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Monday, January 25, 2010

What happens to HITSP Now?

As many of you know, ANSI/HITSP's contract with ONC expires on January 31st of this month.  Many have assumed that with the expiration of this contract, HITSP would also disappear, but this is NOT the case.  ANSI/HITSP was created in 2005 by ANSI with collaboration from HIMSS, the Advanced Technology Institute (ATI) and Booz Allen Hamilton prior to any government contract.  Major funding for HITSP activities over the last four years has come from HHS through the award of the ONCHIT-1 contract to HITSP, and other contracts have also been awarded. 

The expiration of the ONCHIT-1 contract will have several impacts on ANSI/HITSP, but the organization is not disappearing.  Leaders of ANSI and of HIMSS have indicated in previous communications to HITSP members that there were plans to continue the organization after the expiration of the ONCHIT-1 contract.  HITSP also has another contract with CMS that continues (as I understand it) through the 2010 HIMSS Interoperability Showcase where HITSP specifications used for quality reporting will be demonstrated.

Carol Bean of the Office of the National Coordinator indicated in her comments to the HITSP Panel that there will be an RFP for an organization to replace HITSP which will be "coming soon".  As always, ONC can state very little about any pending issue that has not been released through official channels.  She did indicate that there is funding available to support continued communication through HITSP for its harmonization activities (although that cannot be used to respond to any RFP).  Communications in HITSP include conference calls, mailing lists and the HITSP web site.  I'm sure we will hear more from HITSP program management team about pursuit of that funding opportunity in the near future. 

John Halamka also referred to the RFP and indicated that it will very likely result in a differently named organization: He suggested the Standards Harmonization Collaborative.  This is a name similar to what is used in Canada as Mike Nusbaum reported on here earlier this year in A Canadian Perspective on Standards Harmonization.  The Canadian Standards Collaborative operates under the custodianship of Canada Health Infoway.  In Hello again, it's me, stirring up the pot I talk about what a similar organization might do in the US.

One component of this new organization would address one of the common issues that have been mentioned with regard to access to some of the standards in various communications on the web, and at the same time address a longstanding issue in HL7.  That issue has been the lack of an HL7 US Affilliate.  Some of the details of what being an affiliate entails are described in the 2009 Affiliate Agreement Form available as a Word document from the International Council page of the HL7 Web site.  Among the functions of an International Affiliate are:
  • To represent the interests of the Affiliate realm to HL7 through voting on HL7 ballots, participation in HL7 governance, and through a seat on the International Council
  • To make HL7 standards available to affiliate members
  • Be able to localize HL7 standards (word document) for use in the Affiliate's realm, including the ability to specify vocabularies used with HL7 standards
I look forward to the RFP for the replacement for HITSP.  Many of us who have been volunteers and leaders in the HITSP activities will certainly be active in any replacement, and I intend to be one of those who are. 

On other topics, I have begun review of the NPRM with respect to how it aligns with the standards selected in the IFR and will be posting those comments tomorrow.


P.S.  There have been some concerns raised within HL7 with regard to how a US Affiliate could impact HL7's revenue.  Realistically, I don't believe this will be a large impact.  I do not believe that many US organizations that are currently members of HL7 directly would defect to the US affiliate just because it provides a more inexpensive way1 to get access to the standards.  In so doing they would lose the principal benefit of HL7 membership: the ability to vote on HL7 standards and governance. A US Affiliate would have those same privledges, but they would be executed on behalf of the affiliate in its entirety, not by individual members. Most HL7 members that I know of find the most significant benefit of membership to be the ability to vote, rather than access to the standards (although that is also important).  HL7 members have much more influence in voting and governence of HL7 International, which is as it should be.
1 Our brethren in other countries can access HL7 standards by being a member of the affiliate organizations.  Affiliate membership is often much less expensive that HL7 membership.  HL7 membership ranges from $1000 to more than $18,000 depending upon your organizations revenue or budget.  In comparison, an organization can join HL7 UK for £650 + VAT (~ $1230 USD), or HL7 Australia for $350 AUD (~ $315 USD), or HL7 India for 10000 INR (~ $215 USD).