Fernández Engo

The Servicio Andaluz de Salud (SAS – Andalusia Health The main objectives of the HL7 SOA strategy are: Services) is the public organization providing health ser- • Adoption of a strategy and an information policy vices in the Autonomous Community of Andalusia, Spain. and integration defined and stable over time SAS serves a population of 8 million people distributed in • Establishing a governance model that allows both a 33,694.4 sq mile territory through a network of approxi- the consolidation and dissemination of these poli- mately 85,000 health professionals working in 29 hospitals cies and the rules, master data, etc. and 1,500 PHC centers. • Definition, modeling and consolidation of organizational processes; and the definition and imple- Background mentation of sustainable life cycle models for all During the last decade, SAS has centered its IT efforts on necessary services whether or not technological providing a centralized information system for general prac- • The widespread application of rules and stan- titioners and pediatricians. This system covers the whole dards (HL7 2.x, CDA, CIE9, etc.) for process PHC (primary healthcare) level, including the patient elec- modeling and establishing responsibility for the tronic PHC record, an electronic prescription tool integrated information of the organization with private pharmacy offices; and a laboratory orders tool • The implementation of the services that establish accessible from public PHC premises throughout the entire and unify the interpretation of the information in territory. The project is named Diraya, which is the Arabic the organization word for knowledge. • The adoption of a syntax based communication standard common to all systems, the force of law However, public hospitals have remained mostly isolated IT derived from the modeling business environments characterized by locally developed or third • Hardware architecture for information manage- party solutions, with specific integrations at a local level ment and communications based technology and a discrete number of point to point integrations with standards, which ensure the exchange of informa- SAS corporate information systems. tion on the physical level

SOA Governance and HL7 Messaging The SOA Governance group of the SAS IT Department is The SAS strategic IT plan foresaw providing corporate so- responsible for the Interoperability Technical Office (OTI) lutions to tertiary care while respecting the particularities and is supported by and partnered with Accenture, who of IT ecosystems within the different clinical departments has broad experience in health business process and IT in each hospital as well as allowing for seamless infor- systems. The role of the OTI is to define communication mation exchange within the organization itself among interfaces between clinical applications and to define and all levels of care: with other public health organizations, standardize SOA services. It also coordinates develop- external providers, other regional health information ments made by the various players of the Andalusian Pub- systems, the Spanish Health Ministry and European health lic Health System (SSPA) for the construction of DIRAYA. authorities with the utmost security and reliability. The The OTI’s functions include the following: plan focuses on reducing IT and business costs, promoting • Implement the governance model defined by SOA IT reusability and ordered growth, and providing a solid governance group organization-wide basis for better clinical and manage- • Coordinate modeling process ment decision making. • Set rules and standards, use and dissemination policies and procedures To turn the plan into a reality, five years ago, the Subdi- • Establish and manage the service catalog rección de Tecnologías de la Información (SAS IT Depart- • Define master data of the organization and its ment), with the help of Red.es, undertook two complemen- responsibilities tary lines: building a comprehensive catalogue of corporate • Trace the path of convergence of systems to the services throughout the organization to fulfill the needs new model, project to project, as part of a global within hospitals and among different levels of care for clini- macro-project, ensuring coexistence with the cal and management purposes, and using an international existing systems and reliable standard for information exchange among • Integrate the actors participating in the SSPA health information systems. information management through a corporate or departmental policy dissemination of standards,

16 MAY 2012 Andalusia Health Services, continued from previous page

training activities and a certification program of • Decouples applications, allowing the independent developments aimed at interoperability evolution of business areas based on functional needs Main Results • Scalability and Sustainability Today, eight public hospitals are fully operational in the KNOWLEDGE MANAGEMENT DAE project. A tight deployment schedule is under way • Internalizes the knowledge of the business by to extend it to the other 22 hospitals. Organization-wide improving internal control projects and reversing logistics and IT management systems are also being progres- the knowledge in the organization, thus avoiding sively integrated into the SOA and HL7 messaging strategy. dependence on external agents Since the implementation of the strategy in September 2009, • Avoids data inconsistencies by having role models of important results have been achieved. The scope of these the information that reflect that data results more than justifies the investment, both economi- • Ensures interoperability of the organization both cally and in terms of effort, from the Directorate of IT in internally and externally internalization, dissemination and training. The results are summarized below: To illustrate these results, the following table shows some MANAGEMENT counters: • SOA and HL7 strategy from OTI in DAE has pro- duced a savings of 86% in development and implementation costs expected with a maximum reuse rate obtained with the SAS SOA Services Catalogue DEVELOPMENT • Provides documentation or reference to a lot of control in their evolution • Unifies support, simplifying the training of both technological and project management, etc. • Simplification and reuse of developments for these units “atomic” from the stand- point of business functionality and not its technological configuration

LCAM, continued from page 15 disease’s prevalence increases), and the use of a highly 3. Communicating between the different assistance consistent test such as spirometry. This is what LCAM levels by using communication protocols and considers, therefore improving the patient’s assistance standards, trying to mitigate the report, diagnosis quality, together with the clinical professional’s assis- and/or treatments duplicity tance, for three clear reasons: References 1. Monitoring and early diagnosis, by computerizing Estrategia en EPOC del Sistema Nacional de Salud. Sanidad 2009 Ministerio de Sanidad y the clinical practical guides, together with medicine Política Social. Sobradillo V, Miravitlles M, Gabriel R, Jiménez-Ruiz CA, Villasante C, Masa JF, et al. based scientific evidence in order to improve the Geographical variations in prevalence and underdiagnosis of COPD. Results of the IBERPOC assistance quality for one of the twenty-first century multicentre epidemiological study. Chest. 2000; 118:981-989. epidemics for developed countries: chronic diseases Sobradillo-Peña V, Miravitlles M, Jiménez CA, Gabriel R, Viejo JL, Villasante C, Masa JF, et al. Estudio Epidemiológico de la Enfermedad Pulmonar Obstructiva Crónica en España 2. Solving the current problem of the lack of com- (IBERPOC): Prevalencia de síntomas respiratorios crónicos y limitación del flujo aéreo. Arch. munication between the different assistance levels, Bronconeumol. 1999; 35: 159-66. Health Level Seven Clinical Context Object Workgroup [online] http://www.hl7.org/Special/ generating an alarm at any level, thus alerting the committees/visual/index.cfm (Consultada: Agosto de 2011). clinical professionals about an early diagnosis or Oracle Healthcare Transaction Base [online] http://www.oracle.com/us/industries/health- informing the clinical professional that the patient care/046614.html Health Level Seven International Version 3 [online] http://www.hl7.org/implement/stan- is already under treatment dards/product_brief.cfm?product_id=186

MAY 2012 17 Electronic Surveillance of Healthcare-Associated Infections Dr. Klaus-Peter Using HL7’s Arden Syntax Adlassnig

By Dr. Klaus-Peter Adlassnig, CEO and Scientific Head, Medexter Healthcare in Vienna, Austria; and Section for Medical Expert and Knowledge-Based Systems, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna

Arden Syntax is a medical knowl- 1999 with the approval of version 2.0 programming language—an inter- edge representation and processing of the standard. The latest release is preter or compiler for Arden Syntax, scheme for the development of clini- Arden Syntax version 2.8 which was and an execution engine to have the cal decision support (CDS) systems approved in January 2012; however, MLMs being processed. In addition, that that originated in 1989 at a gath- HL7’s Arden Syntax Work Group is an authoring tool containing an ering of several medical informati- still preparing further improvements editor for writing MLMs—which pos- cists from the USA, the Netherlands, of, and extensions to, this representa- sibly includes an execution engine and Sweden at the Arden Homestead tion and programming code. for testing them before they become Retreat in Orange County, NY, confer- enacted—usually comes with such a ence estates owned by the Columbia Arden Syntax is a syntax defining suite of Arden Syntax software. University. The intention was to how to arrange input data to be write computer-based clinical re- processed, condition and action parts Following current software archi- minders, diagnostic and therapeutic of clinical rules to be written, and tectures and providing the Arden recommendations, and crucial alerts how and where to output the com- Syntax execution engine within a in a clear and readable way and—as puted results. Medical logic modules service-oriented architecture makes one of the main objectives—to make (MLMs) are the basic representa- it possible to offer interoperable CDS them shareable to others. tion and processing units in Arden systems for a variety of tasks. These Syntax, and the syntax was designed tasks all have in common that data Since then, the early versions of such that each MLM may contain sources such as clinical, laboratory, Arden Syntax have been updated, all the knowledge for at least one or intensive care information systems extended, and were adopted by single decision. However, MLMs can or the web “itself” supply the data standards organizations. The Ameri- call each other, be interconnected, to be processed—preferably through can Society for Testing and Materials even intertwined, and can thus form standardized data communica- (ASTM) first approved the Arden whole medical knowledge packages tion—and that the MLM-processed Syntax as standard E-1460-92 in 1992. (MKPs)1, consisting of sets of MLMs. results be returned to the connected Ownership was transferred to Health information systems or be reported Level Seven (HL7) and the American To make the syntax operable, one by separate web-based applications. National Standards Institute (ANSI) in needs to write—say program in a

Figure 1: Suite of Arden Syntax software—service-oriented architecture and software components

18 MAY 2012 Figure 1 shows the structure of an interwoven MLMs was established plication is used by 12 ICUs with Arden-Syntax-based, service-orient- (Figure 3). Patients’ medical data is a total of 96 beds and the micro- ed CDS system and lists some of its measured, observed and automati- biology department provide about software components, as it is offered cally transferred from the intensive 15-18,000 data items every day. For and applied by Medexter Healthcare. care medical information systems each of the 96 patients, an Arden This software for Arden Syntax was and the microbiology laboratory. It Syntax knowledge package contain- written, distributed, and has been is then put through a step-by-step ing 74 MLMs (with emulated clinical incorporated into a number of hospi- pipeline of aggregation, interpreta- fuzzy set definitions and fuzzy logic tals and some healthcare companies tion, and evaluation that is eventu- processing operators) is automati- information systems. ally used to draw conclusions about cally invoked, and both intermediate whether one or more of the included medical concepts and final infection One large-scale application is called infection criteria are fulfilled, ful- results are computed, stored, and Moni-ICU and runs as clinical filled to a certain degree, or not ful- prepared for viewing on screen or routine application at the Vienna filled. Most of the encoded clinical for reporting. General Hospital, a tertiary care entities are modeled as fuzzy sets, hospital with 2,134 beds and the and fuzzy logic is used to perform A study evaluating the effectiveness main teaching hospital of the Medi- the subsequent inference steps. Fig- has shown an excellent conformance cal University of Vienna, Austria. ure 3 shows a graphical depiction of of Moni-ICU with an established Moni-ICU has been built for elec- the processing layers in Moni-ICU. clinical reference standard as well tronic, fully-automated surveillance as Moni-ICU’s superiority in of healthcare-associated infections At present, this Arden Syntax ap- continued on next page (HAIs) at the hospital’s intensive care units (ICUs) with adult patients. The primary user is the infection control team of the Clinical Department of Hospital Hygiene of the Vienna General Hospital, which receives daily automated updates on its cockpit surveillance screen to see which patient at which ICU ward developed an ICU-associated infection, continued to have one, or recovered from one (See Figure 2). Based on classification criteria for HAIs, as they have been issued by the US Centers for Disease Control (CDC), the European CDC, and Ger- man KISS, the published definitions of the various forms of septicemias, pneumonias, urinary tract and central-venous-catheter-associated infections were linguistically de- composed, formally rearranged and structured, and brought into Arden Syntax MLM code.

