HL7 Pilot Program Provides Key Intellectual Property Free ...

MAY 2012

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 require-ments 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 require-ments 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) profession-als. 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.

HL7 Pilot Program Provides Key Intellectual Property Free of Charge

® Health Level Seven and HL7 are registered trademarks of Health Level Seven International, registered in the US Trademark Office

In This Issue...

2

is the official publication of: Health Level Seven International3300 Washtenaw Avenue, Suite 227, Ann Arbor, MI • 48104-4261 USAPhone: +1 (734) 677-7777 • Fax: +1 (734) 677-6622 • www.HL7.org

Mark McDougall, Publisher • Andrea Ribick, Managing Editor • Karen Van Hentenryck, Technical Editor

Adoption of HL7 CDA®

to Connect Clinical Trial Data, EHRs: Technology to Support Patient Care, Speed Process from “Bench to Bedside”

HL7 recently announced a collaborative effort with the National Cancer Institute (NCI) to use the HL7 Clinical Document Architecture (CDA®) in a unique way that solves the problem of connecting clini-cal trial data to patients’ electronic health records (EHRs).

“This is a significant advance in HIT con-nectivity because it brings clinical trial data directly to patients’ personal physicians, which means we can improve patient care by speeding the process of moving medi-cal advances from bench to bedside,” said Bob Dolin, MD, FACP, vice chair of the HL7 Board of Directors and co-editor of the CDA. “Studies have shown that right now it can take seven years or more for new research advances to be put into clinical practice. We can make that process much quicker by improving physician access to clinical trial data, and by expressing clinical trial data us-ing meaningful use EHR standards.”

The new project demonstrates that clinical trial data can be packaged using the same HL7 standards that are incorporated into EHRs that meet the Stage 1 meaningful use criteria of the US Office of the National Co-ordinator (ONC) to bring clinical trial data

directly to the point of care and facilitate data analysis. Physicians will have a more complete picture of the care provided to their patients during clinical trials, and the project will also help facilitate data analysis that may speed the availability of new treat-ments to patients.

According to John Speakman, chief program officer for the NCI’s Center for Biomedical Informatics and Information Technology, the program will lower the barriers for systems to interoperate in the service of biomedical research and, ultimately, precision medicine. To reach these goals, the use of HHS-en-dorsed industry standards such as HL7 CDA must be part of the picture, he said.

The HL7 CDA addresses universal require-ments for the exchange and management of structured clinical documents. It supports the exchange of clinical documents between those involved in the care of patients and allows for the re-use of clinical data for public health reporting, quality monitoring, patient safety and clinical trials.

The program will be launched as a pilot program later this year.

HL7 Pilot Program Provides Key Intellectual Property Free of Charge.................................................... 1

Adoption of HL7 CDA® to Connect Clinical Trial Data.................................. 2

Meaningful Use Stage 2 Standards Proposed Rule Selects Additional HL7 Standards............................................... 3

Update From Headquarters.................. 4-5

Demo at HIMSS12 Showcased Benefits of Consolidated CDA.............................. 6

Implementations of the HL7 Context-Aware Knowledge Retrieval (“Infobutton”) Standard........................ 7

Clinical Genomics: Determined to Stay Ahead of Game-Changing Technologies 8-9

News from the PMO and ProjectServices Work Group....................... 10-11

Interoperability throughout a Corporate Integration Platform Using HL7 Standards....................................... 11-13

News from the PBS Metrics Team......... 14

LCAM: Local Clinical Alarm Manager for COPD’s Chronic Patients from the Belearic Islands.............................. 15

Andalusia Health Services: A New SOA and HL7 Strategy...................... 16-17

Electronic Surveillance of Healthcare-Associated Infections Using HL7’sArden Syntax................................... 18-20

Upcoming International Events............ 20

HL7 International Project Supports theUS Office of Personnel Management’s Blue Button® Requirements................. 21

Certification Exam Congratulations 22-23

One Step Closer to Secure EHRs and mHealth............................................... 24

Health IT Standards – What Went Wrong?........................................... 25-26

HL7 Benefactors................................... 26

Organizational Members................ 27-29

2012 Technical Steering Committee Members ............................ 30

Steering Divisions................................. 30

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

3MAY 2012

Meaningful Use Stage 2 Standards Proposed Rule Selects Additional HL7 Standards

ByKeithBoone,Director,HL7BoardofDirectors;andStandardsArchitect,GEHealthcare; andAustinKreisler,Chair,HL7TechnicalSteeringCommitteeandTechnicalFellow,SAIC

TheMeaningfulUseStage2StandardsandCertificationRulewaspublishedintheFederalRegisterMarch7,2012.ThelongawaitedchangestotheMeaningfulUseregulationsnowin-cludethreeadditionalHL7standardsandimplementationguides,includingtheIHEHealthStoryCDA®Consoli-dationImplementationGuideDraftStandardforTrialUse(DSTU),theHL72.5.1S&IFrameworkLabResultsInterfaceInformativeDocument,andtheHL7ContextAwareKnowledgeRetrieval(InfoButton)standard.TheUSHealthIT(HIT)StandardsCom-mitteealsorecommendedthatonlyonestandardbeusedforElectronic

Laboratory,Immunizations,andSyndromicSurveil-lancereportingtoPublicHealth.UnderStage1,theHL7Version2.3.1and2.5.1standardswereavailableforthosepurposes,butnowonlyHL7Version2.5.1isbeingproposed.TheyalsoselectedHL72.5.1implementationguidesforeachofthosepurposes,althoughnoguidewasselectedforSyndromicSurveillancefromambula-toryenvironments(thatworkiscurrentlyinprogressintheInternationalSocietyforDiseaseSurveillance(ISDS)).

IHE Health Story CDA Consolidation Implementation GuideTheIHEHealthStoryConsolidationDraftStandardforTrialUsewasdevelopedjointlybymembersofHL7,IHE,HealthStoryandtheONCStandardsandInteroper-abilityFrameworkteam.Thenewguideincludesninedocumenttemplates:

• ContinuityofCareDocument(Version1.1)• ConsultationNote• DiagnosticImagingReport• DischargeSummary• HistoryandPhysical(H&P)Note• OperativeNote• ProcedureNote• ProgressNote• UnstructuredDocument

UndertheMeaningfulUseregulation,aclinicalsum-marymustincludepatientdemographics,providerin-formation,dateandlocationofthevisit,reasonforthevisit,problem,medicationandallergylists,proceduresperformed,immunizationsormedicationsadministeredduringthevisit,vitalsigns,testresultsandpendingtests,careplan,referrals,andsmokingstatus.

TheavailabilityofnewdocumenttypesunderMeaning-fulUsemeansthatproviderscanusetheappropriatetypeofdocumenttorecordinformationaboutthevisit,andsupplythatrecordtothepatientasaclinicalsum-mary.ThiswasoneofthekeygoalsoftheIHEHealthStoryConsolidationproject.

Lab Results InterfaceTheHL72.5.1LabResultsInterfaceImplementationGuideistheresultofcollaborativeeffortsbetweenHL7andtheHealthandHumanServicesStandardsandInteroperabilityFrameworkLaboratoryResultsInter-faceInitiative.Thisguideaddressesthechallengesofreportinglabresultstoambulatoryproviders,harmo-nizespreviousHL7effortsonlaboratoryreporting,andaddressesregulatoryrequirementsundertheClinicalLaboratoryImprovementAct(CLIA).Itprovidesclearconformancerequirementsforimplementinglaboratoryresultsinterfacesintheambulatorysetting.Thenewguidegeneratedhundredsofballotcommentsinitsinitialroundofballoting,hasbeensubstantiallyrevisedbasedonreconciliationofthosecomments,andwillgothroughanadditionalroundofballotinginthenearfuturewiththegoalofachievingdraftstandardstatuslaterthissummer.

InfoButtonWhilemostofwhatappearedinMeaningfulUseStage2wasquitepredictable,asONCcloselyfollowedtheHITStandardsCommitteeRecommendations,therewasonesurpriseintheruleforsomereaders.TheHL7ContextAwareKnowledgeRetrievalStandard,otherwiseknownasInfoButton,wasselectedaspartoftherequiredsetofstandardstosupportClinicalDecisionsupportfortwoseparatecases.ItisrequiredtobesupportedbyEHRstoenableclinicianaccesstoreferenceinformationonproblems,medications,allergies,labresultsandotherstructuredcontentofthemedicalrecord,andalsoen-ablesaccesstopatient-specificeducationmaterials.

Keith Boone

Austin Kreisler

4 MAY 2012

Update from Headquarters ByMarkMcDougall,ExecutiveDirector,HL7

Mark McDougall

January MeetingMorethan400attendeesparticipatedinourJanuaryWorkingGroupMeet-ingheldinSanAntonio,Texas,Janu-ary15-20,2012.Over40HL7workgroupsmetinSanAntonio,ofwhich29workgroupsconductedco-chairelectionsfor42positions.Attendeesalsotookadvantageof30tutorialsthatweek.

Board ChangesTheNewYearbroughtachangeatthehelmoftheHL7BoardofDirec-tors.WewelcomedDonMon,PhD

tothestartofhistwo-yeartermasboardchair.Wealsorecognizedthemanycontributionsofoutgoingboardchair,BobDolin,MD.IthasbeenatreattoworkwithBobduringhistermaschairandwethankhimforhisbrillianceandongo-ingcalmnesswhichheconsistentlybroughttoanysituationwefaced.

Bobwillcontinuetoserveontheboardasthevicechair.

WealsorecognizedthreeoutgoingboardmemberswhoservedtermsontheHL7BoardofDirectors:BillBraith-waite,MD,PhD;HansBuitendijk;andDennisGiokas.Allthreecontrib-utedheavilytoimportantandvalu-ablerolesfortheHL7organizationthroughouttheirmanyyearsofservicetoHL7.SincerethanksalsogoestoBillandHansfortheiryearsofserviceontheHL7FinanceCommittee.

Aspreviouslyannounced,wearepleasedtowelcomethreenewDirec-torsontheHL7BoardofDirectors:

JamesFergusonofKaiserPerma-nente,EdwardTrippwithEdwardS.TrippandAssociates,andDiegoKaminkerfromHL7Argentina.Fol-lowingtermsastheaffiliatedirectorontheboard,MichaelvanCampenofGordonPointInformaticswasalsoelectedtoserveasthetreasureroftheboard.Welookforwardtowork-ingwithalloftheseindividualsalongwiththeentire2012HL7BoardofDi-rectorsthatarelistedonpage38.OnbehalfoftheentireHL7organization,Ithankeachmemberoftheboardfortheirongoingleadershipandcontri-butionstoHL7.

Meeting SponsorsIamalsopleasedtorecognizethefol-lowingorganizationsthatsponsoredkeycomponentsofourrecentJanu-aryWorkingGroupMeetinginSanAntonio:

• LINKMED• iNTERFACEWARE• GordonPointInformatics• BeelerConsultingLLC• SPARX

TheadditionalsponsorshipsupportprovidedbytheseorganizationsheavilycontributestoHL7’smeetingbudgetandismuchappreciated.

HIMSSForover20years,HL7hasexhibitedeachyearattheannualconferenceoftheHealthcareInformationandMan-agementSystemsSociety(HIMSS).Thisyear’sHIMSSconferencecon-venedinLasVegas,Nevadadur-

Bill BraithwaiteMD, PhD

Hans Buitendijk Dennis Giokas

James Ferguson Edward Tripp Diego Kaminker

Bob Dolin, MD

5MAY 2012

ingtheweekofFebruary20,2012.HIMSS12reportedlyattractedover37,000people.

HL7’sDirectorofCommunications,AndreaRibick,oversawtheproduc-tionof27thirtyminutepresenta-tionsonHL7standardsandrelevanttopics.Manyofthepresentationsat-tractedcrowdsthatfilledthetheaterareaandwerestandingroomonly.Ialsowishtoexpressoursincerethankstothemanyindividualswhovolunteeredtostaffourboothand/ormakepresentationsinourbooth,including:

CalvinBeebe

WoodyBeeler,PhD

AlanBrookstone,MD

JimCase,MD

BobDolin,MD

JohnGutai

FreidaHall

ChuckJaffe,MD,PhD

MarkJanczewski

ThomKuhn

KenMcCaslin

DonMon,PhD

GalenMulrooney

JohnQuinn

KenRubin

ScottRobertson,PharmD

DaveShaver

JimSt.Clair

SandyStuart

MichaelvanCampen

GrantWood

Benefactors and SupportersWearethrilledtohaveattractedthealltimehighestnumberofHL7bene-factorsandsupporters,whoarelistedonpage27.TheirsupportofHL7isverymuchneededandsincerelyap-preciated.Wearepleasedtorecog-nizeourbenefactorsinallofourHL7newsletters,ontheHL7website,inourHL7pressreleases,andatallofourHL7workinggroupmeetings.Aspecialthankyouisextendedtothelistoffirmsthatrepresentour2012HL7benefactorsandsupporters.

Organizational Member FirmsAslistedonpages27-29,HL7isproudtoreportthatthenumberofHL7organizationalmembercom-paniesisatanalltimehighof758companies.Wesincerelyappreci-atetheirongoingsupportofHL7viatheirorganizationalmember-shipdues.

In ClosingAsIwritethisarticle,twoofmyfavoriteeventsareoccurringthisweekend:St.Patrick’sDayandtheannualbasketballtournamentintheUSthatinvolvesteamsfrom64universitiesparticipatingin“thedance”or“MarchMadness.”Mayyouandyourlovedonesbeblessedwithawinningseasonandplentyoffundancing.

HL7 Vice Chair, Bob Dolin, MD, gives a presentation at the HL7 Booth at HIMSS12

6 MAY 2012

Health Story Demo at HIMSS12 Showcased Benefits of Consolidated CDA®

ByLioraAlschuler,HL7HealthStoryProjectLiaison;HealthStoryProjectExecutive CommitteeMember;Co-EditoroftheHL7CDA;andCEO,LantanaConsultingGroup

HL7associateorganization,theHealthStoryProject,demonstrateduseoftheHL7ImplementationGuideforCDARelease2:IHEHealthStoryConsolida-tion,Release1–USRealmforthefirsttimeattheHIMSS12InteroperabilityShowcasewithausecaseprovidedbytheAmericanCollegeofPhysicians.Thedemonstrationhighlightedhow12vendorsusedConsolidatedCDAtomaximizeinformationavailablethroughoutatransitionofcareusingallavail-ablechannels—fromunstructured,scanneddocumentstodictatednotesenrichedwithabstractor,computer-assistedandNLPcoding—whilemaintainingthepatientstory.

Onthelastdayoftheshowcase,thenationalcoordina-torforHIT,FarzadMostashari,MD,challengedpartici-pantstodemonstratereadinessforintegrationbysecurelyexchanginginformationwithanunrelatedpartneronthefloorwithinonehour.TheHealthStoryProjectpartici-patedinthechallengeandwassuccessfulinexchangingaclinicaldocumentwithinthedeadlinewithtwoseparatedemonstrationpartners.AHistory&PhysicalwassentbywayoftheVerizonMedicalDataExchangetotheSTEMTransitionofCarePilotandtoEHRvendor,OnBase,usingConsolidatedCDA.Theexchangerevealstheeffective-nessofConsolidatedCDAforexchangeofhealthdataatamoment’snotice.

ThemissionoftheHealthStoryProjectistounlockthevaluabledatainclinicalnotesandmakepossibleanunrestrictedflowofthisnarrative-sourcedataintoEMRandothersystemsforusewithinhealthcareenterprisesandhealthinformationexchanges.OverthepreviousfouryearsHealthStorysupporteddevelopmentofeightHL7implementationguidesforcommonclinicaldocu-mentsaswellaslastyear’seffortwithHL7,IHEandtheONCStandards&InteroperabilityFrameworktoconsoli-

datethemintooneimplementationguidealongwiththeHL7Continu-ityofCareDocumentstandard.ConsolidatedCDAoffersanationalfoundationforexchangeofinfor-mationcollectedinclinicaldocu-mentsandisahugestepforwardforhealthinformationinteroper-abilityintheUS.

HealthStorymembersfeaturedintheHIMSS12demon-strationincluded:Apixio,CanonU.S.A,ChartLogic,Fujit-su,Inofile,LantanaConsultingGroup,M*Modal,Nuance,OptumandVerizon.HealthStoryisdiscussingplanswithitsmembersfortheHIMSS13demonstration.InterestedvendorsshouldcontactJoyKuhlatjoy@optimalaccords.com.Visitwww.healthstory.comformoreinformationabouttheproject,andhttp://www.hl7.org/implement/standards/product_brief.cfm?product_id=258formoreinformationaboutConsolidatedCDA.

