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Thursday, October 7, 2010

Scope and Focus

One of the places I've been paying attention to in HL7 and in our national program is how to make the best use of resources.  I've had some very interesting discussions on this topic over the last three weeks on both fronts.  One of my concerns about our national program is that we seem to be getting distracted by every good idea.  The same thing is true in HL7.  For example, here are a list of projects in HL7 that are in some ways trying to facilitate use of HL7 standards:
  1. Green CDA
  2. Micro-ITS
  3. New ITS
  4. RIM ITS
  5. Mapping Tools
  6. Templating Tools
  7. Template Registry Pilot 
  8. Virtual Medical Record
  9. Netrual Mapping Notation
  10. CDA Release 3
  11. Common Document Types
  12. hData ITS
  13. Template Design Pilot
  14. ... (I think you get the point)
The good thing about these is that they are aligned to some degree to a strategic initiative.  The bad thing is that there really is no overall architecture that explains how all of these things work together, and how they are tied into that strategic initiative.

On top of that are all of the other projects that are coming in that are not related to a strategic initiative.

Each project has a cost in time and effort, not only in members that are active in development of the project, but other members who observe, participate and vote to approve the project and its outputs (standards and implementation guides).

There are limited resources in any organization, and I know in most businesses, that for every project suggested and approved, there are probably 2 to 10 that didn't make the cut because they don't offer sufficient return on investment.  Since these standards are our products in HL7, we should be making some business decisions about the projects to produce them that affects what we deliver to our customers (and as I've noted before, our customers and our members are two different audiences).  That means that occasionally we need to say no, and that we need to better align and coordinate those projects that are part of strategic programs.

The same thing is true in our national program.  We are about to see use cases coming out of the woodwork.  We need to develop a framework of governance that ensures these uses cases are
  1. Aligned with National Strategic Initiatives
  2. Will have a reasonable impact, based on an assessment of the increases in effectiveness, outcomes or access, and the efforts involved.
I'll be trying to figure out how we accomplish this over the next couple of years, both in HL7 and in the US


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