Processing layers from raw data calculation and interpretation to intermediate and high-level clinical Figure 2: Screenshot of Moni-ICU showing daily results (lower half, middle part) including detailed explanations (lower half, right part) and patients’ infection concept evaluation were introduced period over time (upper half) and a package of hierarchically MAY 2012 19 Electronic Surveillance continued from page 19 minimizing time demands on the infection control team with respect to electronically supported versus sole human surveillance [2].

The next steps include extend- ing Moni-ICU to neonatal care (Moni-NICU), forming standardized interfaces to medical information systems apply- ing the HL7 messaging standards, defining and adopting a genuine Fuzzy Arden Syntax (presumably Arden Syntax version 2.9), and adding several automated reporting schemes for HAIs as requested by legal requirements in Austria, Ger- many, and the US. Figure 3: Processing layers from raw data to high-level clinical concept evaluation using Arden Syntax

[1] Adlassnig, K.-P. and Rappelsberger, A. (2008) Medical Knowledge Packages and their Integration into Health-Care Information Systems and the World Wide Web. In Andersen S.K., Klein, G.O., Schulz, S., Aarts, J., and Mazzoleni, M.C. (Eds.) eHealth Beyond the Horizon–Get IT There. In Proceedings of the 21st International Congress of the European Federation for Medical Informatics (MIE 2008), IOS Press, Amsterdam, 121–126. [2] Blacky, A., Mandl, H., Adlassnig, K.-P., and Koller, W. (2011) Fully Automated Surveillance of Healthcare-Associated Infections with MONI-ICU – A Break- through in Clinical Infection Surveillance. Applied Clinical Informatics 2(3), 365–372.

Upcoming INTERNATIONAL EVENTS

eHealth Conference 2012 / World of Health MIE 2012: Quality of Life through IT Conference and Exhibition Quality of Information Copenhagen, Denmark Pisa, Italy May 7 - 9, 2012 August 26 - 29, 2012 For more information, please visit For more information, please visit http://www.worldofhealthit.org/ http://www.mie2012.it

HL7 May Working Group Meeting HIMSS AsiaPac 2012 Vancouver, BC, Canada Marina Bay Sands, Singapore May 13 - 18, 2012 September 17 - 19, 2012 For more information, please visit For more information, please visit http://www.hl7.org/events/Working Group Meetings http://www.himssasiapac.org

eHealth 2012: Innovating Health e-Care 13th International HL7 Interoperability Vancouver, BC, Canada Conference May 27 - 30, 2012 Vienna, Austria For more information, please visit September 28 - 29, 2012 http://www.e-healthconference.com Watch the HL7 website for more information.

20 MAY 2012 Health Level Seven International Project Supports the US Office of

John Ritter Personnel Management’s Blue Button® Requirements

By John Ritter, Co-Chair, HL7 Electronic Health Records Work Group and HL7 Ambassador; and Lenel James, CPHIT, CPEHR, Member, HL7 EHR Work Group and HL7 Ambassador

HL7 recently announced a response mation exchange continuum by enabling Veterans and to the US Office of Personnel Man- consumers to share their data with clinicians and other Lenel James agement’s (OPM) recent requirement caregivers via a simple text file. The service is part of that US Federal Employees Health the expanding landscape of national and local initiatives Benefit Program (FEHBP) health in- such as the Office of the National Coordinator’s Stan- surance carriers support the US Department of Veterans dards and Interoperability Framework and the Beacon Affairs (VA) Blue Button® text file format as a means of Community Programs. conveying personal health information to federal employees. In January 2012, HL7 launched a project that John Ritter, co-chair of the HL7 Electronic Health Re- defines the conversion of an cord Work Group (EHR HL7 Continuity of Care Docu- The Blue Button, developed by WG), noted that HL7 ment (CCD®) to the Blue But- quickly assembled a ton format via an XSLT style the VA in collaboration with the broad set of industry sheet tool. Because most Centers for Medicare and Med- stakeholders, includ- Meaningful Use–certified icaid Services (CMS), empowers ing vendors, providers, health information exchange payers, and federal systems already possess Veterans to access and download agencies, as part of its CCD-export capabilities, the their health information as an ongoing commitment tool will be able to leverage ASCII text file or PDF® document. to be responsive to the those capabilities as a simple industry’s needs in a and effective way for many timely manner. carriers to meet OPM’s new requirement. The EHR WG and Structured Documents Work Group, The Blue Button, developed by the VA in collaboration co-sponsors of the project, expect to publish the file with the Centers for Medicare and Medicaid Services conversion tool and User’s Guide after the May Working (CMS), empowers Veterans to access and download Group Meeting in Vancouver. Doug Dormer, President their health information as an ASCII text file or PDF® of SPINNphr and member of the project team stated, “I document. The Blue Button initiative was made nation- am pleased to be involved in this project. This tool will ally available in October 2010. In December 2011, OPM reduce my technical team’s effort to offer a data down- issued a formal request to all carriers in the FEHBP to load channel to consumers in the Blue Button format add Blue Button functionality to their web-based per- and help our clients meet OPM’s requirement.” sonal health record systems. (See: http://www1.opm. gov/news/blue-button-added-to-health-insurance-carri- For more information visit: www.HL7.org/EHR ers-for-federal-employees,1744.aspx )

The Blue Button service participates in the health infor- MAY 2012 21 Congratulations ttttttttttttttttttttt To the following people who recently passed the HL7 Certification Exams

Certified HL7 Version Dipak Patel Kevin Dama HL7 Spain 2.x Chapter 2 Control Cliff A. Searl Hardik Delwari Specialist Scott H. Shellenbarger Adarsh Dharmavarapu November 14, 2011 Raghavan Srinivasan John E. Fernandes José Ignacio Sánchez Alonso November 17, 2011 Levi M. Teitelbaum Rasika V. Inamdar Martín Calvete Iglesias Vince Cirelli David J. Yacono Roshan Kamble María Esther Saavedra Shane Fleeger Robert Ziegenfus Ajay Kapoor Martínez Violeta Jankov Rohit P. Khot Julio José Gómez Díaz Robert Kitchen, Jr. HL7 Australia Rohit Kulkarni Ana Azpiazu Carmouze Emmanuel Luna Amol Maralikar Jason Martin November 30, 2011 Teresa Mathew December 12, 2011 Cesar Flores Carrera Dan McHugh Randal J. Fletcher Miss Pritam N. More Miquel Adrover Carrie Van Stedum Mark A. Gilson Rohit Natraj Josep Lluís Muñoz Ribalta Jeff Yost Chris J. Page Udeshangbhai Agarshangbhai Sandra N. Polmear Parmar December 13, 2011 December 9, 2011 Neha Pathak Carlos Sánchez García Mary Kay Burke HL7 Canada Priya Ramachandran Juan Carlos González Moreno Bruce A. Craig Ami Ramani Ainhoa Barbeito Pardiñas Richard A. Day November 23, 2011 Shweta Satpalkar Bárbara Goyanes Valero John C. Delius Feda Birani Priyank Shah Ignacio Arnott González-Tova John Macintosh Nilesh A. Shinde Connie M. Egerer Víctor Sancho Lorenzo Dorothy Seiler Deesha Pratap Shingadia Patti Hansen Rubén García Broncano Sandeep Swamy Hannah L. Howard Pablo Esteve Díaz January 6, 2012 Bina Vivek Babette M. Jacobson-Barnes José Moralo Molero Tak M. Ko Bini Vijan Matthew D. Jeanfreau Francisco Novillo Pérez Nicolas V. Molinos Verónica Sáez Pérez HL7 India February 25, 2012 Sandi D. Meacham José Martínez Hellín Amy D. Moy Sipra Dimri José María Leal Pozuelo Ryan A. Rush November 19, 2011 Bharathiraj Kanagaraj José Luis Fernández Rueda Tina M. Sobey Suchitra Bapat Meena Namasivayam Víctor Castaño Labajo Tarun Chopra Sandeep Narasimhegowda Gustavo Roig Domínguez January 19, 2012 Aditya Josh Javier Arribas Pastor Lori M. Ashford Kapil Joshi HL7 Singapore Francisco Javier Lubias García Patricia Bauer Madhuri Krishnakumar Matthew M. Cettei Subashini Narayanan November 21, 2011 December 14, 2011 Teresa E. Garriott Ravichandra K. Patel Fu Yanto Myriam Barroso Partida Douglas S. Graham Dr. Pawandeep Singh Seera Srinivasa Rao José Andrés Morey Súñer Dale Grobeck Padmavathi K. Lee Chou Wee José Javier Pozo Morales Chi Chen J. Hong Thiruvenkadam Hu Bo María Ángeles Merino Jesse M. Phillips Arun Kumar Tiriveedhi Reymond Darwin Wilaisono Paredes Nagavalli Pothineni Chin Teck Wei Raúl Palomino Sánchez Dejan Zivanovic February 11, 2012 Hendry Wijaya Nikita Agrawal December 15, 2011 March 8, 2012 Mohammed Saleej Saleem Ak February 9, 2012 Naroj Macías Duarte Khatera Cama Jayesh Bhanushali Jocelyn R. Jawili Marco Antonio Sánchez Joseph H. Dent INDRANEEL S CHAUDHARY Chan Hock Yan López

