© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Strategic Initiative Thoughts SITF members Hans Buitendijk, Liora Alschuler, Ken McCaslin, Klaus Veil, Dan Russler 14 September 2006 Transformation - Transparency - Teamwork

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Where did we come from? Drivers: –Recognized need to improve/accelerate standards development –A burgeoning organizational structure –Responsiveness to volunteers/stakeholder/PIC concerns –Request to the Board to do something Initially leading to formation of the Organizational Review Committee (ORC) –Established January 2004 –Broad representation –Identified key issues and recommendations Robert Wood Johnson Foundation expressed interest to explore ways to accelerate the standards development process –Discussions started early 2005 –Yielded a unique opportunity to gain new perspective on organization and process with dedicated focus

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Strategic Initiative TaskForce Strategic Initiative Taskforce –Kickoff – August 2005 –Multi-national, multi-faceted group of HL7 members, staff, and consulting team Objectives –Create a strategy/plan to restructure the organization to: Establish and meet long term strategic objectives Support role as global/international SDO while addressing concerns of national affiliates Develop standards more efficiently and expeditiously –Deliverable by May 2006 WGM

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office A Very Basic Premise Optimize the effectiveness of our core resource: the volunteers –Maintain culture of volunteerism –Global participation –Document institutional process –Identify new sources of volunteers –Support: Comprehensive toolkit –Support: Professional/HQ staff –Support: e-Working –Support: Organization/Governance

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Problems & Solutions Product Line Confusion over role of V2, V3; messages, documents; functional spec, interoperability Define product line in conformance with product & services strategy Confusion over role of HL7 relative to other SDO, professional and clinical organizations Products & Services strategy must articulate relationship with external groups Lack of quality in ballot material Introduce and enforce quality measures; hire technical editor

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Problems & Solutions Priorities / Project Management Cumbersome, hard to maintain tooling Investing in tooling enhancements and web site/collaboration tools Lack of a well-conceived, well- executed business plan Develop and adopt a products & services strategy that can guide the organization No coordination between projects, groups Reorganize TCs & SIGs by functional area; clearly articulate harmonization processes and ownership; increase communication through TSC. Individual work products fail to support organizational goals Develop a Technical Directorate to lead development of HL7 Technical Architecture, set priorities among projects

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Problems & Solutions Marketing and Communication Lack of clarity on role of HL7 in key user communities (both traditional enterprise users and new exchange communities) Develop and promote a brand hierarchy that conforms to products & services strategy (white papers, web, etc.); hire in- house marketing expertise

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Problems & Solutions Organization/Governance Leadership cadre is narrow, does not reflect all constituencies. Need to ensure balance, full spectrum of users as well as developers and to recruit new talent. Revise P&P, Bylaws: open nomination process; Revise Board of Directors drawing from different constituencies Insufficient professional management addressing strategic, product management Hire CEO, CTO, ½ time marketing professional; integrate w/existing operations staff (AMG) Tension between requirements of the organization as a whole, the affiliates and the US constituency Promote a US Affiliate and adopt an international structure for HL7 as a whole Too driven by technology, theory; lost connection to market, users Define market, user requirements; initiate user conferences

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Transition Planning Board of Directors met August 2006 –Developed transition strategy –Start to identify transition team(s) –Assigned major task areas: Structure/Organization/Governance Product Life Cycle/Project Management Product & Services Strategy Communication/Branding Funding/Revenue Sources Volunteer Resources

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Foundation & Technologies Structure & Semantic Design Conformance CCOW Infrastructure & Messaging Electronic Services Java Modeling & Methodology Security Publishing Implementation Early Adopters Tools Services Oriented Architecture Domain Experts Government Projects Clinical Decision Support Arden Syntax Lab Templates TermInfo Healthcare Devices Image Integration XML Vocabulary Structured Documents Orders and Observations Clinical Guidelines Anatomic Pathology Emergency Care Anesthesiology Cardiology Community Based Health Pediatrics Data Standards Pharmacy Patient Safety Public Health/Emergency Response Establish Harmonization Processes Clarify Governance Provide Project Support Attachments Clinical Genomics Patient Care RCRIM RIM EHR Personnel Management Financial Management Scheduling & Logistics Patient Administration

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Structure/Organization/Governance

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Role of TSC What you will see in the SIIP Draft: –The co-chairs of the Committees and SIGs represent the primary labor pool and will remain the core source of technical expertise and development within HL7. The Technical Steering Committee (TSC) is the primary voice and organization belonging to this core cadre of volunteers. –It will be re-invigorated by providing self-elected leadership and a voice on the TD and the Board. –... In addition to these new powers, the TSC will adopt a new routine for meetings to facilitate communication and lessen the need for joint meetings. Summary: Elects own co-chairs who sit on Board of Directors Elects 3 reps to TD Input to slate of nominations for open election to TD Elects 2 representatives to the Board nomination committee Introduce more flexible meeting schedule How is the Board responding to these recommendations?