Liora Alschuler

Susan Lucci, AHIMA Liaison to Health Story and Linda Brady, Acting CEO, AHDI and CDIA

7MAY 2012

Implementations of the HL7 Context-Aware Knowledge Retrieval (“Infobutton”) Standard

ByGuilhermeDelFiol,MD,PhD,Co-Chair,HL7ClinicalDecisionSupportWorkGroupandDepartmentofBiomedicalInformatics,UniversityofUtah;andHowardStrasberg,MD,MS,Co-Chair,HL7ClinicalDecisionSupportWorkGroupandWoltersKluwerHealth

Thehighfrequencyofclinicians’pa-tientcareinforma-tionneedsthatgounansweredisawell-knownprob-lem.Estimatesvaryfrom0.2to3

informationneedsperpatientseenandabouthalfoftheseneedsarenotmet.1Onlinehealthknowledgeresourceshaveanswerstomostofthesequestions,butimportantbarrierslimittheiruseatthepointofcare.2Anincreasinglypopularap-proachtohelpcliniciansandpatientsmeettheirinformationneedsistoenablecontext-specificaccesstoknowledgeresourceswithinEHRandPHRsystemsviaInfobuttons.3BasedontheclinicalcontextinanEHR/PHR(e.g.,patientdata,task,userattributes,caresettingattributes),Infobuttonsanticipateclinicians’andpatients’informationneedsandprovideautomatedlinkstorelevantknowledgeresources.Forexample,fromaproblemlistofa73yearoldfemale,anInfobuttonmayprovideaccesstospecificinpatienttreatmentguidelinesofcommunityacquiredpneumoniainthisagegroup.Inaddition,thesameInfobuttoncouldprovideaccesstopatienteducationmaterialoncommunityacquiredpneumoniatobegiventothepatientuponthepatient’sdischarge.Stud-ieshaveshownthatclinicianswhoaccessedInfobuttonswereabletomeettheirinformationneedsin86%oftheInfobuttonsessions,reportingenhancementofpatientcaredeci-sionsin62%ofthesesessions.4

ToenablescalableandeffectiveintegrationbetweenEHR/PHRsystemsandknowledgeresources,theHL7ClinicalDecisionSupport(CDS)WorkGroupdevelopedtheContext-AwareKnowledgeRe-trieval(“Infobutton”)standard.TheInfobuttonstandardconsistsofasetofspecificationsthatincludeanormativespecificationandtwoimplementationguides.Thenorma-tivespecification(http://www.hl7.org/implement/standards/prod-uct_brief.cfm?product_id=208)hasbeenrecentlyincludedinthedraftEHRMeaningfulUseStage2StandardsandCertificationCri-teria.ThisspecificationdefinesasharedcontextinformationmodeltobeimplementedbyEHR/PHRsystemsandknowledgeresources.Thefirstimplementationguide,URL-BasedImplementationsoftheContext-AwareInformationRetrievalDomain(http://www.hl7.org/imple-ment/standards/product_brief.cfm?product_id=22),specifiesInfobuttonimplementationsusingsimpleURLs.Thesecondimple-mentationguideisadraftstandardfortrialuse(DSTU)calledContext-AwareKnowledgeRetrieval,Service-OrientedArchitecture(SOA).TheSOAimplementationguidespecifiesSOAPandRESTfulInfobuttonimple-mentations.Inaddition,thisdocu-mentspecifiesastandardknowledgeresponsepayloadbasedontheIETFAtomStandard.

Toassesstheperceivedadoption,benefits,challenges,andlessonslearnedofimplementersoftheHL7

InfobuttonStandard,weinterviewedrepresentativesof17organizationsthatimplementedthestandard,includingEHRvendors,health-careorganizations,andknowledgepublishers.AnarticlepresentingtheresultsofthisstudyhasbeenpublishedinaspecialissueoftheJournal of Biomedical Informatics dedicatedtostandardsinpractice.5Theanalysisidentified20recur-rentthemes.Overall,intervieweesunderscoredthebenefits,simplic-ity,andflexibilityoftheInfobuttonStandard.Ontheotherhand,par-ticipantsrequestedeasieraccesstostandardspecificationsandguidancetonoviceimplementerswhoarenotfamiliarwithHL7.ParticipantsalsorequestedeasieraccesstoHL7terminologyassetsthatareusedintheInfobuttonStandard.Imple-mentersexpectthattheInfobut-tonStandardwillbewidelyoratleastfairlywelladopted.However,uptakewilldependespeciallyontheadoptionbyEHRsystems,whichshouldbesignificantlyacceleratedbytherequirementtoimplementtheInfobuttonStandarddefinedintheEHRMeaningfulUseStage2StandardsandCertificationCriteria.WidespreadadoptionoftheInfobut-tonstandardhasthepotentialtobringcontextuallyrelevantclinicaldecisionsupportcontentintothehealthcareproviderworkflowaswellastoeducatepatientsabouttheirhealthcareandtreatmentop-tions,enablingpatientengagementandpatient-centeredcare.

Guilherme Del FiolMD, PhD

1.SmithR.Whatclinicalinformationdodoctorsneed?Bmj.1996;313(7064):1062-8.Epub1996/10/26.2.ElyJW,OsheroffJA,ChamblissML,EbellMH,RosenbaumME.Answeringphysicians’clinicalquestions:obstaclesandpotentialsolutions.JournaloftheAmericanMedicalInformatics Association:JAMIA.2005;12(2):217-24.Epub2004/11/25.3.CiminoJJ,ElhananG,ZengQ.Supportinginfobuttonswithterminologicalknowledge.Proceedings:aconferenceoftheAmericanMedicalInformaticsAssociation/AMIAAnnualFall SymposiumAMIAFallSymposium.1997:528-32.Epub1997/01/01.4.DelFiolG,HaugPJ,CiminoJJ,NarusSP,NorlinC,MitchellJA.Effectivenessoftopic-specificinfobuttons:arandomizedcontrolledtrial.JournaloftheAmericanMedicalInformatics Association:JAMIA.2008;15(6):752-9.Epub2008/08/30.5.DelFiolG,HuserV,StrasbergHR,MavigliaSM,CurtisC,CiminoJJ.ImplementationsoftheHL7Context-AwareKnowledgeRetrieval(“Infobutton”)Standard:Challenges,strengths, limitations,anduptake.Journalofbiomedicalinformatics.2012.Epub2012/01/10.

8 MAY 2012

Clinical Genomics Determined to Stay Ahead of Game-Changing TechnologiesByMollieUllman-Cullere,Co-Chair,HL7ClinicalGenomicsWorkGroupandSeniorBioMedicalInformaticist,Dana-FarberCancerInstitute,PartnersHealthCareSystem,Inc;AmnonShabo,PhD,Co-Chair,HL7ClinicalGenomicsWorkGroupandHeadoftheHealthcareandLifeSciencesStandardsProgram,IBM;GrantWood,HL7ClinicalGenomicsPublishingFacilitatorandSeniorITStrategist,IntermountainHealthcare;andBobMilius,SeniorDataAnalyst,BioinformaticsResearch,NationalMarrowDonorProgram

Theworldofclinicalgenomicshaschangedrapidlysincethegenetics-themedplenarysessionheldinBostoninOctoberof2010.Speakersdiscussedfamilyhealthhistoryandgeneticdataflowingintotheelectronichealthrecord.Theytalkedabouttheeverexpandingresearchwithnewlyavailableandsignificantlylargergenomicdatasets.Yetwiththehealthcareindustrytalkingaboutpersonal-izedmedicine,datamodelsandtransmissionstandardshavebeenslowinadoptionandimplementation.

Theearth-shatteringnewsnowisthatresearchfromtheNationalHumanGenomeResearchInstituteshowssequenc-ingcostsdroppinglikearockfallingfromthesky.Infact,theyareoutstrippingtheexponentialcurvesofMoore’sLaw.Wholegenomesequencinghasfallenatarecord-settingrateof$100million10yearsagotojust$1,000today.Thefirstradicallysteepdropappearedin2008withtheintroductionofnextgenerationsequencingtechnologies.

Weshouldbeabletoperformeverlargerstudiestocor-relategeneswithmedicalhistoriesduetothefallingsequencingprices.Disruptivetechnologieshavesetthestageforanacceleratedrevolutioninbothresearchandclinicalgenetics.

Next Generation Sequencing Impacting Clinical CareResearchpublications,newsstories,andscientificconfer-encesarealreadyfocusingontheuseofwholegenomeorexomesequencingintheclinic.Asanexample,triplenegativebreasttumors,whichmakeupnearly20per-centofbreastcancers,donotrespondtotreatmentwithtargetedtherapiessuchasHerceptin.Toinvestigatenew

optionsforthesepatients,clinicaltri-alsofwhole-genomesequencingforthisdiseasebeganin2010.Basedonmutationsuncoveredbysequencing,physiciansorderedtreatmentproto-colsforeitherexistingdrugs,ornewagentsbeingevaluatedinpharma-sponsoredclinicaltrials.

Amajorchallengeinwholegenomesequencingistheinterpretationofthegeneticdataforuseindiagnosticandtreatmentdecisions.Manyvendorsaredevelopingsoftwarethatwillhelpcliniciansinterpretandunderstandgeneticdataforclinicalapplication.Collaborationsbetweenvendors,academicresearch,andhealthcareprovidersarebeginningtoidentifybestpracticesfordiagnosticdevelopmentandgenediscoveryasamodelforge-nomesequencinginaclinicalsetting.

Clinical Genomics RoadmapPreviousworkdonebytheClinicalGenomics(CG)WorkGrouphelpssupportthesenewtechnologies.ThePedi-gree(familyhealthhistory)Modelpassednormativeballotin2007,andtheCCD®wasextendedtosupporttransmissionoffamilyhistorysummations.Yeteffortsarestillrequiredtogainwideradoptionofthestandard.Hopeincreaseddramaticallywhencapturingfamilyhistoryus-ingcodeddatawasannouncedaspartofMeaningfulUseStage2proposedstandards.

Mollie Ullman-Cullere

Amnon Shabo, PhD

Grant Wood

Bob Milius

9MAY 2012

TwoVersion2implementationguideswhichextendthe2.5.1LaboratoryReportingGuidetosupportstructured/codifiedreportingofcytogeneticandgeneticvariationtestresultspassedinformativeballotinJanuaryandwillbepublishedthisspring.Asthesecondreleaseofthegeneticvariationguide,thisincludedsupportforad-ditionalusecasesbasedonearlyadopterfeedbackandimprovedstructuringofinterpretationandlinkstopublicknowledgebases.WorkiscontinuingongeneexpressionprofilingandaCDA®implementationguideforgenetictestreports.AnOMICSdomainanalysismodel(DAM)willbecreatedandalignedwithalifescienceDAMandtheBRIDGmodel.Moving Forward with Projects and PilotsRecently,theCGWorkGrouphaslaunchedseveralnewprojects:reaffirmingfamilyhealthhistory,expandingitwitharelease2,clinicalsequencing,andanimplementa-tionguideforCDAgenetictestresults,aswellaspartici-pationinrelease2ofthespecimenCMET.

Lastyeartheworkgroupbeganaprojectreachingouttostakeholdersinvolvedinnextgenerationsequencingtechnologies.Theissuestobeaddressedare:(1)whatarethecompellinginitialusecasesforfullsequencing,(2)whataretherequirementsforscalingoutfromre-searchusetorobustclinicalapplications,(3)whoarethelikelyearlyadoptersandhowwillweengagetheminthestandardsprocess,and(4)whatarethelikelysystemsarchitecturesthatwillevolveinordertoaccommodategeneticsequences.

TheCGWorkGroupisalsoexploringtheuseofHL7standardsformessagingandstructureddocumentstoaddressthechallengeforrecordingandreportingHLAtypingresults.Thematchingofstemcelldonor(bonemarrow,peripheralbloodorumbilicalcordblood)toarecipientisdeterminedbycomparingtheirtissuetypes,andisknownasHumanLeucocyteAntigen(HLA)types.TheCDAimplementationguideforgenetictestingreports(CDAGTR)willbefurtherconstrainedandspecializedforuseinHLAtypingreports.ApilotisbeingdevelopedtoexchangeHLAtypingresultswithinHL7messagesanddocumentsbetweentwoclinicalgroups(HadassahMedicalOrganizationandNorthwesternUniversity)and

theNationalMarrowDonorProgram(NMDP).Thispilotincludesdevelopingusecasesandstoryboards,whichwillbeusedtoguidestructureddocumentdesignandmodelrefinement,aswellasexchangingdatausingHL7containersandpayloads.

HL7 Multi-Workgroup Collaboration Critical for Success TheCGWorkGroupactivelycollaborateswithanumberofotherHL7workgroups,includingOrdersandObserva-tions(O&O),AnatomicPathology(AP),ClinicalDecisionSupport(CDS),ImageIntegration(II),RegulatedClinicalResearchInformationManagement(RCRIM),ClinicalInteroperability(CIC),andMarketing.Twonewprojectsbeganthisspring:CGisworkingwithII,CDS,AP,andLabonO&O’sspecimenCMETrelease2andclinicalsequencingwilllooktoLab,O&O,AP,andSDformes-sagingcomponentswithintheoverallclinicalsequencingworkflow.CGandCDShavealong-termcollaborativeeffortaroundfamilyhistoryandthepedigreemodel.CGisworkingwithCIConoverallstrategyfordevelopmentoftheOMICSDAM,examiningstrategywhichsupportscrossorganizationcollaborationofalignedDAMswhichsupportawidevarietyofstakeholdersfromresearchtoclinicaltrialtoclinicalenvironments.

Happeningfasterthananyonepredicted,wewillhaveanunderstandingofourgenomessuchthatgettingeveryonesequencedwillmakebothmedicalandeconomicsense.Weneedtokeepinmind,however,thatfallingpricesaresimplythefirststep.Clinicalinterpretationsarestillcomingslowly–fornowanyway.AndtheClinicalGenomicsWorkGroupwillcontinueitseffortstostayaheadofthecurve.

10 MAY 2012

Dave Hamill

NewsfromthePMOand Project Services Work GroupByDaveHamill,Director,HL7ProjectManagementOffice;RickHaddorffandFreidaHall,Co-Chairs,ProjectServicesWorkGroup

SAIF Pilot Coordination ProjectProjectServicesisleadingthisproject,whichissponsoredbytheTechni-calSteeringCommittee.TheprimarydeliverableoftheSAIFPilotCoordina-tionprojectwillbetocreateconcreteexamplesofartifactsthatcanbeusedinafutureversionofanHL7SAIFimplementationguide.

SAIFPilotCoordinationwillassistinthedocumentationofprocessesen-counteredthroughoutthedevelopmentofprojectsundertheSAIFAP(Archi-tectureProgram)umbrellathatrequireinputfrommorethanoneworkgroup.

TheteamhasusedRASCIchartstocapturetherolesandresponsibili-tiesofgroupsintheseefforts.ThefirstuseofthistoolwastocapturetheinteractionsbetweengroupsasamodelingtoolwasselectedforuseintheOrdersandObservationsCompos-iteOrderproject.TheteamhasalsousedProjectInsighttohelpmodelthedependenciesbetweentheSAIFpilotprojects’activities.

Additionally,theteamhasbeguntouseaconceptmappingtooltopresentthedependenciesdiagrammatically.Thisistheworkwewillbefocusingoninthenextseveralmonths.

Overall,theProjectwilldocumentcoordinationconductedbyover12HL7workgroupsastheyproceedthroughover9projectsundertheSAIFAPumbrella.Fromthiscoordina-tion,suggestedcontributionstoSAIFGovernancedocumentswillbecreatedaswellasmodificationstotheHL7ProjectLifeCycleforProductDevelop-ment(PLCPD).

ProjectServicesishappytobeworkingonthisefforttohelpmoveHL7towardtheadoptionoftheSAIFarchitecture.Weappreciateandwelcomethecontri-butionsfromallthoseinvolvedintheSAIFAPprojects.

Guidance for Steering Divi-sion Co-Chairs: Using PBS Metrics to Evaluate WG Capacity to Undertake New EffortsProjectServiceshascreatedanewdocumentofferingsuggestionsandguidanceforsteeringdivisionco-chairsonusingthePBS(ProjectsBallotsandStandards)Metricstoevaluateworkgroupcapacitywhentheyareunder-takingnewprojects.

InadditiontoreferencingthePBSRe-portslinklocatedontheworkgroup’sHL7.orgpageandthePBSMetricsExcelreportlocatedinGForge,thedocumentcontainsalistofpotentialissuesandquestionswhichsteeringdivisionco-chairscanposetotheworkgroups.

Thedocumentislocatedatwww.HL7.org>Resources>Tools&Resources>ProjectTrackingTools(http://www.hl7.org/documentcen-ter/public/wg/projectServices/PBS-MetricGuidanceforSDCoChairsFinal.doc).

Come Join Us for the Project Management RoundtableEveryworkinggroupmeeting,ProjectServiceshostsaninformalgatheringatlunchtimeonWednesdaycalledtheProjectManagementRoundtable.Lookforthetentcardwith“ProjectManagers”onitinthegeneralsession/lunchballroom.

Theforumisopen.Pleasecomeforwardwithanyprojectquestions,concernoridea.We’dlovetohaveyoujoinus!

Webinar Re-cording: HL7 Project Man-agement Tool Overview for HL7 Project FacilitatorsIncaseyoudidn’tknow,theHL7PMOrecordedawebinarthatprovidesanoverviewofthevariousHL7ProjectManagementtools.Toviewthe38minutewebinarrecording,gotowww.HL7.org>Resources>WebinarRecordings.

Thissession,targetedforco-chairsandthoseleadingHL7projects(i.e.projectfacilitators),demonstratesHL7projecttoolsincludingProjectInsight(HL7’sprimaryprojectrepository),theHL7SearchableProjectDatabase,GForge,aswellasreviewHL7projectprocess-esandmethodologies.

IfyouwouldlikethePMOtopres-entthiswebinaratoneofyourSteeringDivisionorWorkGroupconferencecalls,[email protected].

HL7 Project Tracking ToolsAllofHL7’sprojecttools,includingtheSearchableProjectDatabase,GForgeandProjectInsight,areavailableonwww.HL7.orgviaParticipate>Tools&Resources>ProjectTrackingTools.

Freida Hall

Rick Haddorff

11MAY 2012

Interoperability throughout a Corporate Integration Platform Using HL7 Standards

ThePublicHealthcareProvideroftheAragónAutono-

mousCommunityofSpain(SALUD)isresponsiblefor

thehealthcaredeliveryto1.34millioninhabitantsinthe

AragónregioninnorthernSpain.Withanannualbudget

of1.8billionin2012,SALUDcoversageographicalareaof

47,719km.

SALUD,throughitshospitals,primaryhealthcentersand

otherspecialtyfacilities,offersacomprehensiveportfolioof

servicestocitizens,including:

• Primarycare

• Acutecare

• Chronicallydependentcare(skillednursing)

• Mentalhealth

• Emergency

• Publichealth

• Pharmaceuticalbenefits,orthoprosthetic,dietary

productsandhealthtransport

Thepublichealthsystemisdividedintoeightgeographi-

calsectors,eachofofwhichhasareferencehospital.The

healthdistrictisthebasicterritorialframeworkforprimary

healthcare,havingdirectaccesstothepopulationandwith

theabilitytoprovideongoingsupport,andincludes:

• 124Primarycarecenters

• 990Primarycarephysicians

• 167Pediatricphysicians

• 933Primarycarenurses

InDecember2006,theinteroperabilityprojectbeganasthe

basisfortheITstrategyforthepublichealthsystem.Orion

HealthRhapsodywaschosenforthispurpose,mainlyfor

itssimple,efficient,robustmanner,independentofvendor-

specifictechnology.