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Natalia Medina Medina March 8, 2012 Carolina Hernández Ramos U. Prajapati Francisco Javier Martínez Randy P. Ayers Javier Arencibia West Rajiv Shahi Aguiar Joshua A. Douglas Rosa Mª Paz Espinosa January 19, 2012 Rosa Mª Paz Espinosa Mark K. Caro Natalia Medina Medina Patrick E. Loyd Noé Andrés Rodríguez Terry L. Grammer Marco Antonio Sánchez González Kim M. Kegg López March 8, 2012 Francisco Rodríguez Almeida Randolph G. Pelikan Agustín Tapia Quesada Carolina Saborio Javier Arencibia West Joshua N. Robinson Arman Samani December 12, 2011 HL7 Canada December 16, 2011 Alireza H. Tabrizi David Rodríguez Cocinero Jonay González Suárez Benjamin E. Victorica Martí Pàmies Solà November 23, 2011 Carlos Rodríguez Reyes Saunya M. Williams Francesc Ramos Rocarols Paul Brown Alfonso Hernández Ibáñez Ying Zhang Silvia Morea Julián Justin Fyfe Alexis Barrera Torres María Belén Zabala Durán Harry Edwards HL7 Argentina February 23, 2012 December 13, 2011 February 8, 2012 Ángel José Faria Rodríguez November 2, 2011 Pedro Mayor Izquierdo Mark Cong David Campos Nieto Lucía Grundel Rafael Gallardo Picón December 14, 2011 HL7 India Jesús Mozos Ibáñez HL7 Canada Raquel Casaus Álvarez José Jesús Jiménez Flores November 19, 2011 February 28, 2012 February 8, 2012 Manuel Jesús Morales Lara Dinesh Cheluvegal Salvador Preckler Rick Lambert Balasundara December 16, 2011 Certified HL7 CDA HL7 India Noé Andrés Rodríguez HL7 Pakistan Specialist González February 11, 2012 February 12, 2012 November 17, 2011 Akash Gupta February 23, 2012 Midhat Akhtar Sanjeev Baral Mayank Kapoor Diego Bosca Tomás Karim Amirali Luan Dinh Kanchan Sanjay Kokal Diego Caballero Higueras Asif Ansari Carlos Guzman Pankjaj Kumar R. Mishra Ángel Colao Patón Anita Abdul Habib Dharani Mike Lomangino Manali Mannur José Rambla Lop Uzma Mahmood Steven T. Porteus Sandeep K. Patil Erum Qadir Memon Roman Radomski Santosh Gopi Pillai February 28, 2012 Shehzad Shahabuddin Julie Steele Ritu Shukla Alexis Barrera Torres Merchant Michael Tyburski Ankur R. Tripathi Shahana Mobin Chun Yu Certified HL7 Version Kamran Nayyer HL7 Korea 3 RIM Specialist Hafsa Saadat January 19, 2012 Salma Shiraz Ali Dobani Louise K. Brown November 19, 2011 November 17, 2011 Kashif Siddiqui Denny Cordy Dong Wook Park Sushmita Behera Wayne Heth Sunitha Byreddy Phillip E. Kiefer HL7 Spain James Chan Carlos J. Muentes Eldo Daniel Kanaka Ramyasiri November 14, 2011 Viabhav Kothale Thomas S. Reventas Francisco Javier Martínez Viveka Panwar Cameron D. Tully-Smith Aguiar Vivek Pillai ttttttttttttttttttttttttttttttttttt

MAY 2012 23 One Step Closer to Secure EHRs and mHealth: OMG and HL7 Andrea Ribick Announce Adoption of the hData Specification

By Andrea Ribick, HL7 Director of Communications

HL7 and OMG® recently announced the adoption and “MITRE initiated and led hData’s development in 2008 availability of the hData Record Format and hData RESTful in an effort to promote the adoption and use of scalable Transport specifications, a scalable electronic method for electronic health record systems,” says Gerald Beuchelt, exchanging patient health information (such as electronic Lead Software Systems Engineer, MITRE. “Doctors cite health records, “EHR” and mobile health, “mHealth”) compliance as an area that will improve a patient’s among patients, doctors, hospitals, and clinics. health and also help keep costs in the US system down. Mobile health is a useful tool, but first we need scal- “This is the latest in a number of standards jointly cre- able exchange and semantic interoperability of health ated as a result of our partnership with OMG. This col- IT systems, and then we can support future growth in laborative relationship is successful because it combines tools like mobile health that can all share common data HL7’s expertise in creating healthcare interoperability – hence hData.” standards with OMG’s expertise in distributed process models, wrappers and transport specifications that are RESTful specification services are low-cost and easy to common to all industries,” said John Quinn, CTO, HL7 deploy versus other service types that are more cum- International. “It is also one of the first published efforts bersome to build and implement. hData allows a Web to adopt the significant contributions and balloting efforts developer to demonstrate a prototype in days instead of of our volunteers from MITRE, giving HL7 implementers months with the current standards in use. Not surpris- API access to the hData RESTful Transport specification.” ingly, RESTful Web services are used by companies such as Amazon.com and Google because they can “The real impetus behind health data information scale to millions of users. standards like hData is saving lives and saving money by connecting clinical systems across doctors’ offices, With the hData specifications, medical records pres- hospitals and research centers. This is accomplished by ent content in a tiered structure that allows for fast and overcoming the differences in systems that make shar- secure access to only the specific information needed ing information difficult in the medical world,” said Dr. at a given time. This means that rather than having to Richard Mark Soley, PhD, Chairman and CEO, OMG. download an entire record to a mobile device, doctors can download just the pieces of data they need in order With the adoption at OMG and at HL7, hData is now to make decisions. hData makes the data securely acces- the first set of peer-reviewed specifications within both sible so the innovation of mobile use can happen. organizations for implementing a RESTful exchange of clinical information in the context of national and The specification is available to the public for download international standards. With hData, implementers can from the OMG website at http://www.omg.org/cgi-bin/ achieve semantic interoperability between clinical sys- doc?dtc/2012-01-03. tems both within and across organizational boundaries. By supporting a wide variety of clinical content models HL7 has published the hData Record Format as a DSTU and media types, hData offers maximal flexibility while (Draft Standard for Trial Use). It is available on the HL7 ensuring high scalability and efficiency through an opti- website at http://www.hl7.org/dstucomments/. mized transport architecture.

24 MAY 2012 Health IT Standards –

Dr. Adam Chee What Went Wrong Where?

By Dr. Adam Chee, Vice-Chair, HL7 Singapore

I had an interesting conversation interesting one: “It’s the same.” care of a patient may be easily about health IT standards recently, Before I could explain the differ- found, selected and retrieved in a private setting, where a group ences, I was shot down (well, it was irrespective of the repository of people debated a few popular a three person team versus me) and where they are actually stored standards adopted in the realm of given an example from an article medical imaging. taken off the Internet, citing how The example given obviously has a physician was trying to access a the document registry part missing; The discussion started with XDS patient’s medical records with an therefore the implementation was not (Cross Enterprise Document Shar- XDS enabled system and had trouble in compliance with the XDS specifica- ing) from IHE and the topic was locating what he needed because he tion. But somehow, XDS got blamed why it was not suitable for handling had to open every single document for it! This is like saying “work is non-DICOM images. The first red to find out what it was. going to kill you” because there are flag that went off in my head was reported incidents of Karōshi (death ‘Perversion of the XDS standard!’ I was half-amused and half-worried from overwork) in Japan! XDS is not meant for handling of at this stage. non-DICOM images; it is meant to • Half-amused because the ex- The topic then shifted suddenly register and share electronic health ample was describing a half-at- to HL7 Version 2.x (V2) and the record documents between health- tempted adoption of XDS (citing complaint was that HL7 V2.x is all care enterprises, ranging from physi- one article out of millions off the the same, but they are not back- cian offices to clinics to acute care Internet) in order to support the ward compatible, hence the need for inpatient facilities. In other words, it point that XDS failed to support interface engines. I tried to explain is meant to be used in an EMR/EHR a workflow that it was never the concepts of HL7 V2.x and why environment for sharing of docu- meant to it is in such a chaotic state (due to ments. The individual placing the • Half-worried because there will the lack of semantic interoperabil- complaint can go on about the how be people in the group walking ity, hence the reason why a logical XDS has failed for him and he will out of the discussion, spewing information model such as RIM was be “correct” because it has indeed the same misguided information developed), but the accuser became “failed,” since XDS has been made really defensive and further attempts to serve a wrong purpose. There are To describe the concept of XDS in to set the context right were met by no surprises here. a very simplistic manner – XDS rebuttals claiming that: standards manages a federated document looks nice on paper but fail in real However, the rationale of his argu- repositories and a document registry world implementation and standards ment is akin to saying that airplanes to create a longitudinal record of in- are developed by people sitting in have failed because they make formation pertaining to a patient (in ivory towers whereas he works in terrible cars when one tries to drive a given ‘clinical affinity domain’). the industry so he “knows better.” them like one – thinking that both I pointed out politely that standards are transportation devices, hence These are distinct entities with sepa- bodies like HL7 and IHE are made they should serve the same purpose. rate responsibilities. up of volunteers from the industry I call this a case of plain cognitive • A document repository is re- (myself included – I am practitioner failure. sponsible for storing documents first, academian second, consultant in a transparent, secure, reli- third) and the notion that standards As a firm believer of adopting rele- able and persistent manner and have ‘failed in the real world’ is due vant standards in the right context, I responding to document retrieval to implementers not understanding tried to highlight that if one is look- requests the standards being implemented, ing at imaging, then maybe XDS-I • A document registry is respon- thus implementing them half-right (Cross Enterprise Document Shar- sible for storing information or just plain-wrong. ing for Imaging) would be a better about those documents so that choice. The reply I received was an the documents of interest for the continued on next page MAY 2012 25 Heath IT Standards, continued from page 15 To put his argument into another arguments above, standards have information. While constant com- context, it is akin to saying that: not failed; the implementation and munication and knowledge transfer • The traffic light system of Red enforcement has. If one cannot see between standards developers and = Stop, Yellow = Caution and the difference than one cannot fix users are vital toward the effective Green = Go has failed because the problem—it really is that simple. adoption of standards, it is also motorists are ignoring them or Now don’t get me wrong, health- important that users of standards that in some places the color care IT standards are by no means take the effort and initiative to look has been changed perfect (and nothing is) and the for credible information from the • Because he is accustomed to people working on the development right sources. As HL7 affiliates, we driving in a such a chaotic envi- of standards and their consistent can serve as the enabler, facilitating ronment (such as above), he is improvements are practitioners the flow of knowledge between the convinced that his opinions are from the industry who have not two groups. the only ones that matter only encountered real-life problems, but have also decided to make a dif- Last but not least, let us applaud Well, the world is a very big place ference by volunteering their time the self-sacrificing individuals who and even traffic rules differ from to help rectify these problems. dedicate their time and effort in the place to place (e.g. speed limits, left- development of health It standards, hand drive versus right-hand drive), However, in order for standards to facilitating interoperability that let alone healthcare systems. It is be effectively adopted, it is very im- improves care delivery. important to understand that in the portant that users receive the right

