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Friday, February 27, 2015

An open letter to members of the HL7 Board

I am asking for your support in the upcoming vote to appoint the incoming chair.

Shortly you will be making an important decision for HL7, which is who will lead the organization in the coming years. It’s an unprecedented decision for this Board to make, but I certainly understand the circumstances that brought it about. I also realize that you would probably rather not be forced by our organizational bylaws to be making the decision that you are now faced with.

We are truly faced with bigger crises in governance ahead. While HL7 FHIR®™ has taken off, and HL7 has also established itself as a leader in many national programs, we are faced with several challenges in the near future.

  • For the most part, we are still responding to trends rather than being ready for them or better yet, creating them.
  • The evolution of HL7 as an organization has been a painful and slow process, now accelerating as a result of many years of effort. However, it is still unclear how our future business model should evolve.
  • Participation of the International community in HL7 governance is still a major concern of many members. We’ve been working on that for a decade or more with little substantial change.

On the flip side, we have received a great deal of increased attention due to success of many HL7 initiatives:

  • Freely licensed standards
  • FHIR 
  • Consolidated CDA

  • Quality Improvement
  • Mobile Health
  • Payer Summits
We cannot rest on these successes. Collectively we need to understand not just how to take advantage of and respond to emerging trends, but also how to be setting them. Our attention five years ago to taking a “Fresh Look” at HL7 produced amazing results with FHIR. When the trend emerged towards open APIs, FHIR was standing in the wings. As a result, it produced an unanticipated re-invigoration of interest in HL7 from the Health IT community.

We need to institutionalize this success, and be ready with the standards when the next trend occurs. We need to become known not just for the standards that meet emerging trends, but for creating them in our industry. And not just in my home country, the US, but also internationally.

Some of you I am certain have also thrown (or had your name thrown) into the ring with me. I know almost all of you personally, and am certain that you too have a vision for making HL7 a successful organization. I am also certain that you will do a good job, and if you are appointed to the role of incoming chair instead of me, I offer you both these thoughts, and any assistance I can provide in bringing them about.


     Keith W. Boone

P.S.  For those of you not on the board, you can find the board members here. Feel free to contact them and tell them your opinion.


  1. I am surprised that the re-election of the Chair was not taken to the HL7 Membership - as is customary in democracies when an elected representative is not able to fulfil the office there were elected to.

    1. Noone is happy with this section of our bylaws, and action is being taken to correct it. But until that can be done (it takes several months), we must operate as they are written.

  2. Thank you for posting, Keith. Wishing you and the HL7 Board much luck and continued success.

  3. The specific bylaw section legalizes the Board to not take a re-election to the Membership in this special case. However, do the bylaws explicitely prohibit the Board to not use this option and take a re-election in this special case to the Membership if a majority of the Board-members would vote to do so ? (e.g, for democratic or other reasons)

    1. Key words in the bylaws are board appoint and timely. Interpretation in the past has been with one or two board meetings. An election takes about four months. While I'm not happy about where we are, I think the board has duly considered its options in this case.

  4. I hope this anomaly is fixed soon, as only six members (= 46%) of current Board will have been directly elected by the members. (Another three are indirectly elected by the Affiliates and the Co-Chairs)