InJune2007,thefirstinterfaceswentintoproduction,and

Rhapsodyhasoperatedcontinuouslysincethen.Today,

Rhapsodyprovidesthebasisforintegrationbetweenthe

differentinformationsystemsoftheDepartmentofHealth

ofAragón.TherearecurrentlynineinstancesofRhapsody

inproduction,oneforeachterritorialsectorofAragón,as

wellasthecentralnode.

TheHL7Version2.5standardwasadoptedatthebegin-

ningoftheprojectforeverymessagepassingthroughthe

integrationengine.AnimplementationguideforAragónis

currentlybeingcompiledandisexpectedtobepublished

thisyear.

ThedeploymentofRhapsodyinAragónisbeingledbythe

CenterforIntegratedManagementofCorporateProjects

(CGIPC)ofSALUD.Thedevelopmentandmaintenanceteam

iscomposedentirelyofC2CConsultingTSISconsultants.

Case I: Patient Unique Identification at Corporate LevelAtAragónHealthService,auniqueidentifierhasbeen

definedforeverypatient(CIA,AutonomicIdentification

Code),insuchawaythattheyareuniquelyidentified

acrossallfacilitiesanddevicesinsidethehealthsystem.

Thiscodeisautomaticallycreatedandmanagedbyan

EnterpriseMasterPatientIndex(EMPI)system.Thenormal

operationofthesystemcomprisestwocircuits,relatedto

thepatient’sentrypointstothehealthsystem:primary

careandemergencyservicesathospitals.

Clinicalsystemsarepermanentlysynchronizedwiththede-

mographicdatabaseandEMPIforprimarycaresince

continued on page 12

Carlos Tellería Orriols

ByCarlosTelleríaOrriols,IntegrationManager,SALUD

12 MAY 2012

patientshavebeenprevi-

ouslygrantedtheirhealth-

careassurance.Whena

newpatientiscreatedin

theassurancedatabase,a

notificationissenttoan

EMPIWebService,which

createsauniqueID(CIA)

forthatpatientandthen

returnstheinformationto

thedemographicdatabase.

Thisdatabasebroadcasts

anADTA28messagetoall

primarycaresystems.

Thecircuitismore

complexwiththehospi-

talemergencysystem.A

patientmaynotexistin

theEMPIsystem,butit

ismandatorytoprovide

assistancetohimorherin

asecureway.Innormal

conditions,whenapatient

arrivesatemergency,HIS

sendsanADTmessage

toEMPI,whichidenti-

fiesthatpatientand

returnshisorheruniqueID(CIA),creatingitifnecessary.

Thereafter,HISkeepsthatidentifierandincludesitin

everymessagesenttothirdpartysystems,suchasRISor

laboratory.

Ifacommunicationproblemoccurswhenapatienthasn’t

yetbeenassignedhisorheruniqueCIA,theEAIbus,

responsibleforcommunicationsamongsystems,detectsa

SIUorORMmessagelackingaCIAandtriestolookforit

intheEMPI.Ifthisoperationisnotpossible,EAIassignsa

temporaryuniqueIDtothepatientwiththeformat“PROV”

+LocalHistoryNumber,andaddsaPID.3elementtothe

messagewiththisID.Oncecommunicationsarerestored,

andwiththepermanentCIAalreadycreatedinEMPI,EAI

broadcastsamergemessageA34toallinvolvedsystemsin

whichthetemporaryCIAisreplacedbyapermanentone.

Thisoperationallowsfortherestorationofidentifiersand

guaranteesthatthepatient’shealthcareandcorrectidentifi-

cationareprovidedatalltimes.

Case II: Simultaneous management of laboratory orders and appointments with HL7 messagesSALUDhasanelectronichealthrecordtoolforprimary

healthcarethatallowsthegenerationandsendingoflabora-

toryorders,butitdoesnotsupportappointmentmanage-

mentforanalytictests.Admissionstaffatthespecialty

facilitiesusuallyperformsthisaction.

SALUDhasalsodevelopedacustomsolution(LabRM,

Interoperability, continued from page 12

Case 1: EMPI at Aragon Health Service

13MAY 2012

Case II: SALUD’s LabRM system

LaboratoryRequestManager)formanagingbothlab

ordersandpatients’appointmentsforanalytictests.This

solutionismulti-labandmulti-requester,andconnectiv-

ityisdefinedwithasetofHL7messagesformanaging

ordersaswellasappointments.

Aimingtofacilitatepatientappointments,andalsowith

thegoalofreducingpressureonadmissionpersonnel,a

routehasbeendevelopedbetweenprimarycaresystems

andLabRM.Beginningwiththeorderrequest,therouteis

asfollows:

• Registerslaboratoryorders

• Selectsthecorrect

extractionpointand

scheduledepend-

ingonordertype

requested

• Assignsappoint-

mentsfindingfirst

availablegaponthat

schedule

• Linksappointment

toorder

• Returnstheappoint-

mentdetailstothe

clinicalapplication

Thus,patientsleavetheir

consultationwithboththe

appointmentandthelab

ordersimultaneously.

LabRMisalsoresponsible

forsendingrequeststolabo-

ratory,andmanagingresults

aswellasforwardingthem

toclinicalsystems.These

transactionsaredeliveredus-

ingstandardOML/ORLand

ORU/ACKschemes.

Allthelogicinsidetheprocessesforselectingschedules,

findingschedulegaps,tryingtofixanappointment(re-

cursivelyifneeded),andcomposingamessagethatjoins

orderandappointmentdetails,hasbeendevelopedover

OpenESBBPELengine.

Allintegrationroutesandtrafficmanagementhavebeen

implementedwiththeOrionHealthRhapsodyEngine.

ITstaffatSALUD,incollaborationwithC2Cconsultants,

developedthesystem.

14 MAY 2012

News from the PBS Metrics TeamByHL7InternationalStaffMembersDaveHamill,Director,ProjectManagementOffice;LynnLaakso,TSCProjectManager;DonLloyd,PhD,DirectorofTechnicalPublications;andKarenVanHentenryck,AssociateExecutiveDirector

PBS Metrics (Projects, Ballots and Standards) ReportThePBSMetricsTeamwouldliketothankalltheworkgroupco-chairs,projectfacilitatorsandeveryoneelsethathadahandincleaninguptheir‘infractions’(i.e.reditems).Theteamcontinuestoenhancereporting,visibilityandresourcestomakeitaseasyaspossibleforworkgroupstoaddressproblemareas.OnHL7.org,viaResources>WorkGroups,youcannowfindforms,templatesandprocessdocumentationtohelpyouaddressPBSinfractions.

PBS Metrics Work for 2012ThePBSMetricsTeamwillfocusonmakingthePBSinfor-mationeasiertoaccessandmorevisible.AlinktothePBSMetricsExcelreportwillbeaddedtoeveryworkgroup’swebpageonwww.HL7.orgaswellastheHL7Search-ableProjectDatabase.‘Interim’reportswillbepublishedbetweenworkinggroupmeetings(WGMs)toprovidemoretimelyinformation.Co-chairswillbeprovidedtheirProjectInsightlogincredentialspriortoWGMssoprojectcleanupwillbeeasier.PBSTeammemberswillassistincreatingeducationalmaterialonHL7balloting,andtheSearchableProjectDatabasewillbemodifiedtoindicateiftheprojecthasaPBSMetricsinfraction.PBS Metrics Reports and DashboardThePBSMetricsreportinganddashboardsareeasilyac-cessibleviatheReportslinkonyourworkgroup’sHL7.orgpage.ThislinkdirectsyoutoGForge,wherethereportresideswithintheTSC’sFilearea(http://gforge.hl7.org/gf/project/tsc/frs/?action=FrsReleaseBrowse&frs_pack-age_id=169).

Asareminder,thePBSreportinganddashboardsreflectthefollowingcriteriaforeachworkgroup:

1. IdleBallots-Itemsthathaven’tballotedinayear,andarestill“open”(haven’tsuccessfullycomplet-edtheirballot)

2. NoReconPackage-Itemsthathavenothadarec-onciliationpackageposted

3. Non-AdvancingBallots-Itemsthathavegone

through3ormoreballots4. ExpiredDSTUs-ExpiredDS-

TUsthathavenotproceededtonormativeorsomeotherballotlevel

5. UnpublishedCMETs-CMETsthatarefinished(passedbynumbersandReconiscom-plete)butunpublished(wait-ingfortheCMETclean-upworktobecompletedbyAndyStechishinandDaveHamill)

6. UnpublishedBallots-Itemsthatarefinished(passedbynumbersandreconciliationiscomplete)butunpublished(notinNormativeEditionoronHL7Standardspage)

7. ProjectsinProjectInsightthatarebehindmorethan120Days

8. ProjectsinProjectInsightwithan‘Unknown’status

9. Workgroupsthatdonothaveany3-YearPlanItemsinProjectInsight

ThePBSMetricsReportwascreatedtosupporttheHL7strategicinitia-tiveto“streamlinetheHL7standardsdevelopmentprocess.”Itisintendedtobeatooltoassistworkgroupswithmanagingballotsinadditiontocleaningupprojectsandolddata.Byreviewingthereports,workgroupscanidentifypotentialissuesbeforetheygetoutofhandaswellasmoveitemsthroughballotingtoafinaldocumentorstandardstate.

Ifyouhaveanyquestionsorcomments,pleasedirectthemtoanyPBSMetricsteammember:DaveHamill([email protected]),LynnLaakso([email protected]),DonLloyd([email protected])andKarenVanHentenryck([email protected]).

Dave Hamill

Lynn Laakso

Don Lloyd, PhD

Karen Van Hentenryck

15MAY 2012

LCAM: Local Clinical Alarm Manager for COPD’s Chronic Patients from the Balearic Islands ByA.CondeGeli,M.PonsCrespí,M.N.MeliàAguiló,J.C.AmerOliver,F.TousLlull,IntegrationCompetencyCenter(http://cci.ibit.org),DepartmentofHealth,FundacióiBit

AbstractThepresentarticledefinestheLocalClinicalAlarmManager(LCAM),aninteroperabilityprojectofsev-eralinformationsystemsrelatedtothemonitoringandearlydiagnosisofChronicObstructivePulmonaryDis-ease(COPD),whichappliesalgorithmswhichreflectthereferenceclinicalpracticeguides.Theproject’sscopeisdefinedwithintheBalearicIslands’healthandsanitaryenvironment.

LCAMisgenericandconfigurable,andallowsprofes-sionalstomonitoroneorseveralchronicdiseases.ThearchitectureisbasedonaServicesOrientedArchitecture(SOA)model,andthesynchronizationwiththelocalclinicalapplicationiscarriedoutusingtheHL7ClinicalContextObjectWorkgroup(CCOW)standardprotocol.

IntroductionChronicdiseasesaretheepidemicsofthetwenty-firstcentury,especiallyincountrieswithapopulationwithahighagingrate.COPDisacauseofhighmorbidity,mortalityanddisabilityinSpain.Itisestimatedthatbetween9%and10%oftheadultpopulationover40yearsofagesufferfromCOPD,andthatover70%ofthemremainundiagnosed.Chronicdiseasesentailcostlyandcomplexprocesses,andrepresentabigper-centageofthesanitarycosts.

Theinformationsystem(IS)thatsupportstheChronicDiseasesAlarmManagerwillbereferredtoasLCAMinthisarticle.

TheISconsistsofaclientpart,installedineachpro-fessional’spersonalcomputer,aswellasaserverpart,whichactsasanintegrationcorewiththedifferentsanitaryinformationsystems.Theclientpartisfedbythesanitaryapplicationwhichtheprofessionalisusingatthetime—generallyanyapplicationwhichusesHL7CCOWasanintegratedcommunicationprotocol.CCOWinformstheclientpartoftheLCAMaboutthecontextpatient—thepatientaboutwhomtheclinicalprofes-sionalisqueryingthesanitaryapplication—andaboutwhichspecificchronicdiseasestheprofessionalisin-terestedinmonitoring.Oncethisinformationhasbeencollected,LCAM’sintegrationengineinformstheclientifitisnecessarytodisplayalarmswhichmayinteresttheclinicalprofessionalrelatedtothepatientwhoisbeenqueriedatthetime.

Project Aim• Assistanceimprovement:supportfortheclinical

professionaluponthemonitoringandtreatmentofthechronicdiseaseCOPD

• MinimizationofCOPDinfra-diagnosis,easinganearlydiagnosisofpeoplewithinEPOCrisk

Designing a Prototype Solution for COPDTheprototypedesignhadtoincludeaprevioussyn-chronizationstepbetweenthepatientthatisbeingqueriedbytheclinicalprofessionalandLCAM.ThissynchronizationprocessiscarriedoutbyimplementingCCOWwithLCAMwithinitsclientpartandtheclinicalapplicationusedbytheclinicalprofessional.Theclini-calapplicationinstigatescontextchanges,cascadinganychangetotherestofapplicationswhichsharetheprotocol(inthiscaseLCAM)everytimeanewpatientqueryiscarriedout.Oncetheclinicalprofessionalhascarriedoutthepatientquerytheapplication,acascadewillbecarriedoutwithinthenewcontext,andLCAMwillgatherinformationaboutwhetherthepatientisorisnotatrisk,orifCOPDhasbeendiagnosed.

Anabsolutepriorityatthetechnicallevel,andinordertoenableaprogressiveadditionofotherchronicdiseas-es,wastoobtainasolutionalreadyadaptedforre-us-ability,flexibilityandscalabilityinthefuture.

Interoperating InformationInordertoenabletheinformation’sinteroperability,ameansoftransportwasneeded,togetherwithasyn-chronizationstandardbetweenthedesktopapplications.TheHL7CCOWandVersion3standardswerechosen.

FutureInordertoincreasethefunctionalitiesofLCAM,theac-tionsthatneedtobecarriedoutforthisinteroperabilityprojectareasfollows:

• Monitoringandearlydiagnosisofvascularrisk/diabetesmellitus

• Monitoringofthespecificcare-givingprograms

ConclusionsTheclientLCAMhasbeensetupinfifteenhealthcentersandthreehospitalswithintheBalearicIslands.Inclinicalliterature,themostacceptedproposalcon-sistsofcombiningthepresenceofthemainriskfactor(smokinghabit),theagecriteria(asageincreases,the

continued on page 17

ByJoséRománFernándezEngo,ChargeofStrategyforInteroperability,ITDepartment,SAS-AndalusiaHealthServices

16 MAY 2012

José Román Fernández Engo

TheServicioAndaluzdeSalud(SAS–AndalusiaHealthServices)isthepublicorganizationprovidinghealthser-vicesintheAutonomousCommunityofAndalusia,Spain.SASservesapopulationof8millionpeopledistributedina33,694.4sqmileterritorythroughanetworkofapproxi-mately85,000healthprofessionalsworkingin29hospitalsand1,500PHCcenters.

BackgroundDuringthelastdecade,SAShascentereditsITeffortsonprovidingacentralizedinformationsystemforgeneralprac-titionersandpediatricians.ThissystemcoversthewholePHC(primaryhealthcare)level,includingthepatientelec-tronicPHCrecord,anelectronicprescriptiontoolintegratedwithprivatepharmacyoffices;andalaboratoryorderstoolaccessiblefrompublicPHCpremisesthroughouttheentireterritory.TheprojectisnamedDiraya,whichistheArabicwordforknowledge.

However,publichospitalshaveremainedmostlyisolatedITenvironmentscharacterizedbylocallydevelopedorthirdpartysolutions,withspecificintegrationsatalocallevelandadiscretenumberofpointtopointintegrationswithSAScorporateinformationsystems.

SOA Governance and HL7 MessagingTheSASstrategicITplanforesawprovidingcorporateso-lutionstotertiarycarewhilerespectingtheparticularitiesofITecosystemswithinthedifferentclinicaldepartmentsineachhospitalaswellasallowingforseamlessinfor-mationexchangewithintheorganizationitselfamongalllevelsofcare:withotherpublichealthorganizations,externalproviders,otherregionalhealthinformationsystems,theSpanishHealthMinistryandEuropeanhealthauthoritieswiththeutmostsecurityandreliability.TheplanfocusesonreducingITandbusinesscosts,promotingITreusabilityandorderedgrowth,andprovidingasolidorganization-widebasisforbetterclinicalandmanage-mentdecisionmaking.

Toturntheplanintoareality,fiveyearsago,theSubdi-reccióndeTecnologíasdelaInformación(SASITDepart-ment),withthehelpofRed.es,undertooktwocomplemen-tarylines:buildingacomprehensivecatalogueofcorporateservicesthroughouttheorganizationtofulfilltheneedswithinhospitalsandamongdifferentlevelsofcareforclini-calandmanagementpurposes,andusinganinternationalandreliablestandardforinformationexchangeamonghealthinformationsystems.

ThemainobjectivesoftheHL7SOAstrategyare:• Adoptionofastrategyandaninformationpolicy

andintegrationdefinedandstableovertime• Establishingagovernancemodelthatallowsboth

theconsolidationanddisseminationofthesepoli-ciesandtherules,masterdata,etc.