HL7 Benefactors as of April 25, 2012

Centers for Disease Control and Prevention

US Department of Defense Military Health System

26 MAY 2012 HL7 ORGANIZATIONAL MEMBERS Benefactors eHealth Workflow Analytics, LLC Cabinet for Health and Family Services Programs Abbott Emergint Technologies, Inc. California Department of Health Care National Health Service Accenture Equinoxys Services National Institute of Standards and Allscripts Etnomedijos California HealthCare Foundation Technology Booz Allen Hamilton Evolvent Technologies CalOptima National Library of Medicine Centers for Disease Control and Prevention/ FEI.com CDISC National Marrow Donor Program CDC Forward Advantage, Inc. Center for Elders’ Independence National Quality Forum Duke Translational Medicine Institute Frank McKinney Group LLC Centers for Disease Control and Prevention/ NATO Consultation, Command and Control Epic Gartner CDC Agency European Medicines Agency Gensa Corporation Centers for Medicare & Medicaid Services New Mexico Department of Health Food and Drug Administration Gordon Point Informatics Ltd. City of Houston New York State Department of Health GE Healthcare IT GSI Health, LLC College of American Pathologists NICTIZ Nat.ICT.Inst.Healthc.Netherlands Hospital Corporation of America (HCA) Guidewire Architecture College of Healthcare Information Mgmt. NIH/CC IBM Healthcare Data Assets Executives NIH/Department of Clinical Research InterSystems Healthcare Integration Technologies Colorado Regional Health Information Informatics Kaiser Permanente HealthVectors Organization North Coast HIE McKesson Provider Technologies HIMAP CompDrug OA-ITSD - Department of Mental Health Microsoft Corporation HLN Consulting, LLC Connecticut Department of Public Health Oak Ridge Associated Universities NHS Connecting for Health Hubbert Systems Consulting Contra Costa County Health Services Office of the National Coordinator for NICTIZ Nat.ICT.Inst.Healthc.Netherlands Huron Valley Physicians Association COPE Community Services,Inc Health IT Novartis Infovide-Matrix S.A. Council of State and Territorial OHIO DEPT. OF JOB AND FAMILY SERVICES Oracle Corporation - Healthcare Lantana Consulting Group Epidemiologists Oklahoma State Department of Health Partners HealthCare System, Inc. LMI Delaware Division of Public Health Oregon Public Health Division Philips Healthcare Mainstream Health, Inc. Delta Dental Plans Association Pennsylvania Dept of Health-Bureau of Quest Diagnostics, Incorporated Matricis Informatique Inc. Department of Computer Science, Aarhus Information Siemens Healthcare MD Informatics, LLC University Pharmaceuticals & Medical Devices Agency Thomson Reuters MedQuist, Inc. Department of Developmental Services Phast US Department of Defense, Military Health newMentor Department of Health Primary Care Information Project, NYC Dept System Ockham Information Services LLC Department of Human-Computer Interaction Health US Department of Veteran Affairs Octagon Research Solutions, Inc. DGS, Commonwealth of Virginia Public Health Data Standards Consortium OTech, Inc. Duke Translational Medicine Institute Region Syddanmark Supporters PenCentric Health Systems Inc ECRI Institute RTI International 7 Delta, Inc PFT LLC Emory University, Research and Health SAMHSA AEGIS.net, Inc. Professional Laboratory Management, Inc. Sciences IT SC Dept. of Health & Environmental Control Beeler Consulting LLC Raven Tech LLC Estonian eHealth Foundation HS Beijing TPHY Technology Development Ray Heath, LLC European Medicines Agency Social Security Administration Co., Ltd. Rob Savage Consulting Food and Drug Administration South Dakota Department of Health Corepoint Health SabiaNet Inc Georgia Department of Public Health State of Montana DPHHS Crescendo Systems Corporation SEC Associates, Inc. Georgia Institute of Technology Telligen Gamma-Dynacare Medical Laboratories Shafarman Consulting Georgia Medical Care Foundation Tennessee Department of Health iNTERFACEWARE, Inc. Soa Software Inc. HIMSS Texas Department of State Health Services LINK Medical Computing, Inc. Strategic Solutions Group, LLC ICCBBA, Inc. - Lab LiveProcess The Audigy Group, LLC Illinois Department of Public Health Texas Health and Human Services Medicity, Inc. The Diebold Company of Canada Illinois Office of Health Information Commission MediSwitch (Pty)Ltd The St. John Group, LLC Technology The Joint Commission Mediture True Process Inc. Indian Health Service The MITRE Corporation Socrates Healthcare Ltd. Virginia Riehl Indiana Health Information Exchange US Army Institute of Surgical Research Westat Indiana State Department of Health University HealthSystem Consortium Consultants Wovenware Interior Health Authority University of AL at Birmingham Accenture Iowa Department of Public Health University of Kansas Medical Center AHIS - St. John Providence Health General Interest Japan Pharmaceutical Manufacturers University of Minnesota Aileron Consulting LLC Agency for Healthcare Research and Quality Association University of Texas Medical Branch at Anakam Identity Services, Equifax AGH University of Science and Technology Kansas Department of Health & Environment Galveston Blackbird Solutions, Inc. Alabama Department of Public Health Kyungpook National Univ. MIPTH University of Utah Pediatric Critical Care/ Booz Allen Hamilton Alliance for Pediatric Quality L.A. County Dept of Public Health IICRC Cambria Solutions, Inc. American Assoc. of Veterinary Lab LCF Research USDA APHIS VS CIO Canon U.S.A., Inc. Diagnosticians Maine Center for Disease Control and Utah Department of Health Capgemini Government Solutions LLC American College of Radiology Prevention Utah Health Information Network CentriHealth American College of Surgeons, NTDB Medical University of South Carolina Utah State Developmental Center Chong Qing TJPAN Inc American Dental Association Michigan Department of Community Health Vermont Department of Health Cirrus Data & Telecom Inc American Dietetic Association Lab Virginia Department of Health CSG American Health Information Management Michigan State University Virginia Information Technologies Agency CTS Association Ministry of Health - Slovenia Washington State Department of Health Dapasoft Inc. American Immunization Registry Association Minnesota Department of Health Wayne State University School of Medicine Dell Services (AIRA) Missouri Department of Health & Senior WEST WIRELESS HEALTH INSTITUTE Dent Technical Consulting Services American Medical Association Services WNY HEALTHeLINK Diagnostic Radiology and Oncology Services AORN N.A.A.C.C.R. WorldVistA Discoverture Health Arizona Department of Health Services NANDA International Eastern Informatics, Inc. Blue Cross Blue Shield Association National Association of Dental Plans Payers Edifecs, Inc. Brigham Young University National Center for Health Statistics/CDC American Imaging Management Edmond Scientific CA Department of Public Health National Council for Prescription Drug Blue Cross and Blue Shield of Alabama MAY 2012 27 HL7 ORGANIZATIONAL MEMBERS, continued

Blue Cross and Blue Shield of Florida Integrated Telemedical Solutions 4Medica Cognovant, Inc Blue Cross Blue Shield of Arizona Intermountain Healthcare A.J. Boggs & Company Community Computer Service, Inc. Blue Cross Blue Shield of North Carolina Johns Hopkins Hospital Abbott Compania de Informatica Aplicata Blue Cross Blue Shield of South Carolina Kaiser Permanente ABELSoft Inc. Computer Technology Corporation CIGNA Kalispell Regional Medical Center ABILITY Network Computrition, Inc. CompliantDRG Kernodle Clinic, Inc. Accent on Integration COMS Interactive, LLC Health Care Service Corporation Laboratory Corporation of America Accumedic Computer Systems, Inc. ConexSys, Inc. Magellan Health Services Lakeland Regional Medical Center Aceso Health Information Management Consilience Software Neighborhood Health Plan Life Labs ADP AdvancedMD, Inc. Core Sound Imaging, Inc. Premera Blue Cross Loyola University Health System Advent InfoSystems LLC Corepoint Health TriWest Healthcare Alliance Lucile Packard Children’s Hospital AEGIS.net, Inc. Cortex Medical Management Systems, Inc. Valence Health Lux Med Aequor Technologies, Inc. Covisint Wisconsin Physicians Service Ins. Corp. Mayo Clinic Affiliated Computer Services, Inc. CPCHS McDonough District Hospital Affiliated Computer Services, Inc., Crescendo Systems Corporation Pharmacy Meridian Health a Xerox Company Croudcare, S.A. Bristol-Myers Squibb Milton S. Hershey Medical Center Agilex Technologies CS STARS, LLC. Eli Lilly and Company MultiCare Health System Alert Life Sciences Computing, Inc. CSAM International AS Merck & Co. Inc. National Cancer Institute Allscripts CSC Healthcare Novartis New York-Presbyterian Hospital AlphaCM, Inc CTIS, Inc. Pharmaxo Pharmacy Services NHS Connecting for Health AlphaGlobal-IT Curaspan Healthgroup, Inc. Sanofi-Aventis R&D North Carolina Baptist Hospitals, Inc. Altos Solutions, Inc Cybernius Medical Ltd. NYC Health and Hospital Corporation Altova GmbH Cyberpulse L.L.C. Providers Oregon Providence Health & Service American Data Cyrus-XP LLC Advanced Biological Laboratories (ABL) Partners HealthCare System, Inc. American Health Care Software Dansk Medicinsk Datacenter ApS SA Pathologists’ Regional Laboratory American HealthTech, Inc. Data Information System Solutions LLC Advantage Dental Pathology Associates Medical AmerisourceBergen Specialty Group Data Services Akron General Medical Center Laboratories Amtelco Data Tec, Inc. Alamance Regional Medical Center Patient First Anasazi Software, Inc. Dataflo Consulting Albany Medical Center Quest Diagnostics, Incorporated Angel Systems, Inc. DATALINK SOFTWARE DEVELOPMENT INC Angel MEDICAL cENTER Rady Children’s Hospital and Health ANXeBusiness Datuit, LLC ARUP Laboratories, Inc. Center Apelon, Inc. Dawning Technologies, Inc. Ascension Health Information Services Regional Medical Center at Memphis Argility Healthcare Daxor Corporation Aspirus - Wausau Hospital Rheumatology and Dermatology ARGO Data Resource Corporation dbMotion LTD Athens Regional Health Services, Inc. Associates PC Askesis Development Group Defran Systems Avalon Health Care Rockford Health System Aspyra, LLC. DeJarnette Research Systems, Inc. Aviir, Inc Rockingham Memorial Hospital Atirix Medical Systems Delta Health Technologies, LLC BayCare HomeCare SA Tartu University Clinics Availity, LLC Dg Med Technology Corp. BJC HealthCare Saint Francis Care Axolotl Corporation Digital Infuzion, Inc. Blessing Hospital Saudi Aramco - Healthcare Applications Axway Digital Medical Merge, Inc. Bloomington Hospital & Healthcare Division Beeler Consulting LLC Div Media Systems Seneca Family of Agencies Beijing TPHY Technology Development DoctorCom Blount Memorial Hospital Sharp HealthCare Information Systems Co., Ltd. DocuTrac, Inc. Butler Healthcare Providers South Bend Medical Foundation, Inc. Benchmark Systems Dolbey & Company Cape Regional Medical Center Spectrum Health BIO-NUCLEAR, S. A. DynamicDR Carilion Clinic Stanford Hospital & Clinics Bostech Corporation EasyMed Services Inc Cedars-Sinai Medical Center Steven Porter, MD Bottomline Technologies EASYTALK MD LLC Center for Life Management Steward Health Care Bradoc Data Management, Inc EBM Technologies Inc. Central Illinois Radiological Associates Summa Health System BusinessOn echoBase Children’s Health System of Alabama Texas Health Resources CAL2CAL Corporation eDerm Systems Children’s Hospital Medical Center of The Children’s Hospital of Philadelphia CareCloud Corp eHana LLC Akron Tuomey Healthcare System Carefx Corporation e-Health Data Solutions Childrens Mercy Hospitals and Clinics US Department of Defense, Military carepaths, inc eHealthCare Systems, Inc. Cincinnati Children’s Hospital Health System Carestream Health, Inc. Electronic Medical Solutions, LLC City of Hope National Medical Center UK HealthCare CareTech Solutions, Inc. eManual System Sdn Bhd Cleveland Clinic Health System UNC Healthcare Caristix Embedded Wireless Labs Concentra University of Chicago Medical Center Center for Clinical Innovation Embla Consolidated Medical Bio-Analysis, Inc. University of Nebraska Medical Center Cerner Corporation EMC Information Intelligence Group Continuum Health Partners University of Pittsburgh Medical Center Certify Data Systems Emdeon, LLC Deaconess Health System University of Utah Health Care Cetrea A/S eMedology LLC Diagnostic Laboratory Services University Physicians, Inc. ChartLogic, Inc. Emerging Systems Dignity Health UT M.D. Anderson Cancer Center ChartWise Medical Systems, Inc. Empower Technologies, Inc Dovetail Health UW Medicine, IT Services ChemWare EMRgence LLC East Alabama Medical Center Vanguard Health Systems Cientive Group Inc. Epic Emergency Medical Services Authority VUMC CJPS Medical Systems, LLC ESRI Emory Healthcare Washington National Eye Center Clear EMR eTransX, Inc. Georgia Cancer Specialists, Inc. West Virginia University Hospitals Clinix Medical Information Services, LLC Expert Sistemas Computacionales S.A. Hill Physicians Medical Group Wheaton Franciscan Healthcare CM Care Technology DE C.V. Hospital Corporation of America (HCA) CMR Explorys Human Service Agency Vendors CNIPS, LLC EyeMD EMR Healthcare Systems, Inc. Inland Northwest Health Services //SOS/Corporation CNSI ezEMRx Institut Jules Bordet 3M Health Information Systems Cognosante, LLC e-Zest Solutions Ltd. 28 MAY 2012 HL7 ORGANIZATIONAL MEMBERS, continued

