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Thursday, May 3, 2012

Balloting Strategies

The HL7 Ballot for May closes this coming Monday, May 7th.  There are about three dozen specifications being balloted this cycle.  It's not really practical for a single person or even in many cases for a single organization to vote on every ballot that HL7 prepares.  IHE is preparing numerous profiles for public comment this week (more than a dozen there) for a 30-day public comment period starting next month.  Again, it can be challenging to comment on everything.

Over the years I've developed a number of strategies that can help you go through the ballots.  There are three key strategies to use when voting on standards:

  1. Prioritize
  2. Spread out the Effort
  3. Borrow from Others   
This should be obvious.  You (or your organization) need not vote on everything that HL7, IHE or any other standards organization produces.  Focus only on those specifications that have an impact on your organization. HL7 and IHE have regularly scheduled times for balloting, which means that numerous specifications will be voted on in the same time period.  Other SDOs vote on standards when they think they are ready, which can spread out the work, but means that you have to pay more attention to schedules for individual work items.  Step 1 of prioritizing is to pick the specifications you plan on voting on for this cycle.

In HL7, ballots are "For Comment Only", "Informative", "Draft Standard for Trial Use (DSTU)", or "Normative".  For Comment Only ballots are just to get feedback and there will always be another opportunity to vote (sometime in the next year before it goes to a publishable stage).  DSTU ballots usually stay in Draft form for 2-3 years, and there will be an opportunity to vote on those again before they go normative.  Informative and Normative documents may not get balloted again for several years (Normative standards can go at most 5 years before being re-affirmed under ANSI rules).

When I prepare my ballot comments, I pay attention to the publications in this order: Normative, DSTU, Informative, For Comment Only.  That way, if I don't get through everything, I've covered the most important pieces first.

Spread out the Effort
Spread out the work.  If you have a team of experts (like I work with), assign one person to shepherd each document through its commenting process.  If you have a team working on one document, you can spread out the effort on a single specification by assigning different sections to different team members based on area of expertise.

We often have several members voting on one document, but assign one person to submit the comments.  All other voters simply vote as the assigned member tells them, and refers to their comments in their vote.  When you have several voting members in an SDO, this ensures that you take the maximum advantage of your voting rights.

There are several ways to review a document, each taking different amounts of time:

  1. Skim and Scan.  Read through the document quickly (this works well for documents that have been through several cycles, or for "Comment Only" ballots where you want to provide high level feedback.  Skim the document first to identify potential problem areas (and focus your attention on the technical content that impacts implementation -- the normative content).  Then scan those sections deeply when you make comments.  
  2. Read through and highlight.  A single person reads through the document, highlighting and commenting on issues as they are found.  Ballots in which content is available in Word or PDF format allow you to use commenting tools in those products.  I even wrote a Word Macro last year to help with this (many HL7 and IHE documents start in word, and even though that may not be what is published for the ballot, you might still be able to get access to the Word version).
  3. When reviewing with a team, provide the team with an overview
    Reviewing with a team can provide greater coverage.  In order to save time, make sure you know how you are going to consolidate comments from the team.  HL7 has a ballot macro to merge several  comment spreadsheets into a single one.  This can be very useful in combining feedback.  Agree first on how to order comments (e.g., by line number or page number), so that you can sort comments by position in the document (allowing you to find duplicates or conflicting comments).
    1. then Split up: This is useful when you have a team that is familiar with the topic, but which may not be familiar with the specification.  Usually this involves holding a meeting to provide an overview of the specification being reviewed, explaining what the material is, and explaining each person's responsibility to them. 
    2. then read through separately.  This produces better coverage than overview and split up, but takes more effort.  
    3. and Read Through together.  This is perhaps the most expensive method.  Usually these are run like a specification inspection or review.  It takes the most time, but gives people the opportunity to come to consensus on comments.  This is very effective when working together with several organizations.  

Borrow from Others
Borrowing from others not just an accepted way to address limited resources (it works for regulatory comments also), but is also encouraged by the process.  Ballots are always public, so you can readily locate what others have already said about the standard.  I usually (especially on ballots on unfamiliar material) look at comments submitted by other organizations to see what I should be looking out for.  This is especially true in the last day of the ballot cycle when I'm playing catch-up on my list of ballots to complete.

If you trust the comment submitter to properly represent the issue, you can even go one step further and simply refer to their comments.  Just be sure to support them through the ballot reconciliation process.

Borrowing from others is also a practice you can take advantage of when submitting your comments.  On critical ballots, I often point others to my comments (and try to get my comments out sooner).  This does two things:  It makes them aware of issues we might share, and saves them effort in finding the critical issues.

When you do that often enough, you'll find that other reciprocate, which can also make your life easier.

Happy balloting.

  -- Keith


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