• Definition,modelingandconsolidationoforgani-zationalprocesses;andthedefinitionandimple-mentationofsustainablelifecyclemodelsforallnecessaryserviceswhetherornottechnological

• Thewidespreadapplicationofrulesandstan-dards(HL72.x,CDA,CIE9,etc.)forprocessmodelingandestablishingresponsibilityfortheinformationoftheorganization

• Theimplementationoftheservicesthatestablishandunifytheinterpretationoftheinformationintheorganization

• Theadoptionofasyntaxbasedcommunicationstandardcommontoallsystems,theforceoflawderivedfromthemodelingbusiness

• Hardwarearchitectureforinformationmanage-mentandcommunicationsbasedtechnologystandards,whichensuretheexchangeofinforma-tiononthephysicallevel

TheSOAGovernancegroupoftheSASITDepartmentisresponsiblefortheInteroperabilityTechnicalOffice(OTI)andissupportedbyandpartneredwithAccenture,whohasbroadexperienceinhealthbusinessprocessandITsystems.TheroleoftheOTIistodefinecommunicationinterfacesbetweenclinicalapplicationsandtodefineandstandardizeSOAservices.Italsocoordinatesdevelop-mentsmadebythevariousplayersoftheAndalusianPub-licHealthSystem(SSPA)fortheconstructionofDIRAYA.TheOTI’sfunctionsincludethefollowing:

• ImplementthegovernancemodeldefinedbySOAgovernancegroup

• Coordinatemodelingprocess• Setrulesandstandards,useanddissemination

policiesandprocedures• Establishandmanagetheservicecatalog• Definemasterdataoftheorganizationandits

responsibilities• Tracethepathofconvergenceofsystemstothe

newmodel,projecttoproject,aspartofaglobalmacro-project,ensuringcoexistencewiththeexistingsystems

• IntegratetheactorsparticipatingintheSSPAinformationmanagementthroughacorporateordepartmentalpolicydisseminationofstandards,

Andalusia Health Services:

A New SOA and HL7 Strategy

17MAY 2012

trainingactivitiesandacertificationprogramofdevelopmentsaimedatinteroperability

Main ResultsToday,eightpublichospitalsarefullyoperationalintheDAEproject.Atightdeploymentscheduleisunderwaytoextendittotheother22hospitals.Organization-widelogisticsandITmanagementsystemsarealsobeingprogres-sivelyintegratedintotheSOAandHL7messagingstrategy.SincetheimplementationofthestrategyinSeptember2009,importantresultshavebeenachieved.Thescopeoftheseresultsmorethanjustifiestheinvestment,botheconomi-callyandintermsofeffort,fromtheDirectorateofITininternalization,disseminationandtraining.Theresultsaresummarizedbelow:

MANAGEMENT• SOAandHL7strategyfromOTIinDAEhaspro-

ducedasavingsof86%indevelopmentandimple-mentationcostsexpectedwithamaximumreuserateobtainedwiththeSASSOAServicesCatalogue

DEVELOPMENT• Providesdocumentationor

referencetoalotofcontrolintheirevolution

• Unifiessupport,simplifyingthetrainingofbothtechno-logicalandprojectmanage-ment,etc.

• Simplificationandreuseofdevelopmentsfortheseunits“atomic”fromthestand-pointofbusinessfunctional-ityandnotitstechnologicalconfiguration

• Decouplesapplications,allowingtheindependentevolutionofbusinessareasbasedonfunctionalneeds

• ScalabilityandSustainabilityKNOWLEDGEMANAGEMENT• Internalizestheknowledgeofthebusinessby

improvinginternalcontrolprojectsandreversingtheknowledgeintheorganization,thusavoidingdependenceonexternalagents

• Avoidsdatainconsistenciesbyhavingrolemodelsoftheinformationthatreflectthatdata

• Ensuresinteroperabilityoftheorganizationbothinternallyandexternally

Toillustratetheseresults,thefollowingtableshowssomecounters:

disease’sprevalenceincreases),andtheuseofahighlyconsistenttestsuchasspirometry.ThisiswhatLCAMconsiders,thereforeimprovingthepatient’sassistancequality,togetherwiththeclinicalprofessional’sassis-tance,forthreeclearreasons:

1.Monitoringandearlydiagnosis,bycomputerizingtheclinicalpracticalguides,togetherwithmedicinebasedscientificevidenceinordertoimprovetheassistancequalityforoneofthetwenty-firstcenturyepidemicsfordevelopedcountries:chronicdiseases

2.Solvingthecurrentproblemofthelackofcom-municationbetweenthedifferentassistancelevels,generatinganalarmatanylevel,thusalertingtheclinicalprofessionalsaboutanearlydiagnosisorinformingtheclinicalprofessionalthatthepatientisalreadyundertreatment

3.Communicatingbetweenthedifferentassistancelevelsbyusingcommunicationprotocolsandstandards,tryingtomitigatethereport,diagnosisand/ortreatmentsduplicity

ReferencesEstrategiaenEPOCdelSistemaNacionaldeSalud.Sanidad2009MinisteriodeSanidadyPolíticaSocial.

SobradilloV,MiravitllesM,GabrielR,Jiménez-RuizCA,VillasanteC,MasaJF,etal.GeographicalvariationsinprevalenceandunderdiagnosisofCOPD.ResultsoftheIBERPOCmulticentreepidemiologicalstudy.Chest.2000;118:981-989.

Sobradillo-PeñaV,MiravitllesM,JiménezCA,GabrielR,ViejoJL,VillasanteC,MasaJF,etal.EstudioEpidemiológicodelaEnfermedadPulmonarObstructivaCrónicaenEspaña(IBERPOC):Prevalenciadesíntomasrespiratorioscrónicosylimitacióndelflujoaéreo.Arch.Bronconeumol.1999;35:159-66.

HealthLevelSevenClinicalContextObjectWorkgroup[online]http://www.hl7.org/Special/committees/visual/index.cfm(Consultada:Agostode2011).OracleHealthcareTransactionBase[online]http://www.oracle.com/us/industries/health-care/046614.html

HealthLevelSevenInternationalVersion3[online]http://www.hl7.org/implement/stan-dards/product_brief.cfm?product_id=186

LCAM, continued from page 15

Andalusia Health Services, continued from previous page

18 MAY 2012

ArdenSyntaxisamedicalknowl-edgerepresentationandprocessingschemeforthedevelopmentofclini-caldecisionsupport(CDS)systemsthatthatoriginatedin1989atagath-eringofseveralmedicalinformati-cistsfromtheUSA,theNetherlands,andSwedenattheArdenHomesteadRetreatinOrangeCounty,NY,confer-enceestatesownedbytheColumbiaUniversity.Theintentionwastowritecomputer-basedclinicalre-minders,diagnosticandtherapeuticrecommendations,andcrucialalertsinaclearandreadablewayand—asoneofthemainobjectives—tomakethemshareabletoothers.

Sincethen,theearlyversionsofArdenSyntaxhavebeenupdated,extended,andwereadoptedbystandardsorganizations.TheAmeri-canSocietyforTestingandMaterials(ASTM)firstapprovedtheArdenSyntaxasstandardE-1460-92in1992.OwnershipwastransferredtoHealthLevelSeven(HL7)andtheAmericanNationalStandardsInstitute(ANSI)in

1999withtheapprovalofversion2.0ofthestandard.ThelatestreleaseisArdenSyntaxversion2.8whichwasapprovedinJanuary2012;however,HL7’sArdenSyntaxWorkGroupisstillpreparingfurtherimprovementsof,andextensionsto,thisrepresenta-tionandprogrammingcode.

ArdenSyntaxisasyntaxdefininghowtoarrangeinputdatatobeprocessed,conditionandactionpartsofclinicalrulestobewritten,andhowandwheretooutputthecom-putedresults.Medicallogicmodules(MLMs)arethebasicrepresenta-tionandprocessingunitsinArdenSyntax,andthesyntaxwasdesignedsuchthateachMLMmaycontainalltheknowledgeforatleastonesingledecision.However,MLMscancalleachother,beinterconnected,evenintertwined,andcanthusformwholemedicalknowledgepackages(MKPs)1,consistingofsetsofMLMs.

Tomakethesyntaxoperable,oneneedstowrite—sayprogramina

programminglanguage—aninter-preterorcompilerforArdenSyntax,andanexecutionenginetohavetheMLMsbeingprocessed.Inaddition,anauthoringtoolcontaininganeditorforwritingMLMs—whichpos-siblyincludesanexecutionenginefortestingthembeforetheybecomeenacted—usuallycomeswithsuchasuiteofArdenSyntaxsoftware.

Followingcurrentsoftwarearchi-tecturesandprovidingtheArdenSyntaxexecutionenginewithinaservice-orientedarchitecturemakesitpossibletoofferinteroperableCDSsystemsforavarietyoftasks.Thesetasksallhaveincommonthatdatasourcessuchasclinical,laboratory,orintensivecareinformationsystemsortheweb“itself”supplythedatatobeprocessed—preferablythroughstandardizeddatacommunica-tion—andthattheMLM-processedresultsbereturnedtotheconnectedinformationsystemsorbereportedbyseparateweb-basedapplications.

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

Adlassnig

ByDr.Klaus-PeterAdlassnig,CEOandScientificHead,MedexterHealthcareinVienna,Austria;andSectionforMedicalExpertandKnowledge-BasedSystems,CenterforMedicalStatistics,Informatics,andIntelligentSystems,MedicalUniversityofVienna

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

Figure1showsthestructureofanArden-Syntax-based,service-orient-edCDSsystemandlistssomeofitssoftwarecomponents,asitisofferedandappliedbyMedexterHealthcare.ThissoftwareforArdenSyntaxwaswritten,distributed,andhasbeenincorporatedintoanumberofhospi-talsandsomehealthcarecompaniesinformationsystems.

Onelarge-scaleapplicationiscalledMoni-ICUandrunsasclinicalroutineapplicationattheViennaGeneralHospital,atertiarycarehospitalwith2,134bedsandthemainteachinghospitaloftheMedi-calUniversityofVienna,Austria.Moni-ICUhasbeenbuiltforelec-tronic,fully-automatedsurveillanceofhealthcare-associatedinfections(HAIs)atthehospital’sintensivecareunits(ICUs)withadultpa-tients.TheprimaryuseristheinfectioncontrolteamoftheClinicalDepartmentofHospitalHygieneoftheViennaGeneralHospital,whichreceivesdailyautomatedupdatesonitscockpitsurveillancescreentoseewhichpatientatwhichICUwarddevelopedanICU-associatedinfection,continuedtohaveone,orrecoveredfromone(SeeFigure2).BasedonclassificationcriteriaforHAIs,astheyhavebeenissuedbytheUSCentersforDiseaseControl(CDC),theEuropeanCDC,andGer-manKISS,thepublisheddefinitionsofthevariousformsofsepticemias,pneumonias,urinarytractandcentral-venous-catheter-associatedinfectionswerelinguisticallyde-composed,formallyrearrangedandstructured,andbroughtintoArdenSyntaxMLMcode.Processinglayersfromrawdatacalculationandinterpretationtointermediateandhigh-levelclinicalconceptevaluationwereintroducedandapackageofhierarchically

interwovenMLMswasestablished(Figure3).Patients’medicaldataismeasured,observedandautomati-callytransferredfromtheintensivecaremedicalinformationsystemsandthemicrobiologylaboratory.Itisthenputthroughastep-by-steppipelineofaggregation,interpreta-tion,andevaluationthatiseventu-allyusedtodrawconclusionsaboutwhetheroneormoreoftheincludedinfectioncriteriaarefulfilled,ful-filledtoacertaindegree,ornotful-filled.Mostoftheencodedclinicalentitiesaremodeledasfuzzysets,andfuzzylogicisusedtoperformthesubsequentinferencesteps.Fig-ure3showsagraphicaldepictionoftheprocessinglayersinMoni-ICU.

Atpresent,thisArdenSyntaxap-

plicationisusedby12ICUswithatotalof96bedsandthemicro-biologydepartmentprovideabout15-18,000dataitemseveryday.Foreachofthe96patients,anArdenSyntaxknowledgepackagecontain-ing74MLMs(withemulatedclinicalfuzzysetdefinitionsandfuzzylogicprocessingoperators)isautomati-callyinvoked,andbothintermediatemedicalconceptsandfinalinfectionresultsarecomputed,stored,andpreparedforviewingonscreenorforreporting.

AstudyevaluatingtheeffectivenesshasshownanexcellentconformanceofMoni-ICUwithanestablishedclinicalreferencestandardaswellasMoni-ICU’ssuperiorityin

continued on next page

19MAY 2012

Figure 2: Screenshot of Moni-ICU showing daily results (lower half, middle part) including detailed explanations (lower half, right part) and patients’ infection period over time (upper half)

20 MAY 2012

Upcoming INTERNATIONAL EVENTSeHealthConference2012/WorldofHealth

ITConferenceandExhibitionCopenhagen, Denmark

May 7 - 9, 2012Formoreinformation,pleasevisithttp://www.worldofhealthit.org/

HL7MayWorkingGroupMeetingVancouver, BC, Canada

May 13 - 18, 2012Formoreinformation,pleasevisit

http://www.hl7.org/events/WorkingGroupMeetings

eHealth2012:InnovatingHealthe-CareVancouver, BC, Canada

May 27 - 30, 2012Formoreinformation,pleasevisit

http://www.e-healthconference.com

MIE2012:QualityofLifethroughQualityofInformation

Pisa, ItalyAugust 26 - 29, 2012

Formoreinformation,pleasevisithttp://www.mie2012.it

HIMSSAsiaPac2012Marina Bay Sands, Singapore

September 17 - 19, 2012Formoreinformation,pleasevisit

http://www.himssasiapac.org

13thInternationalHL7InteroperabilityConference

Vienna, AustriaSeptember 28 - 29, 2012

WatchtheHL7websiteformoreinformation.

minimizingtimedemandsontheinfectioncontrolteamwithrespecttoelectronicallysupportedversussolehumansurveillance[2].

Thenextstepsincludeextend-ingMoni-ICUtoneonatalcare(Moni-NICU),formingstan-dardizedinterfacestomedicalinformationsystemsapply-ingtheHL7messagingstan-dards,definingandadoptingagenuineFuzzyArdenSyntax(presumablyArdenSyntaxver-sion2.9),andaddingseveralautomatedreportingschemesforHAIsasrequestedbylegalrequirementsinAustria,Ger-many,andtheUS. Figure 3: Processing layers from raw data to high-level clinical concept

evaluation using Arden Syntax

Electronic Surveillance continued from page 19

[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.

21MAY 2012

Health Level Seven International Project Supports the US Office of Personnel Management’s Blue Button® Requirements

HL7recentlyannouncedaresponsetotheUSOfficeofPersonnelMan-agement’s(OPM)recentrequirementthatUSFederalEmployeesHealthBenefitProgram(FEHBP)healthin-

surancecarrierssupporttheUSDepartmentofVeteransAffairs(VA)BlueButton®textfileformatasameansofconveyingpersonalhealthinformationtofederalem-ployees.InJanuary2012,HL7launchedaprojectthatdefinestheconversionofanHL7ContinuityofCareDocu-ment(CCD®)totheBlueBut-tonformatviaanXSLTstylesheettool.BecausemostMeaningfulUse–certifiedhealthinformationexchangesystemsalreadypossessCCD-exportcapabilities,thetoolwillbeabletoleveragethosecapabilitiesasasimpleandeffectivewayformanycarrierstomeetOPM’snewrequirement.

TheBlueButton,developedbytheVAincollaborationwiththeCentersforMedicareandMedicaidServices(CMS),empowersVeteranstoaccessanddownloadtheirhealthinformationasanASCIItextfileorPDF®document.TheBlueButtoninitiativewasmadenation-allyavailableinOctober2010.InDecember2011,OPMissuedaformalrequesttoallcarriersintheFEHBPtoaddBlueButtonfunctionalitytotheirweb-basedper-sonalhealthrecordsystems.(See:http://www1.opm.gov/news/blue-button-added-to-health-insurance-carri-ers-for-federal-employees,1744.aspx)

TheBlueButtonserviceparticipatesinthehealthinfor-

mationexchangecontinuumbyenablingVeteransandconsumerstosharetheirdatawithcliniciansandothercaregiversviaasimpletextfile.TheserviceispartoftheexpandinglandscapeofnationalandlocalinitiativessuchastheOfficeoftheNationalCoordinator’sStan-dardsandInteroperabilityFrameworkandtheBeaconCommunityPrograms.

JohnRitter,co-chairoftheHL7ElectronicHealthRe-cordWorkGroup(EHRWG),notedthatHL7quicklyassembledabroadsetofindustrystakeholders,includ-ingvendors,providers,payers,andfederalagencies,aspartofitsongoingcommitmenttoberesponsivetotheindustry’sneedsinatimelymanner.

TheEHRWGandStructuredDocumentsWorkGroup,co-sponsorsoftheproject,expecttopublishthefileconversiontoolandUser’sGuideaftertheMayWorkingGroupMeetinginVancouver.DougDormer,PresidentofSPINNphrandmemberoftheprojectteamstated,“Iampleasedtobeinvolvedinthisproject.Thistoolwillreducemytechnicalteam’sefforttoofferadatadown-loadchanneltoconsumersintheBlueButtonformatandhelpourclientsmeetOPM’srequirement.”

Formoreinformationvisit:www.HL7.org/EHR

The Blue Button, developed by the VA in collaboration with the Centers for Medicare and Med-icaid Services (CMS), empowers Veterans to access and download their health information as an ASCII text file or PDF® document.

