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).


  1. Fran Schroeder of ANSI reported at the end of the Panel meeting on the future of HITSP. There is now a no-cost extension of the HITSP contract with HHS through the end of April. The primary contractors (ANSI, HIMSS, ATI, Booz Allen Hamilton) will remain actively engaged. The HITSP Public website will remain available though the extension period and ANSI is considering leaving it up beyond the extension period as well. There will be periodic teleconferences of the HITSP Panel and the Board to keep people engaged.

    ANSI has asked the current leadership, including the chair (John Halamka), Board Members, and TC chairs to remain in their current positions through the extension period. John has agreed to retain his role, and I too will be retaining my roles.

    None of the HITSP Technical Committees will be officially convened during this period. The HITSP Web site, sharepoint, and list serves will remain available (with restrictions limiting members to communication and not official workgroup activities).

    All current HITSP deliverables will be provided to ONC with an indication of their current status. The portions of the HITSP work that are ready for public comment today will be published for comment on the HITSP web site. The comment tracking system will be retained and will be used to gather comments on these documents. There is no plan for disposing of these comments given that there will be no official TC meetings. However, all comments will be made available for access by government and industry.

    Lastly, HITSP will not be providing feedback on the NPRM and IFR as there is no funding available to coordinate a HITSP response. ANSI recommends that organizations provide their own response to promote HITSP objectives.

  2. I find your comments about an US affiliate to be very interesting. Being a member of HL7 in three ways - one via an affiliate in HL7 Canada, one via a company I work for, and the last being an individual membership - I understand what you are referring to when it comes to voting. My individual vote is obviously more valuable to me than the company vote which is more valuable than my affiliate say.

    If you could clarify, do you think that moving to a "One Member, One Vote" platform like I've seen discussed at the Affiliates' Council would help us with that? Or do you see that as a detriment to HL7?

    Just wondering.