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Transitional Technical Task Force The Transitional Technical Task Force (T3F) is a forerunner of the Technical Directorate which will be brought in under the changes initiated within the Strategic Initiative. The T3F will develop an approach that will be ratified by the Technical Directorate and endorsed by the Board of Directors.

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office T3F Tasks Define parameters of an HL7 technical architecture including: –Relationship among HL7 technical work products including specifications, implementation guides and tools. –Relationship of those products to external products/standards Define the relationship of these products to the HL7 Products & Services strategy. Establish an approach to meeting new product requirements identified by the Products & Services Task Force.

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office What can we expect? When fully defined, the Technical Directorate will ratify this approach, with the endorsement of the Board. At that time, they will address issues/questions such as, for example: –When to create a new specification and when to constrain an existing specification? –When to use messaging and when to use a service oriented architecture? –When to use a message and when to use a document?

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office How will the T3F be formed? The T3F will be created at the September Plenary: –2 members elected by the International Affiliates (Sunday) –3 members elected by the Technical Steering Committee (Monday) –1 member appointed by the Board (Tuesday) The Transition Team will recommend to the Board, and the Board will approve, a method and schedule to convene the T3F, latest January, 2007

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Board What you will see in the SIIP draft: –Nominations: 2 options – from membership or member-elected nominating committee –Composition 3 elected from TSC (co-chairs) 1 from Advisory Council 1 Emeritus (5-year term, elected) 1 each from 3 geo groups of Affiliates 1 from US Affiliate 4 directors at large –Officers: Chair, Secretary, elected by the Board Alternate from Governance Transition Team: –Nominations: no change –Composition: Streamlined Board of Directors 4 fewer Directors at large 2 from Affiliates Vice-chair replaces chair-elect No HL7 Technical or vice-chair positions How will these issues be resolved? –With recommendations by the Transition Team –By the Board –In conjunction with the CEO –Ultimately reflected in changes to Bylaws and Policies & Procedures Member votes to adopt Bylaws P&P is set by the Board

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Transition to US Affiliate/HL7 What youll read in the SIIP Draft: –Affiliate or HL7 or joint membership –Financial obligations tbd –The change will take place over a 3-year period... How is the Board addressing these points: –Under discussion: Affiliate or HL7 or joint membership Financial obligations: developed in collaboration with Affiliates Transition timing recommended by Transition Team, approved and adopted by Board in consultation with CEO

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Conclusion Change is happening Many aspects in play What is known: –Board is committed to the HL7 Mission –Objective is more rapid, effective standards development What is unknown: –Exact form, timing of transition

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Process & Productivity

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Objectives HL7 will implement a product-oriented project management approach to ensure development of high-quality standards and associated products in a committed timeframe. All standards will undergo quality testing at key stages of the development process.

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Product-oriented Project Management Approach

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Product-oriented Project Management Product Sunset

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Next Steps Seek your comments on Product Oriented Project Management Approach –Peer Review and source document will be posted on the HL7 Website under Strategic Initiatives – responses to by 11/01/2006

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Volunteers

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Volunteers The HL7 work is done by volunteers... –... but many are "volun-tolds" (eg. their contribution is driven by their organisation's goals) –HL7 recognises that its "workers" cannot be managed the same way as a corporation or army... How to "push a piece of rope"? HL7 is listening!!! Proposed approach: –Support, support, support... –Motivation... –Work management

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Volunteers: Support HL7 has and will continue to increase the professional support to its volunteer workers: –Project Management Office –Technical Editor (in progress) –Better web-site tools for balloting –Better web-site tools for tele-conferences –Better web-site for collaboration (Wiki) –Better V3 tooling (Manager & Collaborative ) Also: –Free WiFi, First-timer Education, Co-chair Training, e- Learning, nice locations, …

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Volunteers: Motivation Volunteer Recognition: –"Volunteer of the Year" –Co-Chair recognition –Recognition of other functions: Facilitators, Editors, TC/SIG "Secretaries", etc. Volunteer Recruitment: –Outline professional benefits of participation –Outline different jobs within HL7 –Outline skills-enhancement of working in HL7

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Volunteers: Work Management Project Management: –Overview/information, NOT control/pressure –Project Management Office –Project Reporting System (in progress) New Projects: –... Require sufficient resources –... Require commitment –… Have sunset mechanisms

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Wrap-Up

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Execution: Current Hiring Technical Editor Investing in Tooling Contracting for Web-site Contracting for e-learning Contracting project tooling

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Execution: Next Step Convene Transitional Technical Task Force Enhance TSC Org Structure Refine design of Technical Directorate

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Management & Coordination Hire CEO Create Product line management Improve Marketing Message Prioritize

© 2006 Health Level Seven ® All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Patent & Trademark Office Strategic Initiatives A renewed HL7 on the horizon Thank you for your attention. QUESTIONS?