F5 Networks Keiser Computers Inc. Notable Solutions Software AG USA, Inc. Falcon LLC Kestral Computing Pty Ltd novaHEALTH Pte Ltd Software Partners LLC Fifth Light Technology Key Management Group NRC - Illuminate SonoSite, Inc First Medical Solutions knowtion O&P Digital Technologies SOUTHERN LIFE SYSTEMS, INC Foothold Technology Krames StayWell OA Systems, Inc. St. Jude Medical Fresenius Medical Care Lab Warehouse, Inc. Oakland Software StatRad, LLC Futures Group Labware, Inc. OD Link STI Computer Services, Inc. Gamma-Dynacare Medical Laboratories Lane Telecommunications, Inc OFFI-PLUS, Inc. Stockell Healthcare Systems, Inc. GE Healthcare Lavender & Wyatt Systems, Inc. Omnicell, Inc. SuccessEHS GEMMS, Inc Lawson OMNICOM srl Suitelinq inc Genesis Systems, Inc. Leafsprout Technologies Inc. Open Dental Software Suncoast Solutions gloStream, Inc. Liaison Technologies Inc., Optima Healthcare Solutions Sunquest Information Systems Greenway Medical Technologies, Inc. Life Systems Software Optimus EMR, Inc. SunRise Systems and Solutions Grow|CMS Life Technologies Opus-ISM LLC Surescripts Haemonetics Corporation Lifepoint Informatics Oracle Corporation - Healthcare Surgical Information Systems Harris Corporation LINK Medical Computing, Inc. Orchard Software SurgiVision Consultants, Inc. Health Care DataWorks Liquent, Inc. Orion Health Swearingen Software, Inc. Health Care Software, Inc. LiveProcess OSSLLC Sybe Medical Management Health Companion, Inc. Logibec Ototronix Systematic Group Health Data Services, Inc. Loopback Analytics OZ Systems Tetrus Health Innovation Technologies LORENZ Life Sciences Group P&NP Computer Services, Inc. TGI Software Health Intersections Pty Ltd LSS Data Systems Panacea Healthcare, LLC The Antidote.biz Health Language, Inc. Lumeris Patient360 The CBORD Group Inc. Health Plan Systems, Inc. M2comsys PCE Systems The Delta Group Health Records for Everyone MacPractice, Inc. PCIS GOLD The Echo Group Healthcare Management Systems, Inc. Maicom Healthcare Solutions GmbH Pegasystems The SIMI Group, Inc. HEALTHeSTATE Mammography Reporting System Inc. Perry Baromedical Inc The SSI Group, Inc. Healthland ManagementPlus Philips Healthcare The Tailored Approach, LLC. HealthTrio, LLC Marin Health Network Physician’s Computer Company Therap Services, LLC Healthwise, Inc. McKesson Provider Technologies Physicians Medical Group of Santa Cruz Thomson Reuters heartbase, inc. MD Logic, Inc County Tiatros Inc. Hewlett-Packard Enterprises Services MDIntelleSys, LLC PilotFish Technology TIBCO Software Inc. Hickman-Kenyon Systems, Inc MD-IT Transcription Services, LLC PPM Information Solutions, Inc. Tidgewell Associates, Inc. Hill Associates MDP Systems, LLC Practice Fusion TIMS INC Hi-Tech Software, Inc. MECTA Corporation Practice Velocity, LLC. Tolven, Inc. Home Dialysis Plus, Ltd MED3OOO, Inc. Premier Healthcare Alliance Tranquilmoney Inc., Hospira MedConnex PresiNET Healthcare Trifork Public A/S HospiServe Healthcare Services Pty) Ltd. Medflow, Inc. Press Ganey Associates Unibased Systems Architecture, Inc. i2i Systems MEDfx Corporation PrimeSource Healthcare Unifi Technologies i4i Inc. (Infrastructures for Information MEDHOST, Inc. Procentive Universal Medical Records, LLC Inc.) MEDIBIS ProComp Software Consultants, Inc Universal Research Solutions Iatric Systems Medical Systems Co. Ltd - medisys Procura Unlimited Systems IBM Medicity, Inc. Prognosis Health Information Systems Valley Hope Association - IMCSS IBS Expertise MediServe Information Systems, Inc. Prometheus Computing LLC VeinDraw iConnect Consulting MediSwitch (Pty)Ltd Proventys, Inc. Verizon Business Ignis Systems Corporation MEDITECH, Inc PsyTech Solutions, Inc. ViMedicus, Inc iMDsoft Mediture QS/1 Data Systems, Inc. Virco BVBA iMetrikus, Inc. MediVault, LLC QuadraMed Corporation Virtify Imprivata Medivo Inc. Quantros VisionTree Software, Inc. Info World MEDIWARE Information Systems Razor Insights, LLC Vitera Healthcare Solutions Information Management Associates Medlinesoft Recondo Technology, Inc. Vocollect Healthcare Systems, Inc. Inmediata Health Group MedLInk Computer Sciences, LLC Redpine Healthcare Technologies, Inc Wairever Inc Innovative Workflow Technologies MedMagic LLC Reed Technology and Information Services Walgreens Insight Software, LLC MEDSEEK Inc. Watermark Research Partners, Inc. Institute for Health Metrics Medtronic RL SOLUTIONS WellCentive, LLC integration AG MedUnison LLC Robust For Life WellDoc, Inc. Intelligent Medical Objects (IMO) MedVirginia Rosch Visionary Systems Wellsoft Corporation Intelliware Development Inc Mellon Consulting Group, LLC RTZ Associates, Inc White Plume Technologies Interbit Data, Inc. Meta, Inc. SAIC - Science Applications International Wolters Kluwer Health Interface People, LP MicroFour, Inc. Corp Workflow.com, LLC iNTERFACEWARE, Inc. Microsoft Corporation Sandlot, Inc. World Medical Center Nordic AS Interfix, LLC Mighty Oak Technology, Inc. SAS Institute Xeo Health InterSystems Mirth Corporation Scantron Corporation XIFIN, Inc. Intuit Health MITEM Corporation Scientific Retail Systems, Inc. XPress Technologies iPatientCare, Inc. Mitochon Systems. ScriptRx, Inc. ZetaSys LLC IQ-EQ Systems, LLC. Mobile Physician Technologies Seeburger AG ZipChart, Inc iRCODER.COM MobileMD Shared Health Zoho Corp. iSEEK Enterprise (USA), LLC Mobiusoft, LLC Siemens Healthcare Zweena Isoprime Corporation Modernizing Medicine, Inc. Simavita Pty Ltd Zynx Health IT Broadcasting MPN Software Systems, Inc. simplifyMD ZetaSys Dental Enterprise Solution J&H Inc. MxSecure SMARTMD Corp ZipChart, Inc Jack Russell Software NetDirector SNAPS, Inc. Zoho Corp. Jackson Healthcare, LLC. NexJ Systems Inc SOAPware, Inc. Zweena JVM NextGen Healthcare Information Systems, Socrates Healthcare Ltd Zynx Health Keane, Inc. Inc. Softek Solutions, Inc. MAY 2012 29 2012 TECHNICAL STEERING COMMITTEE MEMBERS

CHAIR Ravi Natarajan STRUCTURE & SEMANTIC DESIGN Austin Kreisler NHS Connecting for Health CO-CHAIRS Science Applications International Corp. (SAIC) Phone: 44 113-390-6520 Calvin Beebe Phone: 404-542-4475 Email: [email protected] Mayo Clinic Email: [email protected] Phone: 507-284-3827 DOMAIN EXPERTS CO-CHAIRS Email: [email protected] CHIEF TECHNICAL OFFICER Edward Tripp John Quinn Edward S Tripp and Associates, Inc. Patricia Van Dyke HL7 International Phone: 224-234-9769 Delta Dental Plans Association Phone: 216-409-1330 Email: [email protected] Phone: 503-243-4492 Email: [email protected] Email: [email protected] Mead Walker TECHNICAL & SUPPORT SERVICES r Mead Walker Consulting; A B CO-CHAIRS CO-CHAIRS Charles Mead, MD, MSc Phone: 610-518-6259 Frieda Hall 3rd Millennium, Inc. Email: [email protected] Quest Diagnostics, Incorporated Phone: 510-541-8224 Phone: 610-650-6794 Email: [email protected] FOUNDATION & TECHNOLOGY Email: [email protected] CO-CHAIRS Ron Parker George (Woody) Beeler Patrick Loyd HL7 Canada Beeler Consulting, LLC ICode Solutions Phone: 902-832-0876 Phone: 507-254-4810 Phone: 415-209-0544 Email: [email protected] Email: [email protected] Email: [email protected]

