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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
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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
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23MAY 2012
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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
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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]
Patrick LoydICodeSolutionsPhone:415-209-0544Email:[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]
Patrick LoydICodeSolutionsPhone:415-209-0544Email:[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
Karen Van Hentenryck+1-734-677-7777
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
Manager of Administrative
Services
Director of Communications
Linda [email protected]
Director ofTechnical
Publications
Director of Technical Services
Michael Kingery+1-919-636-4032
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
2012 HL7 BOARD OF DIRECTORS
Jill Kaufman, PhDCollegeofAmerican
Robert Dolin, MDLantanaConsultingGroup
+1-714-532-1130bob.dolin
@lantanagroup.com
Edward Tripp EdwardSTripp
andAssociates,Inc.+1-224-234-9769
Directors-at-Large
John QuinnHL7CTO
Keith Boone GEHealthcareIT+1-617-519-2076
Michael van CampenGordonPointInformaticsLtd.
Charles Jaffe, MD, PhD HL7CEO
Mark McDougallHL7ExectiveDirector
Advisory Council Chair
Richard Dixon Hughes HL7Australia/DH4PtyLimited
Ex Officio Members
Catherine Chronaki, MScFORTH-InstituteofComputer
Science;HL7HellasBoD+30-2810-391691
Affiliate Directors
Diego Kaminker Chair,HL7Argentina
Past ChairChair Treasurer Secretary Technical Steering Committee Chair
Rebecca Kush, PhD CDISC
W. Edward Hammond, PhD +1-919-383-3555
Stanley Huff, MD IntermountainHealthcare
Douglas Fridsma, MD, PhD OfficeoftheNational
CoordinatorforHealthIT+1-202-205-4408
James Ferguson KaiserPermanente+1510-271-5639
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