John Ritter

Lenel James

ByJohnRitter,Co-Chair,HL7ElectronicHealthRecordsWorkGroupandHL7Ambassador;andLenelJames,CPHIT,CPEHR,Member,HL7EHRWorkGroupandHL7Ambassador

22 MAY 2012

Congratulations ttttttttttttttttttttt

To the following people who recently passed the HL7 Certification Exams

CertifiedHL7Version2.xChapter2ControlSpecialist

November 17, 2011VinceCirelliShaneFleegerVioletaJankovRobertKitchen,Jr.EmmanuelLunaJasonMartinDanMcHughCarrieVanStedumJeffYost

December 9, 2011MaryKayBurkeBruceA.CraigRichardA.DayJohnC.DeliusConnieM.EgererPattiHansenHannahL.HowardBabetteM.Jacobson-BarnesMatthewD.JeanfreauNicolasV.MolinosSandiD.MeachamAmyD.MoyRyanA.RushTinaM.Sobey

January 19, 2012LoriM.AshfordPatriciaBauerMatthewM.CetteiTeresaE.GarriottDouglasS.GrahamDaleGrobeckChiChenJ.HongJesseM.PhillipsNagavalliPothineniDejanZivanovic

March 8, 2012KhateraCamaJosephH.Dent

DipakPatelCliffA.SearlScottH.ShellenbargerRaghavanSrinivasanLeviM.TeitelbaumDavidJ.YaconoRobertZiegenfus

HL7Australia

November 30, 2011RandalJ.FletcherMarkA.GilsonChrisJ.PageSandraN.Polmear

HL7Canada

November 23, 2011FedaBiraniJohnMacintoshDorothySeiler

January 6, 2012TakM.Ko

HL7India

November 19, 2011SuchitraBapatTarunChopraAdityaJoshKapilJoshiMadhuriKrishnakumarSubashiniNarayananRavichandraK.PatelDr.PawandeepSinghPadmavathiK.ThiruvenkadamArunKumarTiriveedhi

February 11, 2012NikitaAgrawalMohammedSaleejSaleemAkJayeshBhanushaliINDRANEELSCHAUDHARY

KevinDamaHardikDelwariAdarshDharmavarapuJohnE.FernandesRasikaV.InamdarRoshanKambleAjayKapoorRohitP.KhotRohitKulkarniAmolMaralikarTeresaMathewMissPritamN.MoreRohitNatrajUdeshangbhaiAgarshangbhai ParmarNehaPathakPriyaRamachandranAmiRamaniShwetaSatpalkarPriyankShahNileshA.ShindeDeeshaPratapShingadiaSandeepSwamyBinaVivekBiniVijan

February 25, 2012SipraDimriBharathirajKanagarajMeenaNamasivayamSandeepNarasimhegowda

HL7Singapore

November 21, 2011FuYantoSeeraSrinivasaRaoLeeChouWeeHuBoReymondDarwinWilaisonoChinTeckWeiHendryWijaya

February 9, 2012JocelynR.JawiliChanHockYan

HL7Spain

November 14, 2011JoséIgnacioSánchezAlonsoMartínCalveteIglesiasMaríaEstherSaavedra MartínezJulioJoséGómezDíazAnaAzpiazuCarmouze

December 12, 2011CesarFloresCarreraMiquelAdroverJosepLluísMuñozRibalta

December 13, 2011CarlosSánchezGarcíaJuanCarlosGonzálezMorenoAinhoaBarbeitoPardiñasBárbaraGoyanesValeroIgnacioArnottGonzález-TovaVíctorSanchoLorenzoRubénGarcíaBroncanoPabloEsteveDíazJoséMoraloMoleroFranciscoNovilloPérezVerónicaSáezPérezJoséMartínezHellínJoséMaríaLealPozueloJoséLuisFernándezRuedaVíctorCastañoLabajoGustavoRoigDomínguezJavierArribasPastorFranciscoJavierLubiasGarcía

December 14, 2011MyriamBarrosoPartidaJoséAndrésMoreySúñerJoséJavierPozoMoralesMaríaÁngelesMerino ParedesRaúlPalominoSánchez

December 15, 2011NarojMacíasDuarteMarcoAntonioSánchez López

ttttttttttttttttttttttttttttttttttt

23MAY 2012


NataliaMedinaMedinaFranciscoJavierMartínez AguiarRosaMªPazEspinosaNoéAndrésRodríguez GonzálezFranciscoRodríguezAlmeidaJavierArencibiaWest

December 16, 2011JonayGonzálezSuárezCarlosRodríguezReyesAlfonsoHernándezIbáñezAlexisBarreraTorres

February 23, 2012ÁngelJoséFariaRodríguezDavidCamposNietoRafaelGallardoPicónJesúsMozosIbáñez

February 28, 2012SalvadorPreckler

CertifiedHL7CDASpecialist

November 17, 2011SanjeevBaralLuanDinhCarlosGuzmanMikeLomanginoStevenT.PorteusRomanRadomskiJulieSteeleMichaelTyburskiChunYu

January 19, 2012LouiseK.BrownDennyCordyWayneHethPhillipE.KieferCarlosJ.MuentesKanakaRamyasiriThomasS.ReventasCameronD.Tully-Smith

March 8, 2012RandyP.AyersJoshuaA.DouglasMarkK.CaroTerryL.GrammerKimM.KeggRandolphG.PelikanJoshuaN.RobinsonArmanSamaniAlirezaH.TabriziBenjaminE.VictoricaSaunyaM.WilliamsYingZhang

HL7Argentina

November 2, 2011LucíaGrundel

HL7Canada

February 8, 2012RickLambert

HL7India

February 11, 2012AkashGuptaMayankKapoorKanchanSanjayKokalPankjajKumarR.MishraManaliMannurSandeepK.PatilSantoshGopiPillaiRituShuklaAnkurR.Tripathi

HL7Korea

November 19, 2011DongWookPark

HL7Spain

November 14, 2011FranciscoJavierMartínez Aguiar

CarolinaHernándezRamosJavierArencibiaWestRosaMªPazEspinosaNataliaMedinaMedinaMarcoAntonioSánchez LópezAgustínTapiaQuesada

December 12, 2011DavidRodríguezCocineroMartíPàmiesSolàFrancescRamosRocarolsSilviaMoreaJuliánMaríaBelénZabalaDurán

December 13, 2011PedroMayorIzquierdo

December 14, 2011RaquelCasausÁlvarezJoséJesúsJiménezFloresManuelJesúsMoralesLara

December 16, 2011NoéAndrésRodríguez González

February 23, 2012DiegoBoscaTomásDiegoCaballeroHiguerasÁngelColaoPatónJoséRamblaLop

February 28, 2012AlexisBarreraTorres

CertifiedHL7Version3RIMSpecialist

November 17, 2011SushmitaBeheraSunithaByreddyJamesChanEldoDanielViabhavKothaleVivekaPanwarVivekPillai

U.PrajapatiRajivShahiJanuary 19, 2012PatrickE.Loyd

March 8, 2012CarolinaSaborio

HL7Canada

November 23, 2011PaulBrownJustinFyfeHarryEdwards

February 8, 2012MarkCong

HL7India

November 19, 2011DineshCheluvegalBalasundara

HL7Pakistan

February 12, 2012MidhatAkhtarKarimAmiraliAsifAnsariAnitaAbdulHabibDharaniUzmaMahmoodErumQadirMemonShehzadShahabuddinMerchantShahanaMobinKamranNayyerHafsaSaadatSalmaShirazAliDobaniKashifSiddiqui


24 MAY 2012

One Step Closer to Secure EHRs and mHealth: OMG and HL7 Announce Adoption of the hData Specification ByAndreaRibick,HL7DirectorofCommunications

HL7andOMG®recentlyannouncedtheadoptionandavailabilityofthehDataRecordFormatandhDataRESTfulTransportspecifications,ascalableelectronicmethodforexchangingpatienthealthinformation(suchaselectronichealthrecords,“EHR”andmobilehealth,“mHealth”)amongpatients,doctors,hospitals,andclinics.

“Thisisthelatestinanumberofstandardsjointlycre-atedasaresultofourpartnershipwithOMG.Thiscol-laborativerelationshipissuccessfulbecauseitcombinesHL7’sexpertiseincreatinghealthcareinteroperabilitystandardswithOMG’sexpertiseindistributedprocessmodels,wrappersandtransportspecificationsthatarecommontoallindustries,”saidJohnQuinn,CTO,HL7International.“ItisalsooneofthefirstpublishedeffortstoadoptthesignificantcontributionsandballotingeffortsofourvolunteersfromMITRE,givingHL7implementersAPIaccesstothehDataRESTfulTransportspecification.”

“TherealimpetusbehindhealthdatainformationstandardslikehDataissavinglivesandsavingmoneybyconnectingclinicalsystemsacrossdoctors’offices,hospitalsandresearchcenters.Thisisaccomplishedbyovercomingthedifferencesinsystemsthatmakeshar-inginformationdifficultinthemedicalworld,”saidDr.RichardMarkSoley,PhD,ChairmanandCEO,OMG.

WiththeadoptionatOMGandatHL7,hDataisnowthefirstsetofpeer-reviewedspecificationswithinbothorganizationsforimplementingaRESTfulexchangeofclinicalinformationinthecontextofnationalandinternationalstandards.WithhData,implementerscanachievesemanticinteroperabilitybetweenclinicalsys-temsbothwithinandacrossorganizationalboundaries.Bysupportingawidevarietyofclinicalcontentmodelsandmediatypes,hDataoffersmaximalflexibilitywhileensuringhighscalabilityandefficiencythroughanopti-mizedtransportarchitecture.

“MITREinitiatedandledhData’sdevelopmentin2008inanefforttopromotetheadoptionanduseofscalableelectronichealthrecordsystems,”saysGeraldBeuchelt,LeadSoftwareSystemsEngineer,MITRE.“Doctorscitecomplianceasanareathatwillimproveapatient’shealthandalsohelpkeepcostsintheUSsystemdown.Mobilehealthisausefultool,butfirstweneedscal-ableexchangeandsemanticinteroperabilityofhealthITsystems,andthenwecansupportfuturegrowthintoolslikemobilehealththatcanallsharecommondata–hencehData.”

RESTfulspecificationservicesarelow-costandeasytodeployversusotherservicetypesthataremorecum-bersometobuildandimplement.hDataallowsaWebdevelopertodemonstrateaprototypeindaysinsteadofmonthswiththecurrentstandardsinuse.Notsurpris-ingly,RESTfulWebservicesareusedbycompaniessuchasAmazon.comandGooglebecausetheycanscaletomillionsofusers.

WiththehDataspecifications,medicalrecordspres-entcontentinatieredstructurethatallowsforfastandsecureaccesstoonlythespecificinformationneededatagiventime.Thismeansthatratherthanhavingtodownloadanentirerecordtoamobiledevice,doctorscandownloadjustthepiecesofdatatheyneedinordertomakedecisions.hDatamakesthedatasecurelyacces-siblesotheinnovationofmobileusecanhappen.

ThespecificationisavailabletothepublicfordownloadfromtheOMGwebsiteathttp://www.omg.org/cgi-bin/doc?dtc/2012-01-03.

HL7haspublishedthehDataRecordFormatasaDSTU(DraftStandardforTrialUse).ItisavailableontheHL7websiteathttp://www.hl7.org/dstucomments/.

Andrea Ribick

25MAY 2012

Health IT Standards –

What Went Wrong Where? ByDr.AdamChee,Vice-Chair,HL7Singapore

IhadaninterestingconversationabouthealthITstandardsrecently,inaprivatesetting,whereagroupofpeopledebatedafewpopularstandardsadoptedintherealmofmedicalimaging.

ThediscussionstartedwithXDS(CrossEnterpriseDocumentShar-ing)fromIHEandthetopicwaswhyitwasnotsuitableforhandlingnon-DICOMimages.Thefirstredflagthatwentoffinmyheadwas‘PerversionoftheXDSstandard!’XDSisnotmeantforhandlingofnon-DICOMimages;itismeanttoregisterandshareelectronichealthrecorddocumentsbetweenhealth-careenterprises,rangingfromphysi-cianofficestoclinicstoacutecareinpatientfacilities.Inotherwords,itismeanttobeusedinanEMR/EHRenvironmentforsharingofdocu-ments.TheindividualplacingthecomplaintcangoonaboutthehowXDShasfailedforhimandhewillbe“correct”becauseithasindeed“failed,”sinceXDShasbeenmadetoserveawrongpurpose.Therearenosurpriseshere.

However,therationaleofhisargu-mentisakintosayingthatairplaneshavefailedbecausetheymaketerriblecarswhenonetriestodrivethemlikeone–thinkingthatbotharetransportationdevices,hencetheyshouldservethesamepurpose.Icallthisacaseofplaincognitivefailure.

Asafirmbelieverofadoptingrele-vantstandardsintherightcontext,Itriedtohighlightthatifoneislook-ingatimaging,thenmaybeXDS-I(CrossEnterpriseDocumentShar-ingforImaging)wouldbeabetterchoice.ThereplyIreceivedwasan

interestingone:“It’sthesame.”BeforeIcouldexplainthediffer-ences,Iwasshotdown(well,itwasathreepersonteamversusme)andgivenanexamplefromanarticletakenofftheInternet,citinghowaphysicianwastryingtoaccessapatient’smedicalrecordswithanXDSenabledsystemandhadtroublelocatingwhatheneededbecausehehadtoopeneverysingledocumenttofindoutwhatitwas.

Iwashalf-amusedandhalf-worriedatthisstage.

•Half-amusedbecausetheex-amplewasdescribingahalf-at-temptedadoptionofXDS(citingonearticleoutofmillionsofftheInternet)inordertosupportthepointthatXDSfailedtosupportaworkflowthatitwasnevermeantto

•Half-worriedbecausetherewillbepeopleinthegroupwalkingoutofthediscussion,spewingthesamemisguidedinformation

TodescribetheconceptofXDSinaverysimplisticmanner–XDSmanagesafederateddocumentrepositoriesandadocumentregistrytocreatealongitudinalrecordofin-formationpertainingtoapatient(inagiven‘clinicalaffinitydomain’).

Thesearedistinctentitieswithsepa-rateresponsibilities.

•Adocumentrepositoryisre-sponsibleforstoringdocumentsinatransparent,secure,reli-ableandpersistentmannerandrespondingtodocumentretrievalrequests

•Adocumentregistryisrespon-sibleforstoringinformationaboutthosedocumentssothatthedocumentsofinterestforthe

careofapatientmaybeeasilyfound,selectedandretrievedirrespectiveoftherepositorywheretheyareactuallystored

Theexamplegivenobviouslyhasthedocumentregistrypartmissing;thereforetheimplementationwasnotincompliancewiththeXDSspecifica-tion.Butsomehow,XDSgotblamedforit!Thisislikesaying“workisgoingtokillyou”becausetherearereportedincidentsofKarōshi(deathfromoverwork)inJapan!

ThetopicthenshiftedsuddenlytoHL7Version2.x(V2)andthecomplaintwasthatHL7V2.xisallthesame,buttheyarenotback-wardcompatible,hencetheneedforinterfaceengines.ItriedtoexplaintheconceptsofHL7V2.xandwhyitisinsuchachaoticstate(duetothelackofsemanticinteroperabil-ity,hencethereasonwhyalogicalinformationmodelsuchasRIMwasdeveloped),buttheaccuserbecamereallydefensiveandfurtherattemptstosetthecontextrightweremetbyrebuttalsclaimingthat:standardslooksniceonpaperbutfailinrealworldimplementationandstandardsaredevelopedbypeoplesittinginivorytowerswhereasheworksintheindustrysohe“knowsbetter.”IpointedoutpolitelythatstandardsbodieslikeHL7andIHEaremadeupofvolunteersfromtheindustry(myselfincluded–Iampractitionerfirst,academiansecond,consultantthird)andthenotionthatstandardshave‘failedintherealworld’isduetoimplementersnotunderstandingthestandardsbeingimplemented,thusimplementingthemhalf-rightorjustplain-wrong.

continued on next page

Dr. Adam Chee

26 MAY 2012

HL7 Benefactors as of April 25, 2012

US Department of Defense

Military Health System

Centers for Disease Control and Prevention

Toputhisargumentintoanothercontext,itisakintosayingthat:

• ThetrafficlightsystemofRed=Stop,Yellow=CautionandGreen=Gohasfailedbecausemotoristsareignoringthemorthatinsomeplacesthecolorhasbeenchanged

• Becauseheisaccustomedtodrivinginasuchachaoticenvi-ronment(suchasabove),heisconvincedthathisopinionsaretheonlyonesthatmatter

Well,theworldisaverybigplaceandeventrafficrulesdifferfromplacetoplace(e.g.speedlimits,left-handdriveversusright-handdrive),letalonehealthcaresystems.Itisimportanttounderstandthatinthe

argumentsabove,standardshavenotfailed;theimplementationandenforcementhas.Ifonecannotseethedifferencethanonecannotfixtheproblem—itreallyisthatsimple.Nowdon’tgetmewrong,health-careITstandardsarebynomeansperfect(andnothingis)andthepeopleworkingonthedevelopmentofstandardsandtheirconsistentimprovementsarepractitionersfromtheindustrywhohavenotonlyencounteredreal-lifeproblems,buthavealsodecidedtomakeadif-ferencebyvolunteeringtheirtimetohelprectifytheseproblems.

However,inorderforstandardstobeeffectivelyadopted,itisveryim-portantthatusersreceivetheright

information.Whileconstantcom-municationandknowledgetransferbetweenstandardsdevelopersandusersarevitaltowardtheeffectiveadoptionofstandards,itisalsoimportantthatusersofstandardstaketheeffortandinitiativetolookforcredibleinformationfromtherightsources.AsHL7affiliates,wecanserveastheenabler,facilitatingtheflowofknowledgebetweenthetwogroups.

Lastbutnotleast,letusapplaudtheself-sacrificingindividualswhodedicatetheirtimeandeffortinthedevelopmentofhealthItstandards,facilitatinginteroperabilitythatimprovescaredelivery.

Heath IT Standards, continued from page 15

27MAY 2012

BenefactorsAbbottAccentureAllscriptsBooz Allen HamiltonCenters for Disease Control and Prevention/ CDCDuke Translational Medicine InstituteEpicEuropean Medicines AgencyFood and Drug AdministrationGE Healthcare ITHospital Corporation of America (HCA)IBMInterSystemsKaiser PermanenteMcKesson Provider TechnologiesMicrosoft CorporationNHS Connecting for HealthNICTIZ Nat.ICT.Inst.Healthc.NetherlandsNovartisOracle Corporation - HealthcarePartners HealthCare System, Inc.Philips HealthcareQuest Diagnostics, IncorporatedSiemens HealthcareThomson ReutersUS Department of Defense, Military Health SystemUS Department of Veteran Affairs

Supporters7Delta,IncAEGIS.net, Inc.Beeler Consulting LLCBeijing TPHY Technology Development Co., Ltd.Corepoint HealthCrescendo Systems CorporationGamma-Dynacare Medical LaboratoriesiNTERFACEWARE, Inc.LINK Medical Computing, Inc.LiveProcessMedicity, Inc.MediSwitch (Pty)LtdMeditureSocrates Healthcare Ltd.