INTERNATIONAL REPRESENTATIVE Anthony Julian AD-HOC MEMBER Giorgio Cangioli Mayo Clinic Helen Stevens Love HL7 Italy Phone: 507-266-0958 M Gordon Point Informatics Ltd. [email protected] Email: [email protected] Phone: 250-598-0312 Email: [email protected] STEERING DIVISIONS

DOMAIN EXPERTS FOUNDATION & TECHNOLOGY STRUCTURE & SEMANTIC DESIGN Anatomic Pathology Conformance & Guidance for Arden Syntax Anesthesiology Implementation/Testing Clinical Context Object Workgroup Attachments Implementable Technology Specifications Clinical Decision Support Child Health Infrastructure & Messaging Clinical Statement Clinical Genomics Modeling & Methodology Electronic Health Record Clinical Interoperability Council* RIM Based Application Architecture Financial Management Community Based Collaborative Care Security Imaging Integration Emergency Care Service Oriented Architecture Orders & Observations Health Care Devices Templates Patient Administration Patient Care Vocabulary Structured Documents Patient Safety Pharmacy TECHNICAL & SUPPORT SERVICES Public Health & Emergency Response Education Regulated Clinical Research Electronic Services Information Management International Mentoring Committee Process Improvement Committee *Voice only; no vote Project Services Publishing Tooling

30 MAY 2012 HL7 WORK GROUP CO-CHAIRS Anatomic Pathology Joy Kuhl Mollie Ullman-Cullere Frank Oemig Alliance for Pediatric Quality Partners HealthCare System, Inc. HL7 Germany David Booker, MD Phone: 818-308-7063 Phone: 617-582-7249 Agfa Healthcare College of American Pathologists Email: [email protected] Email: mollie_ullman-cullere@dfci. Phone: 49-208-781194 Phone: 706-736-0991 harvard.edu Email: [email protected] Email: [email protected] Andy Spooner, MD, FAAP Cincinnati Children’s Hospital Clinical Interoperability Ioana Singureanu Victor Brodsky, MD Phone: 513-803-0121 Council Eversolve, LLC College of American Pathologists Email: [email protected] Phone: 603-870-9739 Phone: 646-322-4648 W. Edward Hammond, PhD Email: Email: [email protected] Feliciano Yu, MD Phone: 919-383-3555 [email protected] St. Louis Children’s Hospital Email: [email protected] Jeffrey Karp Phone: 314-454-2808 Robert Snelick College of American Pathologists Email: [email protected] Meredith Nahm Duke Translational Medicine National Institute of Standards & Phone: 847-832-7358 Technology Email: [email protected] Institute Clinical Context Object Phone: 919-668-8339 Phone: 301-975-5924 Architectural Review Workgroup (CCOW) Email: [email protected] Email: [email protected]

Board David Fusari Dianne Reeves Education

Charlie Mead, MD, MSc Microsoft Corporation National Cancer Institute Diego Kaminker 3rd Millennium, Inc. Phone: 978-749-0022 Phone: 301-435-5602 Phone: 510-541-8224 Email: [email protected] Email: [email protected] HL7 Argentina Email: [email protected] Phone: 54-11-4781-2898 Michael Russell, MD Anita Walden Email: [email protected] Ron Parker Duke Translational Medicine Duke Translational Medicine HL7 Canada Institute Institute Patrick Loyd (Interim) Phone: 919-668-8256 Phone: 902-832-0876 Phone: 919-668-3889 ICode Solutions Email: [email protected] Email: Email: [email protected] Phone: 415-209-0544 [email protected] Email: [email protected] David Staggs Clinical Statement US Department of Veterans Affairs Melva Peters John Quinn Hans Buitendijk Health Level Seven International Phone: 858-826-5629 HL7 Canada / Gordon Point Email: [email protected] Siemens Healthcare Phone: 216-409-1330 Phone: 610-219-2087 Informatics Email: [email protected] Email: Phone: 604-515-0339 Clinical Decision Support Email: [email protected] Arden Syntax [email protected] Guilherme Del Fiol, MD University of Utah Patrick Loyd Peter Haug ICode Solutions Electronic Health Records Intermountain Healthcare Phone: 919-213-4129 Email: [email protected] Phone: 415-209-0544 Phone: 801-442-6240 Email: [email protected] Gary Dickinson Email: [email protected] Robert Jenders, MD CentriHealth National Library of Medicine Rik Smithies Phone: 951-536-7010 Robert Jenders, MD HL7 UK Email: National Library of Medicine Phone: 310-435-3192 Email: [email protected] NProgram Ltd. [email protected] Phone: 301-435-3192 Phone: 44-7720-290967 Email: [email protected] Kensaku Kawamoto, PhD Email: [email protected] Don Mon, PhD Attachments Duke Translational Medicine RTI International Institute Community Based Phone: 312-777-5228 Durwin Day Phone: 801-587-8076 Collaborative Care Email: [email protected] Health Care Service Corporation Email: Phone: 312-653-5948 [email protected] Suzanne Gonzales-Webb John Ritter Email: [email protected] US Department of Veterans Affairs Phone: 412-372-5783 Howard Strasberg Phone: 619-972-9047 Email: [email protected] Craig Gabron Wolters Kluwer Health Email: [email protected] Blue Cross Blue Shield of South Phone: 858-481-4249 Helen Stevens Love Carolina Email: howard.strasberg@ Richard Thoreson Gordon Point Informatics Ltd. Phone: 803-763-1790 wolterskluwer.com SAMHSA Phone: 250-598-0312 Email: [email protected] Clinical Genomics Phone: 240-276-2827 Email: Email: [email protected] Jim McKinley [email protected] Blue Cross and Blue Shield of Joyce Hernandez Patricia Van Dyke Alabama Merck & Co., Inc. Delta Dental Plans Association Phone: 732-594-1815 Max Walker Phone: 205-220-5960 Department of Health Phone: 503-243-4492 Email: [email protected] Email: [email protected] Phone: 61-3-9096-1471 Email: Child Health Email: [email protected] Amnon Shabo, PhD [email protected] David Classen, MD, MS IBM Electronic Services Alliance for Pediatric Quality Phone: 972-544-714070 Conformance & Guidance Phone: 801-532-3633 Email: [email protected] for Implementation/ Bill Braithwaite, MD, PhD Email: [email protected] Testing Anakam Equity Services, Equifax Daryl Thomas MSCS, PhD Phone: 202-543-6937 Gaye Dolin, MSN (Interim) Wendy Huang Email: Lantana Consulting Group Life Technologies Canada Health Infoway Inc. [email protected] Phone: 714-744-4152 Email: [email protected] Phone: 416-595-3449 Email: Email: [email protected] [email protected] MAY 2012 31 HL7 Work Group Co-Chairs, continued Lorraine Constable Patty Krantz Robert Stegwee, MSc, PhD— Lorraine Constable Constable Consulting Inc. Medtronic HL7 International Liaison Constable Consulting Inc. Phone: 780-951-4853 Phone: 763-526-0513 HL7 the Netherlands Phone: 780-951-4853 Email: [email protected] Email: [email protected] Phone: 31-30-689-2730 Email: [email protected] Email: Ken McCaslin John Rhoads, PhD (Interim) [email protected] Robert Hausam, MD Quest Diagnostics, Incorporated Philips Healthcare Hausam Consulting Phone: 610-650-6692 Phone: 978-659-3024 Helen Stevens Love—Secretary Phone: 801-949-1556 Email: [email protected] Email: kenneth.h.mccaslin@ Gordon Point Informatics Ltd. Email: [email protected] questdiagnostics.com Phone: 250-598-0312 Imaging Integration Email: Patrick Loyd [email protected] ICode Solutions Emergency Care Helmut Koenig, MD Phone: 415-209-0544 Siemens Healthcare International Mentoring Email: [email protected] Laura Heermann Langford Phone: 49-9131-84-3480 Intermountain Healthcare Email: Committee Ken McCaslin Phone: 801-507-9254 [email protected] Quest Diagnostics, Incorporated Diego Kaminker Email: [email protected] Phone: 610-650-6692 HL7 Argentina Harry Solomon Email: kenneth.h.mccaslin@ Donald Kamens, MD GE Healthcare Phone: 54-11-4781-2898 Email: [email protected] questdiagnostics.com XPress Technologies Phone: 847-277-5096 Email: [email protected] Phone: 904-296-1189 John Ritter Outreach Committee for Email: [email protected] Implementable Technol- Phone: 412-372-5783 Clinical Research Email: [email protected] James McClay, MD ogy Specifications Ed Helton, PhD University of Nebraska Medical Marketing Council National Cancer Institute Center Paul Knapp Knapp Consulting Inc. Phone: 919-465-4473 Phone: 402-559-3587 Rene Spronk Email: [email protected] Email: [email protected] Phone: 604-987-3313 HL7 the Netherlands Email: [email protected] Phone: 31-318-553812 Patient Adminstration Peter Park, PhD Email: [email protected] Dale Nelson US Department of Defense, Squaretrends LLC Alexander deLeon Military Health System Edward Tripp Kaiser Permanente Phone: 916-367-1458 Edward S. Tripp and Associates, Phone: 202-762-0926 Email: Phone: 626-381-1455 Email: [email protected] Inc. Email: [email protected] [email protected] Phone: 224-234-9769 Email: [email protected] Financial Management Andy Stechishin Line Saele Helse Vest IKT CANA Software & Services Ltd. Grant Wood Kathleen Connor Phone: 780-903-0885 Phone: 47-55976494 Intermountain Healthcare Email: [email protected] Edmond Scientific Email: [email protected] Phone: 801-408-8153 Email: Email: [email protected] [email protected] Infrastructure & Patient Care Messaging Modeling and Beat Heggli Stephen Chu, PhD Methodology National eHealth Transition HL7 Switzerland Anthony Julian Authority (NEHTA) Phone: 41-1-806-1164 Mayo Clinic George (Woody) Beeler Jr., PhD Phone: 507-266-0958 Phone : 61-730238448 Email: Beeler Consulting, LLC Email: [email protected] [email protected] Email: [email protected] Phone: 507-254-4810 Email: [email protected] Kevin Coonan, MD Mary Kay McDaniel Patrick Loyd ICode Solutions Deloitte Consulting LLP Markam, Inc. Jean Duteau Email: [email protected] Phone: 415-209-0544 HL7 Canada Email: [email protected] Email: [email protected] Phone: 780-937-8991 William Goossen Email: HL7 The Netherlands Generation Of Anesthesia David Shaver [email protected] Standards Corepoint Health Results4Care B.V. Amersfoort Phone: 214-618-7000 Phone: 31-654-614458 Grahame Grieve Email: [email protected] Martin Hurrell, PhD Email: Health Intersections Pty Ltd [email protected] Phone: 44-7711-669-522 Phone: 61-3-9450-2222 Hugh Leslie Email: grahame@ Email: [email protected] Ocean Informatics Sandra Stuart healthintersections.com.au Email: Kaiser Permanente Terri Monk, MD Phone: 925-924-7473 [email protected] Duke Translational Medicine Lloyd McKenzie Email: [email protected] HL7 Canada (Gordon Point Institute Ian Townend Phone: 919-286-6938 Informatics) International Council Email: [email protected] NHS Connecting for Health Email: [email protected] Phone: 44-113-280-6743 Catherine Chronaki—Affiliate Ravi Natarajan Email: [email protected] Health Care Devices Liaison NHS Consulting for Health HL7 Hellas/FORTH-Institute of Phone: 44-113-390-6520 Klaus Veil Todd Cooper Computer Science Email: [email protected] HL7 Australia 80001 Experts, LLC Phone: 30-2810-391691 Phone: 61-412-746-457 Phone: 858-435-0729 Email: [email protected] Email: [email protected] Email: [email protected] Orders and Observations Philip Scott, PhD - HL7 Hans Buitendijk Allen Hobbs, PhD International Liaison Kaiser Permanente Siemens Healthcare HL7 UK Phone: 610-219-2087 Phone: 510-267-5031 Phone: 44 8700-112-866 Email: [email protected] Email: Email: [email protected] [email protected] 32 MAY 2012 HL7 Work Group Co-Chairs, continued Patient Safety Rob Savage Security Templates Rob Savage Consulting Nick Halsey Email: [email protected] Bernd Blobel, PhD John Roberts European Medicines Agency HL7 Germany; University of Tennessee Department of Health Phone: 44-0-20-7523-7100 Regensburg Medical Center Phone: 615-741-3702 Email: [email protected] Publishing Committee Phone: 49-700-7777-6767 Email: [email protected] Ali Rashidee Email: bernd.blobel@ Quantros George (Woody) Beeler Jr., PhD-V3 klinik.uni-regensburg.de Mark Shafarman Phone: 408-514-4804 Beeler Consulting, LLC Shafarman Consulting Email: [email protected] Phone: 507-254-4810 Mike Davis Phone: 510-593-3483 Email: [email protected] US Department of Veterans Affairs Email: Mead Walker Phone: 760-632-0294 [email protected] Mead Walker Consulting Jane Curry-V2/V3 Email: [email protected] Phone: 610-518-6259 Health Information Strategies Inc. Tooling Email: [email protected] Phone: 780-459-8560 John Moehrke Email: GE Healthcare IT Jane Curry Pharmacy [email protected] Phone: 920-912-8451 Health Information Strategies, Inc. Email: [email protected] Phone: 780-459-8560 Tom de Jong Jane Daus-V2 Email: HL7 the Netherlands McKesson Provider Technologies Services Oriented [email protected] Phone: 31-6-3255291 Phone: 847-495-1289 Architecture Email: [email protected] Email: [email protected] Tim Ireland Gerald Beuchelt NHS Connecting for Health Hugh Glover HL7 Brian Pech-V2 The MITRE Corporation Email: [email protected] UK Blue Wave Informatics Kaiser Permanente Email: [email protected] Phone: 44-07889407113 Phone: 678-245-1762 Andrew Stechishin Email: hugh_glover Email: [email protected] Don Jorgenson CANA Software & Services Ltd. @bluewaveinformatics.co.uk Inpriva, Inc. Phone: 780-903-0855 Andrew Stechishin-V3 Phone: 970-472-1441 Email: [email protected] Melva Peters CANA Software & Services Ltd. Email: [email protected] HL7 Canada / Gordon Point Phone: 780-903-0855 Vocabulary Informatics Email: [email protected] Galen Mulrooney Phone: 604-515-0339 US Department of Veterans Affairs Jim Case, DVM, PhD Phone: 703-815-0900 Email: Sandra Stuart-V2 National Library of Medicine Email: [email protected] [email protected] Kaiser Permanente Phone: 301-594-9152 Phone: 925-924-7473 Email: [email protected] Ken Rubin Process Improvement Email: [email protected] Hewlett-Packard Enterprises Heather Grain Committee Regulated Clinical Services Standards Australia, Llewelyn Grain Research Information Phone: 703-845-3277 Informatics Sandra Stuart Email: [email protected] Phone: 613-956-99443 Kaiser Permanente Management Email: [email protected] Phone: 925-924-7473 Structured Documents Ed Helton, PhD Email: [email protected] Russell Hamm National Cancer Institute Calvin Beebe Apelon, Inc. Phone: 919-465-4473 Mayo Clinic Project Services Phone: 507-271-0227 Email: [email protected] Phone: 507-284-3827 Email: [email protected] Rick Haddorff Email: [email protected] Armando Oliva, MD Mayo Clinic Robert Hausam, MD Food & Drug Administration Robert Dolin, MD Phone: 978-296-1462 Hausam Consulting Phone: 301-796-8126 Lantana Consulting Group Email: [email protected] Phone: 801-949-1556 Email: [email protected] Phone: 714-532-1130 Email: [email protected] Freida Hall Email: Edward Tripp [email protected] Quest Diagnostics, Inc. William T. Klein Edward S. Tripp & Associates, Inc. Phone: 610-650-6794 Klein Consulting, Inc. Phone: 224-234-9769 Grahame Grieve Email: Phone: 631-924-6922 Email: [email protected] Health Intersections Pty Ltd [email protected] Phone: 61-3-9450-2222 Email: [email protected] Email: grahame@ Public Health Emergency RIM Based Application healthintersections.com.au Response Architecture Austin Kreisler Joginder Madra Peter Hendler, MD Science Applications International Gordon Point Informatics Ltd. Kaiser Permanente Corp (SAIC) Phone: 780-717-4295 Phone: 510-248-3055 Phone: 404-542-4475 Email: Email: [email protected] Email: [email protected] [email protected] Amnon Shabo, PhD Brett Marquard Ken Pool, MD IBM Lantana Consulting Group OZ Systems Phone: 972-544-714070 Phone: 413-549-6886 Phone: 214-631-6161 Email: [email protected] Email: brett.marquard@ Email: [email protected] lantanagroup.com Rene Spronk John Roberts HL7 The Netherlands Tennessee Department of Health Phone: 33-318-553812 Phone: 615-741-3702 Email: [email protected] Email: [email protected]

