1. Evolving HL7 A Better Value Proposition in a Constrained Environment HL7 UK Annual Meeting Charles Jaffe, MD, PhD CEO Health Level 7 November 21, 2007

2. Benjamin Disraeli (1804 - 1881) Twice British Prime Minister and always quotable “How much easier it is to be critical than to be correct.”

3. The Global Landscape Disparate and conflicting technical standards Inconsistent policies and regulations Poorly articulated business requirements International disharmony Competing Standards Development Organizations (SDO)

4. The Global Marketplace one reason it’s so hard

5. The Promise for 2008 & Beyond Increased cooperation among SDOs High level cooperation among governmental agencies & regulatory authorities Improved technical deliverables by SDOs Enhanced technical specifications – meeting market demand Defined international requirements for privacy, validation, adoption timelines

6. HL7 Asked the Stakeholders Stakeholders need Clarity and Direction from the SDO leadership Concise explanation of standards: Standards for Dummies Clear articulation of the Mission and Vision of the SDOs A roadmap that defines the scope and timeline for standards An SDO to act as an aggregator of standards A clear message about our processes Improved relationships between SDOs

7. Stakeholder Perspective Robert Wood Johnson & the Strategic Initiative RWJ Grant to improve operational efficiencies Strategic Initiative (2005-7) to effect proposals Reorganization at a business & technical level Refinement of role of International Affiliates Enhanced cooperation with other SDOs –Development of US Realm objectives (HITSP & CCHIT) –Creation of an HL7-CEN-ISO Joint Initiative Council –Cooperative agreements with interacting organizations (ASTM, CDISC, IHE) Increased focus on domain capabilities (CIC, EVS, SOA)

8. Evolution of the HL7 Strategic Initiatives Development of a new Business Model –Revision of the funding model –Positioning as International SDO –Development of marketing activities –Enhancement HL7 web presence –Refinement of comprehensive tooling products and processes

9. The HL7 Value Proposition: Where the Strategic Initiatives Fit Development of a new Organizational Structure –Employment of professional management CEO CTO and Technical Steering Committee Marketing Director and Marketing Council –Engagement with other International SDOs –Support for product and services strategy –Alignment of Board composition and strategic development requirements

10. Affiliates’ Council Executive Committee HL7 Organization Chart Employees Volunteers

11. Technical Steering Divisions – Foundation & Technologies fundamental tools and building blocks − Structure & Semantic Design creation of basic patterns and common messages − Domain Experts creation of messages, services, documents − Technical & Support Services support to the Technical Steering Committee

12. Affiliates’ Council Executive Committee Projects Office Stakeholder HL7 Organization Chart - Future

13. Evolving HL7: Better Technology Redefining V3 –Definitions that go beyond marketing & branding –Understanding the technology Messaging standard Reference model (RIM) Document architecture standard (CDA) Development framework (HDF) Service architecture standard (SOA)

14. Evolving HL7: Better Marketing Marketing Council –Vigor approach to market outreach –Global Marketing Council Full-time professional Marketing Director Integration with Harris Interactive, international market-development and branding company Internal & external communications initiatives Fundamental linkage to education programs and training projects

15. Evolving HL7: Better Working Relationships Outreach & Harmonization –Policy change predates technical innovation –Initiatives for 2007 & Beyond Charter Agreements (CDISC, SAFE) Memoranda of Understanding (GS1, AHIMA) Organizational Harmonization (HL7-CEN-ISO Harmonization Charter – JWG) Cooperative agreements (IHE) Clinical initiatives (CIC, Professional Associations)

16. Evolving HL7: Better Communication HL7 Website Redesign –More than just a pretty face –Superior functionality Microsoft Sharepoint based Technical Committee forums Technical Steering Committee management sites Enhanced search capabilities Improved financial transactions

17. Evolving HL7: Better Resource Development Leveraging Funding Opportunities –Innovative approaches to funding –Prioritizing stakeholder requirements Contract with Manatt Phelps (Washington) Exploration of opportunities for development of an HL7 Foundation Stakeholders’ Roundtable Grant & Foundation funding Stakeholder Project development

18. Change Management "I haven't got the slightest idea how to change people, but still I keep a long list of prospective candidates just in case I should ever figure it out." ~ David Sedaris American Humorist

19. Thanks cjaffe@hl7.org

21. Technical Steering Divisions (1) Foundation & Technologies fundamental tools and building blocks –Conformance –Infrastructure & Messaging –Implementable Technology Specifications –Java –Modeling & Methodology –Security –Service Oriented Architecture (SOA) –Templates –Vocabulary

22. Technical Steering Divisions (2) Structure & Semantic Design creation of basic patterns and common messages –Arden Syntax –Clinical Context Object Workgroup (CCOW) –Clinical Decision Support –Electronic Health Record (EHR) –Financial Management –Genomics –Orders & Observations –Patient Administration –Personnel Management –Scheduling & Logistics –Structured Documents

23. Technical Steering Divisions (3) Domain Experts creation of messages, services, documents –Anatomic Pathology –Anesthesiology –Attachments –Cardiology –Clinical Guidelines –Community Based Health Services –Emergency Care –Government Projects

24. Technical Steering Divisions (3) Domain Experts creation of messages, services, documents –Imaging Integration –Laboratory –Patient Care –Patient Safety –Pediatrics Data Standards –Public Health Emergency Response (PHER) –Pharmacy –Regulated Clinical Research Information Management Clinical Interoperability Council

25. Technical Steering Divisions (4) Technical & Support Services support to the Technical Steering Committee –Education –Electronic Services –Implementation –Marketing Council –Process Improvement Committee (PIC) –Project Services (Project Life Cycle management) –Publishing –Tooling