ConsultantsAccentureAHIS - St. John Providence HealthAileron Consulting LLCAnakam Identity Services, EquifaxBlackbird Solutions, Inc.Booz Allen HamiltonCambria Solutions, Inc.Canon U.S.A., Inc.Capgemini Government Solutions LLCCentriHealthChong Qing TJPAN IncCirrus Data & Telecom IncCSGCTSDapasoft Inc.Dell ServicesDent Technical Consulting ServicesDiagnostic Radiology and Oncology ServicesDiscoverture HealthEastern Informatics, Inc.Edifecs, Inc.Edmond Scientific

eHealth Workflow Analytics, LLCEmergint Technologies, Inc.EquinoxysEtnomedijosEvolvent TechnologiesFEI.comForward Advantage, Inc.Frank McKinney Group LLCGartnerGensa CorporationGordon Point Informatics Ltd.GSI Health, LLCGuidewire ArchitectureHealthcare Data AssetsHealthcare Integration TechnologiesHealthVectorsHIMAPHLN Consulting, LLCHubbert Systems ConsultingHuron Valley Physicians AssociationInfovide-Matrix S.A.Lantana Consulting GroupLMIMainstream Health, Inc.Matricis Informatique Inc.MD Informatics, LLCMedQuist, Inc.newMentorOckham Information Services LLCOctagon Research Solutions, Inc.OTech, Inc.PenCentric Health Systems IncPFT LLCProfessional Laboratory Management, Inc.Raven Tech LLCRay Heath, LLCRob Savage ConsultingSabiaNet IncSEC Associates, Inc.Shafarman ConsultingSoa Software Inc.Strategic Solutions Group, LLCThe Audigy Group, LLCThe Diebold Company of CanadaThe St. John Group, LLCTrue Process Inc.Virginia RiehlWestatWovenware

GeneralInterestAgency for Healthcare Research and QualityAGH University of Science and TechnologyAlabama Department of Public HealthAlliance for Pediatric QualityAmerican Assoc. of Veterinary Lab DiagnosticiansAmerican College of RadiologyAmerican College of Surgeons, NTDBAmerican Dental AssociationAmerican Dietetic AssociationAmerican Health Information Management AssociationAmerican Immunization Registry Association (AIRA)American Medical AssociationAORNArizona Department of Health ServicesBlue Cross Blue Shield AssociationBrigham Young UniversityCA Department of Public Health

Cabinet for Health and Family ServicesCalifornia Department of Health Care ServicesCalifornia HealthCare FoundationCalOptimaCDISCCenter for Elders’ IndependenceCenters for Disease Control and Prevention/ CDCCenters for Medicare & Medicaid ServicesCity of HoustonCollege of American PathologistsCollege of Healthcare Information Mgmt. ExecutivesColorado Regional Health Information OrganizationCompDrugConnecticut Department of Public HealthContra Costa County Health ServicesCOPE Community Services,IncCouncil of State and Territorial EpidemiologistsDelaware Division of Public HealthDelta Dental Plans AssociationDepartment of Computer Science, Aarhus UniversityDepartment of Developmental ServicesDepartment of HealthDepartment of Human-Computer InteractionDGS, Commonwealth of VirginiaDuke Translational Medicine InstituteECRI InstituteEmory University, Research and Health Sciences ITEstonian eHealth FoundationEuropean Medicines AgencyFood and Drug AdministrationGeorgia Department of Public HealthGeorgia Institute of TechnologyGeorgia Medical Care FoundationHIMSSICCBBA, Inc.Illinois Department of Public HealthIllinois Office of Health Information TechnologyIndian Health ServiceIndiana Health Information ExchangeIndiana State Department of HealthInterior Health AuthorityIowa Department of Public HealthJapan Pharmaceutical Manufacturers AssociationKansas Department of Health & EnvironmentKyungpook National Univ. MIPTHL.A. County Dept of Public HealthLCF ResearchMaine Center for Disease Control and PreventionMedical University of South CarolinaMichigan Department of Community Health LabMichigan State UniversityMinistry of Health - SloveniaMinnesota Department of HealthMissouri Department of Health & Senior ServicesN.A.A.C.C.R.NANDA InternationalNational Association of Dental PlansNational Center for Health Statistics/CDCNational Council for Prescription Drug

ProgramsNational Health ServiceNational Institute of Standards and TechnologyNational Library of MedicineNational Marrow Donor ProgramNational Quality ForumNATO Consultation, Command and Control AgencyNew Mexico Department of HealthNew York State Department of HealthNICTIZ Nat.ICT.Inst.Healthc.NetherlandsNIH/CCNIH/Department of Clinical Research InformaticsNorth Coast HIEOA-ITSD - Department of Mental HealthOak Ridge Associated UniversitiesOffice of the National Coordinator for Health ITOHIO DEPT. OF JOB AND FAMILY SERVICESOklahoma State Department of HealthOregon Public Health DivisionPennsylvania Dept of Health-Bureau of InformationPharmaceuticals & Medical Devices AgencyPhastPrimary Care Information Project, NYC Dept HealthPublic Health Data Standards ConsortiumRegion SyddanmarkRTI InternationalSAMHSASC Dept. of Health & Environmental Control HSSocial Security AdministrationSouth Dakota Department of HealthState of Montana DPHHSTelligenTennessee Department of HealthTexas Department of State Health Services - LabTexas Health and Human Services CommissionThe Joint CommissionThe MITRE CorporationUS Army Institute of Surgical ResearchUniversity HealthSystem ConsortiumUniversity of AL at BirminghamUniversity of Kansas Medical CenterUniversity of MinnesotaUniversity of Texas Medical Branch at GalvestonUniversity of Utah Pediatric Critical Care/ IICRCUSDA APHIS VS CIOUtah Department of HealthUtah Health Information NetworkUtah State Developmental CenterVermont Department of HealthVirginia Department of HealthVirginia Information Technologies AgencyWashington State Department of HealthWayne State University School of MedicineWEST WIRELESS HEALTH INSTITUTEWNY HEALTHeLINKWorldVistA

PayersAmerican Imaging ManagementBlue Cross and Blue Shield of Alabama

HL7 ORGANIZATIONAL MEMBERS

28 MAY 2012

Blue Cross and Blue Shield of FloridaBlue Cross Blue Shield of ArizonaBlue Cross Blue Shield of North CarolinaBlue Cross Blue Shield of South CarolinaCIGNACompliantDRGHealth Care Service CorporationMagellan Health ServicesNeighborhood Health PlanPremera Blue CrossTriWest Healthcare AllianceValence HealthWisconsin Physicians Service Ins. Corp.

PharmacyBristol-Myers SquibbEli Lilly and CompanyMerck & Co. Inc.NovartisPharmaxo Pharmacy ServicesSanofi-Aventis R&D

ProvidersAdvanced Biological Laboratories (ABL) SAAdvantage DentalAkron General Medical CenterAlamance Regional Medical CenterAlbany Medical CenterAngel MEDICAL cENTERARUP Laboratories, Inc.Ascension Health Information ServicesAspirus - Wausau HospitalAthens Regional Health Services, Inc.Avalon Health CareAviir, IncBayCare HomeCareBJC HealthCareBlessing HospitalBloomington Hospital & Healthcare SystemsBlount Memorial HospitalButler Healthcare ProvidersCape Regional Medical CenterCarilion ClinicCedars-Sinai Medical CenterCenter for Life ManagementCentral Illinois Radiological AssociatesChildren’s Health System of AlabamaChildren’s Hospital Medical Center of AkronChildrens Mercy Hospitals and ClinicsCincinnati Children’s HospitalCity of Hope National Medical CenterCleveland Clinic Health SystemConcentraConsolidated Medical Bio-Analysis, Inc.Continuum Health PartnersDeaconess Health SystemDiagnostic Laboratory ServicesDignity HealthDovetail HealthEast Alabama Medical CenterEmergency Medical Services AuthorityEmory HealthcareGeorgia Cancer Specialists, Inc.Hill Physicians Medical GroupHospital Corporation of America (HCA)Human Service AgencyInland Northwest Health ServicesInstitut Jules Bordet

Integrated Telemedical SolutionsIntermountain HealthcareJohns Hopkins HospitalKaiser PermanenteKalispell Regional Medical CenterKernodle Clinic, Inc.Laboratory Corporation of AmericaLakeland Regional Medical CenterLife LabsLoyola University Health SystemLucile Packard Children’s HospitalLux MedMayo ClinicMcDonough District HospitalMeridian HealthMilton S. Hershey Medical CenterMultiCare Health SystemNational Cancer InstituteNew York-Presbyterian HospitalNHS Connecting for HealthNorth Carolina Baptist Hospitals, Inc.NYC Health and Hospital CorporationOregon Providence Health & ServicePartners HealthCare System, Inc.Pathologists’ Regional LaboratoryPathology Associates Medical LaboratoriesPatient FirstQuest Diagnostics, IncorporatedRady Children’s Hospital and Health CenterRegional Medical Center at MemphisRheumatology and Dermatology Associates PCRockford Health SystemRockingham Memorial HospitalSA Tartu University ClinicsSaint Francis CareSaudi Aramco - Healthcare Applications DivisionSeneca Family of AgenciesSharp HealthCare Information SystemsSouth Bend Medical Foundation, Inc.Spectrum HealthStanford Hospital & ClinicsSteven Porter, MDSteward Health CareSumma Health SystemTexas Health ResourcesThe Children’s Hospital of PhiladelphiaTuomey Healthcare SystemUS Department of Defense, Military Health SystemUK HealthCareUNC HealthcareUniversity of Chicago Medical CenterUniversity of Nebraska Medical CenterUniversity of Pittsburgh Medical CenterUniversity of Utah Health CareUniversity Physicians, Inc.UT M.D. Anderson Cancer CenterUW Medicine, IT ServicesVanguard Health SystemsVUMCWashington National Eye CenterWest Virginia University HospitalsWheaton Franciscan Healthcare

Vendors//SOS/Corporation3M Health Information Systems

4MedicaA.J. Boggs & CompanyAbbottABELSoft Inc.ABILITY NetworkAccent on IntegrationAccumedic Computer Systems, Inc.Aceso Health Information ManagementADP AdvancedMD, Inc.Advent InfoSystems LLCAEGIS.net, Inc.Aequor Technologies, Inc.Affiliated Computer Services, Inc.Affiliated Computer Services, Inc., a Xerox CompanyAgilex TechnologiesAlert Life Sciences Computing, Inc.AllscriptsAlphaCM, IncAlphaGlobal-ITAltos Solutions, IncAltova GmbHAmerican DataAmerican Health Care SoftwareAmerican HealthTech, Inc.AmerisourceBergen Specialty GroupAmtelcoAnasazi Software, Inc.Angel Systems, Inc.ANXeBusinessApelon, Inc.Argility HealthcareARGO Data Resource CorporationAskesis Development GroupAspyra, LLC.Atirix Medical SystemsAvaility, LLCAxolotl CorporationAxwayBeeler Consulting LLCBeijing TPHY Technology Development Co., Ltd.Benchmark SystemsBIO-NUCLEAR, S. A.Bostech CorporationBottomline TechnologiesBradoc Data Management, IncBusinessOnCAL2CAL CorporationCareCloud CorpCarefx Corporationcarepaths, incCarestream Health, Inc.CareTech Solutions, Inc.CaristixCenter for Clinical InnovationCerner CorporationCertify Data SystemsCetrea A/SChartLogic, Inc.ChartWise Medical Systems, Inc.ChemWareCientive Group Inc.CJPS Medical Systems, LLCClear EMRClinix Medical Information Services, LLCCM Care TechnologyCMRCNIPS, LLCCNSICognosante, LLC

Cognovant, IncCommunity Computer Service, Inc.Compania de Informatica AplicataComputer Technology CorporationComputrition, Inc.COMS Interactive, LLCConexSys, Inc.Consilience SoftwareCore Sound Imaging, Inc.Corepoint HealthCortex Medical Management Systems, Inc.CovisintCPCHSCrescendo Systems CorporationCroudcare, S.A.CS STARS, LLC.CSAM International ASCSC HealthcareCTIS, Inc.Curaspan Healthgroup, Inc.Cybernius Medical Ltd.Cyberpulse L.L.C.Cyrus-XP LLCDansk Medicinsk Datacenter ApSData Information System Solutions LLCData ServicesData Tec, Inc.Dataflo ConsultingDATALINK SOFTWARE DEVELOPMENT INCDatuit, LLCDawning Technologies, Inc.Daxor CorporationdbMotion LTDDefran SystemsDeJarnette Research Systems, Inc.Delta Health Technologies, LLCDg Med Technology Corp.Digital Infuzion, Inc.Digital Medical Merge, Inc.Div MediaDoctorComDocuTrac, Inc.Dolbey & CompanyDynamicDREasyMed Services IncEASYTALK MD LLCEBM Technologies Inc.echoBaseeDerm SystemseHana LLCe-Health Data SolutionseHealthCare Systems, Inc.Electronic Medical Solutions, LLCeManual System Sdn BhdEmbedded Wireless LabsEmblaEMC Information Intelligence GroupEmdeon, LLCeMedology LLCEmerging SystemsEmpower Technologies, IncEMRgence LLCEpicESRIeTransX, Inc.Expert Sistemas Computacionales S.A. DE C.V.ExplorysEyeMD EMR Healthcare Systems, Inc.ezEMRxe-Zest Solutions Ltd.

HL7 ORGANIZATIONAL MEMBERS, continued

29MAY 2012

F5 NetworksFalcon LLCFifth Light TechnologyFirst Medical SolutionsFoothold TechnologyFresenius Medical CareFutures GroupGamma-Dynacare Medical LaboratoriesGE HealthcareGEMMS, IncGenesis Systems, Inc.gloStream, Inc.Greenway Medical Technologies, Inc.Grow|CMSHaemonetics CorporationHarris CorporationHealth Care DataWorksHealth Care Software, Inc.Health Companion, Inc.Health Data Services, Inc.Health Innovation TechnologiesHealth Intersections Pty LtdHealth Language, Inc.Health Plan Systems, Inc.Health Records for EveryoneHealthcare Management Systems, Inc.HEALTHeSTATEHealthlandHealthTrio, LLCHealthwise, Inc.heartbase, inc.Hewlett-Packard Enterprises ServicesHickman-Kenyon Systems, IncHill AssociatesHi-Tech Software, Inc.Home Dialysis Plus, LtdHospiraHospiServe Healthcare Services Pty) Ltd.i2i Systemsi4i Inc. (Infrastructures for Information Inc.)Iatric SystemsIBMIBS ExpertiseiConnect ConsultingIgnis Systems CorporationiMDsoftiMetrikus, Inc.ImprivataInfo WorldInformation Management AssociatesInmediata Health GroupInnovative Workflow TechnologiesInsight Software, LLCInstitute for Health Metricsintegration AGIntelligent Medical Objects (IMO)Intelliware Development IncInterbit Data, Inc.Interface People, LPiNTERFACEWARE, Inc.Interfix, LLCInterSystemsIntuit HealthiPatientCare, Inc.IQ-EQ Systems, LLC.iRCODER.COMiSEEK Enterprise (USA), LLCIsoprime CorporationIT BroadcastingJ&H Inc.Jack Russell SoftwareJackson Healthcare, LLC.JVMKeane, Inc.

Keiser Computers Inc.Kestral Computing Pty LtdKey Management GroupknowtionKrames StayWellLab Warehouse, Inc.Labware, Inc.Lane Telecommunications, IncLavender & Wyatt Systems, Inc.LawsonLeafsprout Technologies Inc.Liaison Technologies Inc.,Life Systems SoftwareLife TechnologiesLifepoint InformaticsLINK Medical Computing, Inc.Liquent, Inc.LiveProcessLogibecLoopback AnalyticsLORENZ Life Sciences GroupLSS Data SystemsLumerisM2comsysMacPractice, Inc.Maicom Healthcare Solutions GmbHMammography Reporting System Inc.ManagementPlusMarin Health NetworkMcKesson Provider TechnologiesMD Logic, IncMDIntelleSys, LLCMD-IT Transcription Services, LLCMDP Systems, LLCMECTA CorporationMED3OOO, Inc.MedConnexMedflow, Inc.MEDfx CorporationMEDHOST, Inc.MEDIBISMedical Systems Co. Ltd - medisysMedicity, Inc.MediServe Information Systems, Inc.MediSwitch (Pty)LtdMEDITECH, IncMeditureMediVault, LLCMedivo Inc.MEDIWARE Information SystemsMedlinesoftMedLInk Computer Sciences, LLCMedMagic LLCMEDSEEKMedtronicMedUnison LLCMedVirginiaMellon Consulting Group, LLCMeta, Inc.MicroFour, Inc.Microsoft CorporationMighty Oak Technology, Inc.Mirth CorporationMITEM CorporationMitochon Systems.Mobile Physician TechnologiesMobileMDMobiusoft, LLCModernizing Medicine, Inc.MPN Software Systems, Inc.MxSecureNetDirectorNexJ Systems IncNextGen Healthcare Information Systems, Inc.

Notable SolutionsnovaHEALTH Pte LtdNRC - IlluminateO&P Digital TechnologiesOA Systems, Inc.Oakland SoftwareOD LinkOFFI-PLUS, Inc.Omnicell, Inc.OMNICOM srlOpen Dental SoftwareOptima Healthcare SolutionsOptimus EMR, Inc.Opus-ISM LLCOracle Corporation - HealthcareOrchard SoftwareOrion HealthOSSLLCOtotronixOZ SystemsP&NP Computer Services, Inc.Panacea Healthcare, LLCPatient360PCE SystemsPCIS GOLDPegasystemsPerry Baromedical IncPhilips HealthcarePhysician’s Computer CompanyPhysicians Medical Group of Santa Cruz CountyPilotFish TechnologyPPM Information Solutions, Inc.Practice FusionPractice Velocity, LLC.Premier Healthcare AlliancePresiNET HealthcarePress Ganey AssociatesPrimeSource HealthcareProcentiveProComp Software Consultants, IncProcuraPrognosis Health Information SystemsPrometheus Computing LLCProventys, Inc.PsyTech Solutions, Inc.QS/1 Data Systems, Inc.QuadraMed CorporationQuantrosRazor Insights, LLCRecondo Technology, Inc.Redpine Healthcare Technologies, IncReed Technology and Information Services Inc.RL SOLUTIONSRobust For LifeRosch Visionary SystemsRTZ Associates, IncSAIC - Science Applications International CorpSandlot, Inc.SAS InstituteScantron CorporationScientific Retail Systems, Inc.ScriptRx, Inc.Seeburger AGShared HealthSiemens HealthcareSimavita Pty LtdsimplifyMDSMARTMD CorpSNAPS, Inc.SOAPware, Inc.Socrates Healthcare LtdSoftek Solutions, Inc.