MAY 2012 33 HL7 FACILITATORS Steering Division Hugh Glover Amnon Shabo, PhD Peter Gilbert Facilitators HL7 UK IBM Covisint Medication Clinical Genomics Structured Documents Phone: 44-0-7889-407-113 Rick Haddorff Phone: 972-544-714070 Phone: 313-227-0358 Email: hugh_glover@ Email: [email protected] Email: [email protected] Mayo Clinic/Foundation bluewaveinformatics.co.uk Structure & Semantic Design AbdulMalik Shakir Phone: 978-296-1462 Robert Hallowell Grahame Grieve City of Hope National Medical Siemens Healthcare Email: Health Intersections Pty Ltd Center Medication; Pharmacy [email protected] Infrastructure & Messaging Clinical Interoperability Council; Phone: 610-219-5612 Phone: 61-3-9450-2222 Modeling & Methodology Lynn Laakso Email: grahame Email: Phone: 626-644-4491 [email protected] Health Level Seven International @healthintersections.com.au Email: Foundation & Technology [email protected] Phone: 906-361-5966 Alexander Henket Alexander Henket HL7 The Netherlands Email: [email protected] HL7 The Netherlands Ioana Singureanu Patient Administration Patient Administration Eversolve, LLC Dave Hamill Email: alexander.henket CBCC & Health Care Devices Email: Health Level Seven International @enovation.nl Phone: 603-870-9739 [email protected] Technical & Support Services Email: William “Ted” Klein Phone: 734-677-7777 [email protected] Anthony Julian Email: [email protected] Klein Consulting, Inc. Mayo Clinic Vocabulary Corey Spears Infrastructure & Messaging Phone: 631-924-6922 Phone: 507-266-0958 Modeling and Email: [email protected] McKesson Provider Technology Methodology Facilitators Electronic Health Records Email: [email protected] Phone: 206-269-1211 Austin Kreisler Helmut Koenig, MD George (Woody) Beeler, Jr., PhD Science Applications International Email: Beeler Consulting LLC Corporation (SAIC) [email protected] Siemens Healthcare Facilitator-at-Large Structured Documents Imaging Integration Phone: 507-254-4810 Phone: 404-542-4475 Mead Walker Phone: 49-9131-84-3480 Email: [email protected] Email: [email protected] Mead Walker Consulting Email: Patient Safety; RCRIM [email protected] Charlie Bishop Patrick Loyd Phone: 610-518-6259 iSoft ICode Solutions Email: [email protected] Austin Kreisler Clinical Statement Orders & Observations Science Applications International Phone: 44-7989-705-395 Phone: 415-209-0544 Publishing Facilitators Corporation (SAIC) Email: [email protected] Email: [email protected] Orders & Observations Becky Angeles Phone: 404-542-4475 Bernd Blobel, PhD Joginder Madra ScenPro, Inc. Email: [email protected] HL7 Germany Gordon Point Informatics Ltd. RCRIM Security Immunization; PHER Phone: 972-437-5001 Margaret (Peggy) Leizear Phone: 780-717-4295 Phone: 49-700-7777-6767 Email: [email protected] Food and Drug Administration Email: RCRIM Email: bernd.blobel@ [email protected] klinik.uni-regensburg.de Douglas Baird Phone: 301-827-5203 Boston Scientific Corporation Lloyd McKenzie Email: [email protected] Kathleen Connor Templates HL7 Canada Phone: 651-582-3241 Edmund Scientific (Gordon Point Informatics) Mary Kay McDaniel Email: Financial Management Email: [email protected] Markam, Inc. Email: [email protected] Financial Management [email protected] Dale Nelson Email: Squaretrends LLC Mike Davis [email protected] Kevin Coonan, MD Implementable Technology US Department of Veterans Affairs Deloitte Consulting LLP Specifications Security Dale Nelson Emergency Care Phone: 916-367-1458 Phone: 760-632-0294 Squaretrends LLC Email: [email protected] Email: Email: [email protected] CMET; Implementable Technology [email protected] Specifications Norman Daoust Jean Duteau Phone: 916-367-1458 Daoust Associates Craig Parker, MD Gordon Point Informatics Ltd. Email: Anatomic Pathology Intermountain Healthcare PHER [email protected] Phone: 617-491-7424 Clinical Decision Support Phone: 780-937-8991 Phone: 801-859-4480 Email: Email: Frank Oemig Email: [email protected] [email protected] [email protected] HL7 Germany German Realm Jenni Puyenbroek Isobel Frean Jean Duteau Science Applications International Phone: 49-208-781194 Bupa Group Gordon Point Informatics Ltd. Corporation (SAIC) Email: [email protected] Patient Care; Pharmacy Conformance & Guidance for Clinical Statement Phone: 780-937-8991 Implementation/Testing Phone: 44-207-656-2146 Email: Phone: 678-261-2099 Email: [email protected] [email protected] Email: [email protected]

