1. Briefing: HL7 Working Group Meeting Update for the VCDE Community Dianne M. Reeves Associate Director, Biomedical Data Standards NCI CBIIT VCDE Meeting June 16, 2011

2. HL7 Mission Health Level Seven International (HL7) is the global authority on standards for interoperability of health information technology with members in over 55 countries hl7.org Documents Workgroups Educational Sessions

3. HL7: Standards HL7 is all about use of standards to provide interoperability in electronic healthcare activities Semantic – understanding of meaning Technical – messaging Process – enable business activities to work together to use the information

4. HL7 Standards From the HL7 Introduction: HL7 creates standards for the exchange, management and integration of electronic healthcare information HL7 does not create or provide any sort of software. It does provide specifications for interoperable systems

5. HL7 Membership & Participation Membership is fee-based Participation shapes the direction of the standards under development Membership insures that organizational business needs are represented in the standards that are produced HL7 Working Group meetings Technical committees and Special Interest groups are a chance to meet F2F to work on standards. Also an opportunity to exchange knowledge and ideas.

6. HL7 Working Groups Working Group meetings held three times yearly Technical committees and Special Interest groups are a chance to meet F2F to work on standards. Provide opportunity to exchange knowledge and ideas. 54 Working groups (Tutorials and workshops) Work is done in Quarters (Q1, Q2, etc.) Agenda planned/published in advance Hosting of one group by another is common

7. HL7 Products What does HL7 produce? Documents that are reviewed and balloted Informative An Informative Document is the product of a Work Group that is not currently deemed normative, but nonetheless is intended for general publication. It explains or supports the structure of the HL7 Protocol Specifications, or provides detailed information regarding the interpretation or implementation of an HL7 Protocol Specification. Draft Document for Comment Only A Work Group, with the concurrence of the TSC, may submit proposed content or requirements documents, such as a Domain Analysis Model (DAM), to comment-only review. The intent is to gather input from members outside of the Work Group on the viability and clarity of content

8. HL7 Products Draft Standards for Trial Use (DSTU) Content is balloted by the general membership as the draft of a future standard which will, following a pre-specified period of evaluation and comment (usually 2 years), be expeditiously incorporated into normative standard. DSTU’s require at least two verified implementations that demonstrate the standard’s use. Normative Standard Content is balloted by the general membership and is considered a structural component of the HL7 Standard. Negative ballots must be resolved. Normative Standards are typically registered with ANSI.

9. HL7 Products ALL HL7 Balloted Standards are introduced first as a DSTU and must show some successful implementations before being advanced as a Normative Standard Balloting is carefully monitored and reflected in the Report Card of each Work group Negative ballots must be reconciled

10. Clinical Interoperability Council CIC Charter: This Workgroup provides a nexus of communication and bridge to the standards development framework, organizational processes and forums for the clinical community to define content, flow and other domain requirements necessary to the development of robust health data standards. CIC will support decision making practices related to clinical domain requirements developed by this committee. We will also, collaborate and offer support to other working groups when requested.

11. CIC Activities Collaboration with EHR Workgroup to investigate need for a set of standards for mobile devices, primarily in developing countries with smart phones Finish a survey of clinicians by September 2011 Sponsor project to create a tool that can import to and from EA, using an xls format document typically used by clinicians; not vendor-specific Model Automated eXchange – MAX Reconciliation of Emergency Medical Services (EMS) balloted DAM Sponsorship of ACC-sponsored Cardiology Model v2.0 (v1.0 in caDSR) Compatible with CDISC terminology and standards Slated for Balloting September 2011 Co-Sponsorship of Diabetes project – standards for Type 1 Diabetes Co-Sponsorship of Child Health Anesthesia DAM Sponsorship of TB DAM (will load into caDSR) New Sponsorship of Trauma Data Exchange DAM Exchange of Trauma Registry info, using ICD-10 codes, defined by ACS Assist groups in connecting with Clinical SMEs

12. CIC Activities Discussion of DAM and DCM construction with Patient Care (PC) Vocabulary constraints Creation of a DAM Process Guide to help CIC develop DAMs Does DAM development require specific terminology(ies)? 1.Evaluate the scope – US vs. International (Universal) 2.If terminology is an open issue, look to RxNorm, LOINC, and SNOMED Other established terminologies like MedDRA do not require change 3.Each Workgroup has a Vocabulary Facilitator to provide support 4.Vocabulary Workgroup offers ability to extend SNOMED Submit Definition, Semantic case, Example and Urgency of need DAM vocabulary requirements are now under discussion Decisions have been made CIC formally voted to partner with NCI to offer requirements for metadata registration for the HL7 community

13. HL7 Activities Next Working Group meeting: September in San Diego Work group Call Schedule on HL7.org website CIC Work group calls every 4 th Thursday of the month The public is welcome to attend the General CIC business Meeting, and any or ALL of the project team meetings If you heard about an activity in which you have interest, please contact Dianne Reeves at reevesd@mail.nih.gov