Software AG USA, Inc.Software Partners LLCSonoSite, IncSOUTHERN LIFE SYSTEMS, INCSt. Jude MedicalStatRad, LLCSTI Computer Services, Inc.Stockell Healthcare Systems, Inc.SuccessEHSSuitelinq incSuncoast SolutionsSunquest Information SystemsSunRise Systems and SolutionsSurescriptsSurgical Information SystemsSurgiVision Consultants, Inc.Swearingen Software, Inc.Sybe Medical ManagementSystematic GroupTetrusTGI SoftwareThe Antidote.bizThe CBORD Group Inc.The Delta GroupThe Echo GroupThe SIMI Group, Inc.The SSI Group, Inc.The Tailored Approach, LLC.Therap Services, LLCThomson ReutersTiatros Inc.TIBCO Software Inc.Tidgewell Associates, Inc.TIMS INCTolven, Inc.Tranquilmoney Inc.,Trifork Public A/SUnibased Systems Architecture, Inc.Unifi TechnologiesUniversal Medical Records, LLCUniversal Research SolutionsUnlimited SystemsValley Hope Association - IMCSSVeinDrawVerizon BusinessViMedicus, IncVirco BVBAVirtifyVisionTree Software, Inc.Vitera Healthcare SolutionsVocollect Healthcare Systems, Inc.Wairever IncWalgreensWatermark Research Partners, Inc.WellCentive, LLCWellDoc, Inc.Wellsoft CorporationWhite Plume TechnologiesWolters Kluwer HealthWorkflow.com, LLCWorld Medical Center Nordic ASXeo HealthXIFIN, Inc.XPress TechnologiesZetaSys LLCZipChart, IncZoho Corp.ZweenaZynx HealthZetaSys Dental Enterprise SolutionZipChart, IncZoho Corp.ZweenaZynx Health

HL7 ORGANIZATIONAL MEMBERS, continued

30 MAY 2012

2012 TECHNICAL STEERING COMMITTEE MEMBERS

CHAIRAustin Kreisler Science Applications International Corp. (SAIC)Phone: 404-542-4475Email: [email protected] CHIEF TECHNICAL OFFICERJohn QuinnHL7 InternationalPhone: 216-409-1330Email: [email protected] ArB CO-CHAIRS Charles Mead, MD, MSc 3rd Millennium, Inc. Phone: 510-541-8224 Email: [email protected]

Ron Parker HL7 CanadaPhone: 902-832-0876Email: [email protected]

INTERNATIONAL REPRESENTATIVE Giorgio Cangioli HL7 Italy [email protected]

Ravi Natarajan NHS Connecting for Health Phone: 44 113-390-6520Email: [email protected]

DOMAIN EXPERTS CO-CHAIRSEdward Tripp Edward S Tripp and Associates, Inc. Phone: 224-234-9769 Email: [email protected]

Mead Walker Mead Walker Consulting;Phone: 610-518-6259Email: [email protected]

FOUNDATION & TECHNOLOGY CO-CHAIRSGeorge (Woody) Beeler Beeler Consulting, LLC Phone: 507-254-4810 Email: [email protected]

Anthony Julian Mayo Clinic Phone: 507-266-0958 Email: [email protected]

STRUCTURE & SEMANTIC DESIGN CO-CHAIRSCalvin BeebeMayo ClinicPhone: 507-284-3827Email: [email protected]

Patricia Van Dyke Delta Dental Plans Association Phone: 503-243-4492 Email: [email protected]

TECHNICAL & SUPPORT SERVICES CO-CHAIRSFrieda HallQuest Diagnostics, IncorporatedPhone: 610-650-6794Email: [email protected]

Patrick Loyd ICode SolutionsPhone: 415-209-0544 Email: [email protected]

AD-HOC MEMBERHelen Stevens Love M Gordon Point Informatics Ltd. Phone: 250-598-0312 Email: [email protected]

DOMAIN EXPERTSAnatomic PathologyAnesthesiologyAttachmentsChild HealthClinical GenomicsClinical Interoperability Council*Community Based Collaborative CareEmergency CareHealth Care DevicesPatient CarePatient SafetyPharmacyPublic Health & Emergency Response Regulated Clinical Research Information Management

FOUNDATION & TECHNOLOGYConformance & Guidance for Implementation/TestingImplementable Technology SpecificationsInfrastructure & MessagingModeling & MethodologyRIM Based Application ArchitectureSecurityService Oriented Architecture TemplatesVocabulary

TECHNICAL & SUPPORT SERVICESEducationElectronic ServicesInternational Mentoring CommitteeProcess Improvement CommitteeProject ServicesPublishingTooling

STRUCTURE & SEMANTIC DESIGNArden SyntaxClinical Context Object WorkgroupClinical Decision SupportClinical StatementElectronic Health RecordFinancial ManagementImaging IntegrationOrders & ObservationsPatient AdministrationStructured Documents

*Voice only; no vote

STEERING DIVISIONS

31MAY 2012

HL7 WORK GROUP CO-CHAIRSAnatomic Pathology David Booker, MD CollegeofAmericanPathologistsPhone:706-736-0991Email:[email protected] Victor Brodsky, MDCollegeofAmericanPathologistsPhone:646-322-4648Email:[email protected]

Jeffrey KarpCollegeofAmericanPathologistsPhone:847-832-7358Email:[email protected]

Architectural Review Board

Charlie Mead, MD, MSc3rdMillennium,Inc.Phone:510-541-8224Email:[email protected]

Ron ParkerHL7CanadaPhone:902-832-0876Email:[email protected]

John QuinnHealthLevelSevenInternationalPhone:216-409-1330Email:[email protected]

Arden Syntax

Peter HaugIntermountainHealthcarePhone:801-442-6240Email:[email protected]

Robert Jenders, MDNationalLibraryofMedicinePhone:301-435-3192Email:[email protected]

Attachments

Durwin DayHealthCareServiceCorporationPhone:312-653-5948Email:[email protected]

Craig GabronBlueCrossBlueShieldofSouthCarolinaPhone:803-763-1790Email:[email protected]

Jim McKinleyBlueCrossandBlueShieldofAlabamaPhone:205-220-5960Email:[email protected]

Child Health

David Classen, MD, MSAllianceforPediatricQualityPhone:801-532-3633Email:[email protected]

Gaye Dolin, MSNLantanaConsultingGroupPhone:714-744-4152Email:[email protected]

Joy KuhlAllianceforPediatricQualityPhone:818-308-7063Email:[email protected]

Andy Spooner, MD, FAAPCincinnatiChildren’sHospitalPhone:513-803-0121Email:[email protected]

Feliciano Yu, MDSt.LouisChildren’sHospitalPhone:314-454-2808Email:[email protected]

Clinical Context Object Workgroup (CCOW)David FusariMicrosoftCorporationPhone:978-749-0022Email:[email protected]

Michael Russell, MDDukeTranslationalMedicineInstitutePhone:919-668-3889Email:[email protected]

David StaggsUSDepartmentofVeteransAffairsPhone:858-826-5629Email:[email protected]

Clinical Decision SupportGuilherme Del Fiol, MDUniversityofUtahPhone:919-213-4129Email:[email protected]

Robert Jenders, MDNationalLibraryofMedicinePhone:310-435-3192Email:[email protected]

Kensaku Kawamoto, PhDDukeTranslationalMedicineInstitutePhone:801-587-8076Email:[email protected]

Howard StrasbergWoltersKluwerHealthPhone:858-481-4249Email:[email protected]

Clinical Genomics

Joyce HernandezMerck&Co.,Inc.Phone:732-594-1815Email:[email protected]

Amnon Shabo, PhDIBMPhone:972-544-714070Email:[email protected]

Daryl Thomas MSCS, PhD (Interim)LifeTechnologiesEmail:[email protected]

Mollie Ullman-CullerePartnersHealthCareSystem,Inc.Phone:617-582-7249Email:[email protected]

Clinical Interoperability Council

W. Edward Hammond, PhDPhone:919-383-3555Email:[email protected]

Meredith NahmDukeTranslationalMedicineInstitutePhone:919-668-8339Email:[email protected]

Dianne ReevesNationalCancerInstitutePhone:301-435-5602Email:[email protected]

Anita WaldenDukeTranslationalMedicineInstitutePhone:919-668-8256Email:[email protected]

Clinical Statement

Hans BuitendijkSiemensHealthcarePhone:610-219-2087Email:[email protected]

Patrick LoydICodeSolutionsPhone:415-209-0544Email:[email protected]

Rik Smithies HL7UKNProgramLtd.Phone:44-7720-290967Email:[email protected]

Community Based Collaborative Care

Suzanne Gonzales-WebbUSDepartmentofVeteransAffairsPhone:619-972-9047Email:[email protected]

Richard ThoresonSAMHSAPhone:240-276-2827Email:[email protected]

Max WalkerDepartment of HealthPhone:61-3-9096-1471Email:[email protected]

Conformance & Guidance for Implementation/Testing

Wendy HuangCanadaHealthInfowayInc.Phone:416-595-3449Email:[email protected]

Frank OemigHL7GermanyAgfaHealthcarePhone:49-208-781194Email:[email protected]

Ioana SingureanuEversolve,LLCPhone:603-870-9739Email:[email protected]

Robert SnelickNationalInstituteofStandards&TechnologyPhone:301-975-5924Email:[email protected]

EducationDiego KaminkerHL7ArgentinaPhone:54-11-4781-2898Email:[email protected]

Patrick Loyd (Interim)ICodeSolutionsPhone:415-209-0544Email:[email protected]

Melva PetersHL7Canada/GordonPointInformaticsPhone:604-515-0339Email:[email protected]

Electronic Health Records

Gary DickinsonCentriHealthPhone:951-536-7010Email:[email protected]

Don Mon, PhDRTIInternationalPhone:312-777-5228Email:[email protected]

John RitterPhone:412-372-5783Email:[email protected]

Helen Stevens LoveGordonPointInformaticsLtd.Phone:250-598-0312Email:[email protected]

Patricia Van DykeDeltaDentalPlansAssociationPhone:503-243-4492Email:[email protected]

Electronic Services

Bill Braithwaite, MD, PhDAnakamEquityServices,EquifaxPhone:202-543-6937Email:[email protected]

32 MAY 2012

HL7 Work Group Co-Chairs, continuedLorraine ConstableConstableConsultingInc.Phone:780-951-4853Email:[email protected]

Ken McCaslinQuestDiagnostics,IncorporatedPhone:610-650-6692Email:[email protected]

Emergency CareLaura Heermann LangfordIntermountainHealthcarePhone:801-507-9254Email:[email protected]

Donald Kamens, MDXPressTechnologiesPhone:904-296-1189Email:[email protected]

James McClay, MDUniversityofNebraskaMedicalCenterPhone:402-559-3587Email:[email protected]

Peter Park, PhDUSDepartmentofDefense,MilitaryHealthSystemPhone:202-762-0926Email:[email protected]

Financial Management

Kathleen ConnorEdmondScientificEmail:[email protected]

Beat HeggliHL7SwitzerlandPhone:41-1-806-1164Email:[email protected]

Mary Kay McDanielMarkam,Inc.Email:[email protected]

Generation Of Anesthesia Standards

Martin Hurrell, PhDPhone:44-7711-669-522Email:[email protected]

Terri Monk, MDDukeTranslationalMedicineInstitutePhone:919-286-6938Email:[email protected]

Health Care Devices

Todd Cooper80001Experts,LLCPhone:858-435-0729Email:[email protected]

Allen Hobbs, PhDKaiserPermanentePhone:510-267-5031Email:[email protected]

Patty KrantzMedtronicPhone:763-526-0513Email:[email protected]

John Rhoads, PhD (Interim)PhilipsHealthcarePhone:978-659-3024Email:[email protected]

Imaging Integration

Helmut Koenig, MDSiemensHealthcarePhone:49-9131-84-3480Email:[email protected]

Harry SolomonGEHealthcarePhone:847-277-5096Email:[email protected]

Implementable Technol-ogy Specifications

Paul KnappKnappConsultingInc.Phone:604-987-3313Email:[email protected]

Dale NelsonSquaretrendsLLCPhone:916-367-1458Email:[email protected]

Andy StechishinCANASoftware&ServicesLtd.Phone:780-903-0885Email:[email protected]

Infrastructure & Messaging

Anthony JulianMayoClinicPhone:507-266-0958Email:[email protected]


David Shaver CorepointHealthPhone:214-618-7000Email:[email protected]

Sandra StuartKaiserPermanentePhone:925-924-7473Email:[email protected]

International CouncilCatherine Chronaki—Affiliate Liaison HL7Hellas/FORTH-InstituteofComputerSciencePhone:30-2810-391691Email:[email protected]

Philip Scott, PhD - HL7 International LiaisonHL7UKPhone:448700-112-866Email:[email protected]

Robert Stegwee, MSc, PhD—HL7 International LiaisonHL7theNetherlandsPhone:31-30-689-2730Email:[email protected]

Helen Stevens Love—Secretary GordonPointInformaticsLtd.Phone:250-598-0312Email:[email protected]

International Mentoring Committee

Diego KaminkerHL7ArgentinaPhone:54-11-4781-2898Email:[email protected]

John RitterPhone:412-372-5783Email:[email protected]

Marketing Council

Rene SpronkHL7theNetherlandsPhone:31-318-553812Email:[email protected]

Edward TrippEdwardS.TrippandAssociates,Inc.Phone:224-234-9769Email:[email protected]

Grant WoodIntermountainHealthcarePhone:801-408-8153Email:[email protected]

Modeling and Methodology

George (Woody) Beeler Jr., PhDBeelerConsulting,LLCPhone:507-254-4810Email:[email protected]

Jean DuteauHL7CanadaPhone:780-937-8991Email:[email protected]

Grahame GrieveHealthIntersectionsPtyLtdPhone:61-3-9450-2222Email:[email protected] Lloyd McKenzieHL7Canada(GordonPointInformatics)Email:[email protected]

Ravi NatarajanNHSConsultingforHealthPhone:44-113-390-6520Email:[email protected]

Orders and Observations

Hans BuitendijkSiemensHealthcarePhone:610-219-2087Email:[email protected]

Lorraine ConstableConstableConsultingInc.Phone:780-951-4853Email:[email protected]

Robert Hausam, MDHausamConsultingPhone:801-949-1556Email:[email protected]


Ken McCaslinQuestDiagnostics,IncorporatedPhone:610-650-6692Email:[email protected]

Outreach Committee for Clinical Research

Ed Helton, PhDNationalCancerInstitutePhone:919-465-4473Email:[email protected]

Patient Adminstration

Alexander deLeonKaiserPermanentePhone:626-381-1455Email:[email protected]

Line SaeleHelseVestIKTPhone:47-55976494Email:[email protected]

Patient Care

Stephen Chu, PhDNationaleHealthTransitionAuthority(NEHTA)Phone:61-730238448Email:[email protected]

Kevin Coonan, MDDeloitteConsultingLLPEmail:[email protected]

William GoossenHL7TheNetherlandsResults4CareB.V.AmersfoortPhone:31-654-614458Email:[email protected]

Hugh Leslie OceanInformaticsEmail:[email protected]

Ian TownendNHSConnectingforHealthPhone:44-113-280-6743Email:[email protected]

Klaus VeilHL7AustraliaPhone:61-412-746-457Email:[email protected]

33MAY 2012

HL7 Work Group Co-Chairs, continued Patient Safety

Nick HalseyEuropeanMedicinesAgencyPhone:44-0-20-7523-7100Email:[email protected] RashideeQuantrosPhone:408-514-4804Email:[email protected]

Mead WalkerMeadWalkerConsultingPhone:610-518-6259Email:[email protected]

Pharmacy

Tom de Jong HL7theNetherlandsPhone:31-6-3255291Email:[email protected]

Hugh Glover HL7 UKBlueWaveInformaticsPhone:44-07889407113Email:[email protected]

Melva Peters HL7Canada/GordonPointInformaticsPhone:604-515-0339Email:[email protected]

Process Improvement Committee

Sandra Stuart KaiserPermanentePhone:925-924-7473Email:[email protected]

Project Services

Rick HaddorffMayoClinicPhone:978-296-1462Email:[email protected]

Freida HallQuestDiagnostics,Inc.Phone:610-650-6794Email:[email protected]

Public Health Emergency Response

Joginder MadraGordonPointInformaticsLtd.Phone:780-717-4295Email:[email protected]

Ken Pool, MDOZSystemsPhone:214-631-6161Email:[email protected]

John RobertsTennesseeDepartmentofHealthPhone:615-741-3702Email:[email protected]

Rob SavageRobSavageConsultingEmail:[email protected]

Publishing Committee

George (Woody) Beeler Jr., PhD-V3 BeelerConsulting,LLCPhone:507-254-4810Email:[email protected]

Jane Curry-V2/V3HealthInformationStrategiesInc.Phone:780-459-8560Email:[email protected]

Jane Daus-V2McKessonProviderTechnologiesPhone:847-495-1289Email:[email protected]

Brian Pech-V2KaiserPermanentePhone:678-245-1762Email:[email protected]

Andrew Stechishin-V3 CANASoftware&ServicesLtd.Phone:780-903-0855Email:[email protected]

Sandra Stuart-V2KaiserPermanentePhone:925-924-7473Email:[email protected]

Regulated Clinical Research Information Management

Ed Helton, PhDNationalCancerInstitutePhone:919-465-4473Email:[email protected]

Armando Oliva, MDFood&DrugAdministrationPhone:301-796-8126Email:[email protected]

Edward TrippEdwardS.Tripp&Associates,Inc.Phone:224-234-9769Email:[email protected]

RIM Based Application Architecture

Peter Hendler, MDKaiserPermanentePhone:510-248-3055Email:[email protected]

Amnon Shabo, PhDIBMPhone:972-544-714070Email:[email protected]

Rene SpronkHL7TheNetherlandsPhone:33-318-553812Email:[email protected]

Security

Bernd Blobel, PhDHL7Germany;UniversityofRegensburgMedicalCenterPhone:49-700-7777-6767Email:[email protected]