34 MAY 2012 HL7 FACILITATORS, continued Nancy Orvis Christof Gessner Robert McClure, MD Sandra Stuart US Department of Defense, HL7 Germany Apelon, Inc. Kaiser Permanente Military Health System Health Care Devices CBCC Infrastructure & Messaging Government Projects Phone: 49-172-3994033 Phone: 303-926-6771 Phone: 925-924-7473 Phone: 703-681-3900 Email: [email protected] Email: [email protected] Email: [email protected] Email: [email protected] Margaret Haber, BSN, RN, OCN Nancy Orvis Pat Van Dyke Craig Parker, MD National Cancer Institute Center US Department of Defense, Delta Dental Plans Association Intermountain Healthcare for Bioinformatics Military Health System Electronic Health Records Clinical Decision Support RCRIM Government Projects Phone: 503-243-4992 Phone: 801-859-4480 Phone: 301-594-9185 Phone: 703-681-3900 Email: Email: [email protected] Email: [email protected] Email: [email protected] [email protected]

John Ritter W. Edward Hammond, PhD Sarah Ryan Tony Weida Electronic Health Records Templates Clinical Interoperability Council Apelon Phone: 412-372-5783 Phone: 919-383-3555 Email: [email protected] Security Email: [email protected] Email: [email protected] Email: [email protected] Harold Solbrig Ioana Singureanu Monica Harry Apelon, Inc. Eversolve, LLC Gordon Point Informatics Modeling & Methodology CBCC PHER Phone: 807-993-0269 Phone: 603-870-9739 Email: Email: [email protected] Email: [email protected] [email protected] Harry Solomon Robert Hausam, MD GE Healthcare IT Margarita Sordo Hausam Consulting Imaging Integration Partners HealthCare System, Inc. Orders & Observations; Structured Phone: 847-277-5096 Gello Documents Email: harry.solomon@med. Phone: 781-416-8479 Phone: 801-949-1556 ge.com Email: [email protected] Email: [email protected]

Anita Walden Joyce Hernandez Duke Translational Medicine Merck & Co. Inc. Institute Clinical Genomics Clinical Interoperability Council Phone: 732-594-1815 Phone: 919-668-8256 Email: Email: [email protected] [email protected]

Grant Wood Wendy Huang Intermountain Healthcare Canada Health Infoway Inc. Clinical Genomics Patient Administration Phone: 801-408-8153 Phone: 416-595-3449 Email: [email protected] Email: [email protected] Vocabulary Facilitators Julie James Paul Biondich, MD Blue Wave Informatics IU School of Medicine Medication; Pharmacy Child Health Email: julie_james@ Phone: 317-278-3466 bluewaveinformatics.co.uk Email: [email protected] William “Ted” Klein Kathleen Connor Klein Consulting, Inc. Edmond Scientific Modeling & Methodology Financial Management; Security Phone: 631-924-6922 Email: Email: [email protected] [email protected] Patrick Loyd Kevin Coonan, MD ICode Solutions Deloitte Consulting LLP Clinical Statement Emergency Care Phone: 415-209-0544 Email: [email protected] Email: [email protected]

Guilherme Del Fiol, MD Susan Matney University of Utah 3M Health Information Systems Clinical Decision Support Patient Care Phone: 919-213-4129 Phone: 801-265-4326 Email: Email: [email protected] [email protected]

MAY 2012 35 Affiliate Contacts

HL7 Argentina HL7 Czech Republic HL7 Luxembourg HL7 Spain Diego Kaminker Libor Seidl Stefan Benzschawel Carlos Gallego Perez Phone: +54-11-4781-2898 Phone: +420 605740492 Phone: +352-425-991-889 Phone: +34-93-693-18-03 Email: diego.kaminker@ Email: [email protected] Email: [email protected] Email: [email protected] kern-it.com.ar HL7 Mexico HL7 Sweden HL7 Australia HL7 Finland Pablo Ceballos Yanez Gustav Alvfeldt Richard Dixon Hughes Juha Mykkanen, PhD Phone: +52 55-5261-4000 Phone: +46 08-123-13-117 Email: [email protected] Phone: +358-403552824 Email: [email protected] Email: [email protected] Email: [email protected] HL7 Austria HL7 Switzerland Stefan Sabutsch HL7 France Beat Heggli Phone: +43-664-3132505 HL7 New Zealand Nicolas Canu Phone: +41-1-806-1164 Email: [email protected] David Hay Phone: +33 02-35-60-41-97 Email: Phone: +64-9-638-9286 Email: [email protected] [email protected] HL7 Bosnia and Herzegovina Email: Samir Dedovic [email protected] Phone: +387 0-33-721-911 HL7 Germany HL7 Taiwan Email: [email protected] Chih-Chan (Chad) Yen Kai Heitmann, MD HL7 Norway Phone: +49-172-2660814 Phone: +886-2-25526990 Espen Moeller Email: [email protected] HL7 Brazil Email: [email protected] Marivan Santiago Abrahao Phone: +47 97008186 Phone: +55-11-3045-3045 Email: [email protected] HL7 The Netherlands Email: [email protected] HL7 Greece Robert Stegwee, MSc, PhD Alexander Berler, PhD HL7 Pakistan Phone: +31-30-689-2730 HL7 Canada Phone: +30-2111001691 Dr. Hafiz Farooq Ahmad Email: Melva Peters Email: [email protected] Phone: +92 51-90852155 [email protected] Phone: +604-515-0339 Email: [email protected] Email: HL7 India HL7 Turkey [email protected] Supten Sarbadhikari, MBBS, HL7 Puerto Rico Ergin Soysal PhD Julio Cajigas Email: [email protected] HL7 Chile Phone: +1 787-805-0505 x6003 Sergio Konig Email: [email protected] Email: [email protected] HL7 UK Phone: +56-2-7697996 Philip Scott, PhD Email: [email protected] HL7 Italy HL7 Romania Phone: +44 8700-112-866 Stefano Lotti Email: [email protected] HL7 China Phone: +39-06-42160685 Florica Moldoveanu, PhD Prof. Baoluo Li Phone: +40-21-4115781 Email: [email protected] HL7 Uruguay Phone: +86-010-65815129 Email: florica.moldoveanu Selene Indarte Email: [email protected] @rdslink.ro HL7 Japan Phone: +5985-711-0711 Michio Kimura, MD, PhD Email: [email protected] HL7 Colombia HL7 Russia Phone: +81-3-3506-8010 Fernando A. Portilla Tatyana Zarubina MD, PhD Phone: +57-2-5552334 x241 Email: Phone: +007-495-434-55-82 Email: [email protected] [email protected] Email: [email protected] HL7 Croatia HL7 Korea HL7 Singapore Miroslav Koncar Byoung-Kee Yi, PhD Phone: +385-99-321-2253 Colleen Brooks Phone: +82 234101944 Email: Phone: +65-68181246 Email: [email protected] [email protected] Email: [email protected] 36 MAY 2012 2012 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 Manager Web Development Director, Project Meetings of Education Coordinator Management Office

Lillian Bigham Mary Ann Boyle Joshua Carmody Dave Hamill +1-989-736-3703 +1-734-677-7777 +1-734-677-7777 +1-734-677-7777 [email protected] [email protected] [email protected] [email protected] Manager of Administrative Director of TSC Project Services Technical Services Manager

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

Director of Director of Technical Director of Membership Publications Communications Services

Diana Stephens Donald Lloyd Andrea Ribick +1-734-677-7777 +1-734-677-7777 +1-734-677-7777 [email protected] [email protected] [email protected] MAY 2012 37 2012 HL7 Board of Directors Chair Past Chair Treasurer Secretary Technical Steering Committee Chair

Donald Mon, PhD Robert Dolin, MD Michael van Campen Jill Kaufman, PhD RTI International Lantana Consulting Group Gordon Point Informatics Ltd. College of American Austin Kreisler +1-312-777-5228 +1-714-532-1130 +1-250-881-4568 Pathologists Science Applications [email protected] bob.dolin michael.vancampen +1-847-832-7163 International Corp. (SAIC) @lantanagroup.com @gpinformatics.com [email protected] +1-404-542-4475 [email protected] Directors-at-Large Chair Emeritus and Director-at-Large

W. Edward Keith Boone James Ferguson Douglas Fridsma, MD, PhD Hammond, PhD GE Healthcare IT Kaiser Permanente Office of the National +1-919-383-3555 +1-617-519-2076 +1 510-271-5639 Coordinator for Health IT [email protected] [email protected] [email protected] +1-202-205-4408 [email protected] Affiliate Directors

Catherine Chronaki, MSc Diego Kaminker Stanley Huff, MD Rebecca Kush, PhD Edward Tripp FORTH-Institute of Computer Chair, HL7 Argentina Intermountain Healthcare CDISC Edward S Tripp Science; HL7 Hellas BoD +54-11-4781-2898 +1-801-442-4885 +1-512-791-7612 and Associates, Inc. +30-2810-391691 kaminker.diego [email protected] [email protected] +1-224-234-9769 [email protected] @gmail.com [email protected] Ex Officio Members Advisory Council Chair

Charles Jaffe, MD, PhD John Quinn Mark McDougall Richard Dixon Hughes HL7 CEO HL7 CTO HL7 Exective Director HL7 Australia / DH4 Pty Limited +1-858-720-8200 +1-216-409-1330 +1-734-677-7777 [email protected] [email protected] [email protected] [email protected] 38 MAY 2012 HL7 EDUCATIONAL SUMMITS

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

What is an Educational Summit? The HL7 Educational Summit is a a two-day schedule of tutorials focused on HL7-specific topics such as Version 2, Version 3 and Clinical Document Architecture. Educational sessions also cover general interest industry topics such as vocabulary. Why Should I Attend? This is an invaluable educational opportunity for the healthcare IT community as it strives for greater interoperability 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. EDUCATIONAL Among the benefits of attending the HL7 Educational SUMMITS Summit are: • Efficiency Concentrated two-day 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 July 17-19, 2012 Become HL7 Certified: HL7 is the sole source for Hilton St. Louis at the Ballpark HL7 certification testing, now offering testing on St. Louis, MO Version 2.7, Clinical Document Architecture, and Version 3 RIM November 13-15, 2012 San Francisco Marriot • Economical Fisherman’s Wharf A more economical alternative for companies who want the benefits of HL7’s on-site training but have fewer employees to train

MAY 2012 39 Upcoming WORKING GROUP MEETINGS

September 9 – 14, 2012 26th Annual Plenary & Working Group Meeting

Hyatt Regency Baltimore Baltimore, MD

January 13 – 18, 2013 May 5 – 10, 2013 Working Group Meeting Working Group Meeting Pointe Hilton Squaw Peak Resort Sheraton Atlanta Hotel Phoenix, AZ Atlanta, GA

September 22 – 27, 2013 January 12 – 14, 2014 27th Annual Plenary & Working Group Meeting Working Group Meeting Hilton in the Walt Disney World® Resort Hyatt Regency Cambridge Lake Buena Vista, FL Cambridge, MA