Mike DavisUSDepartmentofVeteransAffairsPhone:760-632-0294Email:[email protected]

John MoehrkeGEHealthcareITPhone:920-912-8451Email:[email protected]

Services Oriented Architecture

Gerald BeucheltTheMITRECorporationEmail:[email protected]

Don Jorgenson Inpriva, Inc.Phone:970-472-1441Email:[email protected]

Galen MulrooneyUSDepartmentofVeteransAffairsPhone:703-815-0900Email:[email protected]

Ken RubinHewlett-PackardEnterprisesServicesPhone:703-845-3277Email:[email protected]

Structured Documents

Calvin BeebeMayoClinicPhone:507-284-3827Email:[email protected]

Robert Dolin, MDLantanaConsultingGroupPhone:714-532-1130Email:[email protected]

Grahame Grieve HealthIntersectionsPtyLtdPhone:61-3-9450-2222Email:[email protected]

Austin KreislerScienceApplicationsInternationalCorp(SAIC)Phone:404-542-4475Email:[email protected]

Brett MarquardLantanaConsultingGroupPhone:413-549-6886Email:[email protected]

Templates

John RobertsTennesseeDepartmentofHealthPhone:615-741-3702Email:[email protected]

Mark ShafarmanShafarmanConsultingPhone:510-593-3483Email:[email protected]

Tooling

Jane CurryHealthInformationStrategies,Inc.Phone:780-459-8560Email:[email protected]

Tim IrelandNHSConnectingforHealthEmail:[email protected]

Andrew StechishinCANASoftware&ServicesLtd.Phone:780-903-0855Email:[email protected]

Vocabulary

Jim Case, DVM, PhDNationalLibraryofMedicinePhone:301-594-9152Email:[email protected]

Heather GrainStandardsAustralia,LlewelynGrainInformaticsPhone:613-956-99443Email:[email protected]

Russell HammApelon,Inc.Phone:507-271-0227Email:[email protected]

Robert Hausam, MDHausamConsultingPhone:801-949-1556Email:[email protected]

William T. KleinKleinConsulting,Inc.Phone:631-924-6922Email:[email protected]

34 MAY 2012

HL7 FACILITATORSSteeringDivisionFacilitators

Rick HaddorffMayoClinic/FoundationStructure & Semantic DesignPhone:978-296-1462Email:[email protected]

Lynn LaaksoHealthLevelSevenInternationalFoundation & TechnologyPhone:906-361-5966Email:[email protected]

Dave HamillHealthLevelSevenInternationalTechnical & Support ServicesPhone:734-677-7777Email:[email protected]

ModelingandMethodologyFacilitators

George (Woody) Beeler, Jr., PhDBeelerConsultingLLCFacilitator-at-LargePhone:507-254-4810Email:[email protected]

Charlie BishopiSoftClinical StatementPhone:44-7989-705-395Email:[email protected]

Bernd Blobel, PhDHL7GermanySecurity Phone:49-700-7777-6767Email:[email protected]

Kathleen ConnorEdmundScientificFinancial ManagementEmail:[email protected]

Kevin Coonan, MDDeloitteConsultingLLPEmergency CareEmail:[email protected]

Norman DaoustDaoustAssociatesAnatomic PathologyPhone:617-491-7424Email:[email protected]

Jean Duteau GordonPointInformaticsLtd.Patient Care; PharmacyPhone:780-937-8991Email:[email protected]

Hugh Glover HL7UKMedication Phone:44-0-7889-407-113Email:[email protected]

Grahame Grieve HealthIntersectionsPtyLtdInfrastructure & Messaging Phone:61-3-9450-2222Email:[email protected]

Alexander HenketHL7TheNetherlandsPatient AdministrationEmail:[email protected]

William “Ted” KleinKleinConsulting,Inc.VocabularyPhone:631-924-6922Email:[email protected]

Austin KreislerScienceApplicationsInternationalCorporation(SAIC)Structured DocumentsPhone:404-542-4475Email:[email protected]

Patrick LoydICodeSolutionsOrders & Observations Phone:415-209-0544Email:[email protected]

Joginder MadraGordonPointInformaticsLtd.Immunization; PHERPhone:780-717-4295Email:[email protected]

Lloyd McKenzieHL7Canada(GordonPointInformatics)Email:[email protected]

Dale NelsonSquaretrendsLLCImplementable TechnologySpecificationsPhone:916-367-1458Email:[email protected]

Craig Parker, MDIntermountainHealthcareClinical Decision Support Phone:801-859-4480Email:[email protected]

Jenni PuyenbroekScienceApplicationsInternationalCorporation(SAIC)Conformance & Guidance for Implementation/TestingPhone:678-261-2099Email:[email protected]

Amnon Shabo, PhD IBMClinical GenomicsPhone:972-544-714070Email:[email protected]

AbdulMalik ShakirCityofHopeNationalMedicalCenterClinical Interoperability Council; Modeling & Methodology Phone:626-644-4491Email:[email protected]

Ioana SingureanuEversolve,LLCCBCC & Health Care DevicesPhone:603-870-9739Email:[email protected]

Corey SpearsMcKessonProviderTechnologyElectronic Health RecordsPhone:206-269-1211Email:[email protected]

Mead WalkerMeadWalkerConsultingPatient Safety; RCRIMPhone:610-518-6259Email:[email protected]

PublishingFacilitators

Becky AngelesScenPro,Inc.RCRIMPhone:972-437-5001Email:[email protected]

Douglas Baird BostonScientificCorporationTemplates Phone:651-582-3241Email:[email protected]

Mike DavisUSDepartmentofVeteransAffairsSecurity Phone:760-632-0294Email:[email protected]

Jean Duteau GordonPointInformaticsLtd.PHERPhone:780-937-8991Email:[email protected]

Isobel FreanBupaGroupClinical StatementPhone:44-207-656-2146Email:[email protected]

Peter GilbertCovisintStructured DocumentsPhone:313-227-0358Email:[email protected]

Robert HallowellSiemensHealthcareMedication; PharmacyPhone:610-219-5612Email:[email protected]

Alexander HenketHL7TheNetherlandsPatient AdministrationEmail:[email protected]

Anthony Julian MayoClinicInfrastructure & Messaging Phone:507-266-0958Email:[email protected]

Helmut Koenig, MDSiemensHealthcareImaging Integration Phone:49-9131-84-3480Email:[email protected]

Austin KreislerScienceApplicationsInternationalCorporation(SAIC)Orders & ObservationsPhone:404-542-4475Email:[email protected]

Margaret (Peggy) LeizearFoodandDrugAdministrationRCRIMPhone:301-827-5203Email:[email protected]

Mary Kay McDanielMarkam,Inc.Financial ManagementEmail:[email protected]

Dale NelsonSquaretrendsLLCCMET; Implementable Technology SpecificationsPhone:916-367-1458Email:[email protected]

Frank Oemig HL7GermanyGerman RealmPhone:49-208-781194Email:[email protected]

35MAY 2012

Nancy OrvisUSDepartmentofDefense,MilitaryHealthSystemGovernment Projects Phone:703-681-3900Email:[email protected]

Craig Parker, MDIntermountainHealthcareClinical Decision Support Phone:801-859-4480Email:[email protected]

John RitterElectronic Health RecordsPhone:412-372-5783Email:[email protected]

Ioana SingureanuEversolve,LLCCBCCPhone:603-870-9739Email:[email protected]

Margarita SordoPartnersHealthCareSystem,Inc.GelloPhone:781-416-8479Email:[email protected]

Anita WaldenDukeTranslationalMedicineInstituteClinical Interoperability CouncilPhone:919-668-8256Email:[email protected]

Grant WoodIntermountainHealthcareClinical GenomicsPhone:801-408-8153Email:[email protected]

VocabularyFacilitators

Paul Biondich, MDIUSchoolofMedicineChild HealthPhone:317-278-3466Email:[email protected]

Kathleen ConnorEdmondScientificFinancial Management; SecurityEmail:[email protected]

Kevin Coonan, MDDeloitteConsultingLLPEmergency CareEmail:[email protected]

Guilherme Del Fiol, MDUniversityofUtahClinical Decision SupportPhone:919-213-4129Email:[email protected]

Christof GessnerHL7GermanyHealth Care DevicesPhone:49-172-3994033Email:[email protected]

Margaret Haber, BSN, RN, OCNNationalCancerInstituteCenterforBioinformaticsRCRIM Phone:301-594-9185Email:[email protected]

W. Edward Hammond, PhD Templates Phone:919-383-3555Email:[email protected]

Monica HarryGordonPointInformaticsPHEREmail:[email protected]

Robert Hausam, MDHausamConsultingOrders & Observations; Structured DocumentsPhone:801-949-1556Email:[email protected]

Joyce HernandezMerck&Co.Inc.Clinical GenomicsPhone:732-594-1815Email:[email protected]

Wendy HuangCanadaHealthInfowayInc.Patient AdministrationPhone:416-595-3449Email:[email protected]

Julie JamesBlueWaveInformaticsMedication; Pharmacy Email:[email protected]

William “Ted” Klein KleinConsulting,Inc.Modeling & Methodology Phone:631-924-6922Email:[email protected]

Patrick LoydICodeSolutionsClinical StatementPhone:415-209-0544Email:[email protected]

Susan Matney3MHealthInformationSystemsPatient CarePhone:801-265-4326Email:[email protected]

Robert McClure, MDApelon,Inc.CBCCPhone:303-926-6771Email:[email protected]

Nancy OrvisUSDepartmentofDefense,MilitaryHealthSystemGovernment Projects Phone:703-681-3900Email:[email protected]

Sarah RyanClinical Interoperability CouncilEmail:[email protected]

Harold SolbrigApelon,Inc.Modeling & Methodology Phone:807-993-0269Email:[email protected]

Harry SolomonGEHealthcareITImaging Integration Phone:847-277-5096Email:[email protected]

Sandra Stuart KaiserPermanenteInfrastructure & Messaging Phone:925-924-7473Email:[email protected] Van DykeDeltaDentalPlansAssociationElectronic Health RecordsPhone:503-243-4992Email:[email protected]

Tony WeidaApelonSecurityEmail:[email protected]

HL7 FACILITATORS, continued

36 MAY 2012

AFFILIATE CONTACTS

HL7 ArgentinaDiego KaminkerPhone: +54-11-4781-2898Email: [email protected]

HL7 AustraliaRichard Dixon HughesEmail: [email protected]

HL7 AustriaStefan SabutschPhone: +43-664-3132505Email: [email protected]

HL7 Bosnia and Herzegovina Samir Dedovic Phone: +387 0-33-721-911 Email: [email protected]

HL7 BrazilMarivan Santiago AbrahaoPhone: +55-11-3045-3045Email: [email protected]

HL7 CanadaMelva Peters Phone: +604-515-0339 Email: [email protected]

HL7 ChileSergio Konig Phone: +56-2-7697996 Email: [email protected]

HL7 China Prof. Baoluo LiPhone: +86-010-65815129Email: [email protected]

HL7 ColombiaFernando A. Portilla Phone: +57-2-5552334 x241Email: [email protected]

HL7 CroatiaMiroslav KoncarPhone: +385-99-321-2253Email: [email protected]

HL7 Czech RepublicLibor SeidlPhone: +420 605740492Email: [email protected]

HL7 FinlandJuha Mykkanen, PhDPhone: +358-403552824 Email: [email protected]

HL7 France Nicolas Canu Phone: +33 02-35-60-41-97 Email: [email protected]

HL7 GermanyKai Heitmann, MDPhone: +49-172-2660814Email: [email protected]

HL7 GreeceAlexander Berler, PhD Phone: +30-2111001691 Email: [email protected] HL7 IndiaSupten Sarbadhikari, MBBS, PhD Email: [email protected]

HL7 ItalyStefano LottiPhone: +39-06-42160685Email: [email protected]

HL7 JapanMichio Kimura, MD, PhDPhone: +81-3-3506-8010Email: [email protected]

HL7 KoreaByoung-Kee Yi, PhDPhone: +82 234101944 Email: [email protected]

HL7 Luxembourg Stefan Benzschawel Phone: +352-425-991-889 Email: [email protected]

HL7 MexicoPablo Ceballos Yanez Phone: +52 55-5261-4000 Email: [email protected]

HL7 New ZealandDavid HayPhone: +64-9-638-9286Email: [email protected]

HL7 Norway Espen Moeller Phone: +47 97008186 Email: [email protected]

HL7 Pakistan Dr. Hafiz Farooq Ahmad Phone: +92 51-90852155 Email: [email protected]

HL7 Puerto Rico Julio Cajigas Phone: +1 787-805-0505 x6003 Email: [email protected]

HL7 RomaniaFlorica Moldoveanu, PhD Phone: +40-21-4115781Email: [email protected]

HL7 RussiaTatyana Zarubina MD, PhD Phone: +007-495-434-55-82 Email: [email protected]

HL7 SingaporeColleen Brooks Phone: +65-68181246 Email: [email protected]

HL7 SpainCarlos Gallego PerezPhone: +34-93-693-18-03 Email: [email protected]

HL7 SwedenGustav AlvfeldtPhone: +46 08-123-13-117 Email: [email protected]

HL7 SwitzerlandBeat HeggliPhone: +41-1-806-1164Email: [email protected]

HL7 TaiwanChih-Chan (Chad) YenPhone: +886-2-25526990Email: [email protected]

HL7 The NetherlandsRobert Stegwee, MSc, PhDPhone: +31-30-689-2730Email: [email protected]

HL7 TurkeyErgin SoysalEmail: [email protected]

HL7 UKPhilip Scott, PhD Phone: +44 8700-112-866 Email: [email protected]

HL7 UruguaySelene Indarte Phone: +5985-711-0711 Email: [email protected]

37MAY 2012

Chief Executive Officer

2012 HL7 STAFFAssociate Executive

Director

Charles Jaffe, MD, PhD [email protected]

Chief Technical Officer

Executive Director

Mark McDougall+1-734-677-7777

[email protected]

Karen Van Hentenryck+1-734-677-7777

[email protected]

John [email protected]

Director of Meetings

Director, Project Management Office

Lillian [email protected]

Manager of Education

Dave [email protected]

Mary Ann Boyle+1-734-677-7777

[email protected]

Manager of Administrative

Services

Director of Communications

Linda [email protected]

Director ofTechnical

Publications

Director of Technical Services

Michael Kingery+1-919-636-4032

[email protected]

Andrea [email protected]

Donald [email protected]

Director of Membership

Services

Diana [email protected]

TSC Project Manager

Lynn [email protected]

Web Development Coordinator

Joshua [email protected]

38 MAY 2012

Donald Mon, PhD [email protected]

Austin Kreisler ScienceApplications

InternationalCorp.(SAIC)+1-404-542-4475

[email protected]

2012 HL7 BOARD OF DIRECTORS

Jill Kaufman, PhDCollegeofAmerican

[email protected]

Robert Dolin, MDLantanaConsultingGroup

+1-714-532-1130bob.dolin

@lantanagroup.com

Edward Tripp EdwardSTripp

andAssociates,Inc.+1-224-234-9769

[email protected]

Directors-at-Large

John QuinnHL7CTO

[email protected]

Keith Boone GEHealthcareIT+1-617-519-2076

[email protected]

Michael van CampenGordonPointInformaticsLtd.

[email protected]

Charles Jaffe, MD, PhD HL7CEO

[email protected]

Mark McDougallHL7ExectiveDirector

[email protected]

Advisory Council Chair

Richard Dixon Hughes HL7Australia/DH4PtyLimited

[email protected]

Ex Officio Members

Catherine Chronaki, MScFORTH-InstituteofComputer

Science;HL7HellasBoD+30-2810-391691

[email protected]

Affiliate Directors

Diego Kaminker Chair,HL7Argentina

[email protected]

Past ChairChair Treasurer Secretary Technical Steering Committee Chair

Rebecca Kush, PhD CDISC

[email protected]

W. Edward Hammond, PhD +1-919-383-3555

[email protected]

Stanley Huff, MD IntermountainHealthcare

[email protected]

Douglas Fridsma, MD, PhD OfficeoftheNational

CoordinatorforHealthIT+1-202-205-4408

[email protected]

James Ferguson KaiserPermanente+1510-271-5639

[email protected]

Chair Emeritus and Director-at-Large

39MAY 2012

HL7 EDUCATIONAL SUMMITSGain 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 industrytopics such as vocabulary. Why Should I Attend?

This is an invaluable educational opportunity for the healthcare IT community as it strives for greater interop-erability among healthcare information systems. Our classes offer a wealth of information designed to benefit a wide range of HL7 users, from beginner to advanced.

Among the benefits of attending the HL7 Educational Summit are:

• Efficiency Concentrated two-day format provides maximum training with minimal time investment

• LearnToday,ApplyTomorrow A focused curriculum featuring real-world HL7 knowledge that you can apply immediately

• QualityEducation High-quality training in a “small classroom” setting promotes more one-on-one learning

• SuperiorInstructors 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

• CertificationTesting Become HL7 Certified: HL7 is the sole source for HL7 certification testing, now offering testing on Version 2.7, Clinical Document Architecture, and Version 3 RIM

• Economical A more economical alternative for companies who want the benefits of HL7’s on-site training but have fewer employees to train

July 17-19, 2012Hilton St. Louis at the Ballpark

St. Louis, MO

November 13-15, 2012 San Francisco Marriot

Fisherman’s Wharf

UPCOMING EDUCATIONAL SUMMITS

Upcoming WORKING GROUP MEETINGS

January 13 – 18, 2013

Working Group MeetingPointe Hilton Squaw Peak Resort

Phoenix, AZ

September 9 – 14, 2012

26th Annual Plenary &

Working Group Meeting

Hyatt Regency BaltimoreBaltimore, MD

May 5 – 10, 2013

Working Group Meeting Sheraton Atlanta Hotel

Atlanta, GA

January 12 – 14, 2014

Working Group Meeting Hilton in the Walt Disney World® Resort

Lake Buena Vista, FL

September 22 – 27, 2013

27th Annual Plenary &Working Group Meeting

Hyatt Regency CambridgeCambridge, MA