Thursday, September 23, 2010

How I Voted on the InfoButton, Genetic Testing, and Progress Note HL7 Ballots

Another part of being an effective voter on an HL7 Ballot is to share your findings with others.  In that way, you can free them up to review other content in more detail (if they happen to agree), and can at least be cognizant of issues going into the reconcilliation.  All ballot comments are public information anyway, so unless you are persuing the strategy of holding your negatives off till the end, there's no reason not to share your results widely.

HL7 Version 3 Implementation Guide: Context-Aware Knowledge Retrieval (Infobutton) – Decision Support Service (DSS) Implementation Guide, Release 1 (V3_IG_DSS_KM_INFOBUTTON_R1_D1_2010SEP)


Suggestion: The content is good, but it needs a much simpler approach to explain how it works to the everyday engineer. The use of terms like "semantic signifier" means nothing to people who are not familiar with the OMG work. Conformance to OMG profiles also provides some referential problems here. This is an implentation guide, at least by its title. Please tell people how to implement correctly, not what else they have to read. It's fair to refer them to the Atom standard, but not really fair to make them read and comprehend a very high level conformance profile. I don't think rewriting this to make it easier to implement would have require any substantive change, so this is an affirmtive with suggestions.

HL7 Implementation Guide for CDA Release 2: Genetic Testing Reports, Release 1 (CDAR2_IG_GENTESTRPT_R1_D1_2010SEP)

Comment: I like where you are headed, and clearly the MDHT tools have served you well here but need to move towards generating HL7 XML Content for balloting purposes, rather than PDF (for a number of reasons). However, the document is clearly not completely ready for ballot at the DSTU level (perhaps is should have been For Comment Only). I have disagreements with the use of "text-only" templates, and proposals for hyperspecialized section codes.

A File upload was made for this document that can be retreived here

HL7 Implementation Guide for CDA Release 2: Progress Note, Release 1 (US realm) (CDAR2_IG_PROGNOTE_R1_D1_2010SEP)
Comment: Inconcistencies between this document and existing IHE and HITSP work prevent me from voting affirmative, especially given regulatory status of HITSP C32 Version 2.5. These sections MUST be at least identical to those already defined by current regulation in the US Realm. While the current work is not "inconcistent" with that regulation, it does not conform it its complete requirements.

A File upload was made for this document that can be retreived  here


  1. Hi Keith, a quick comment about your MDHT statement "need to move towards generating HL7 XML Content for balloting purposes, rather than PDF". MDHT produces DITA output from UML model publishing, which is then transformed to PDF and XHTML (and possibly other presentation formats). We intend to support CDA-based specifications for ONC spec factory and IHE, in addition to HL7. I have never seen a CDA IG created using the HL7 XML Content (i.e. MIF plus ad hoc XML).

  2. Dave, I'm quite clear on how the output was generated, and the capabilities of the toolset, which is so much better than our existing publishing tools. To have used these and then generated yet another PDF based implementation guide made me want to cry. It's time for us to move away from Word and PDF and into the 21st century. Believe me, I know about the CDA Guide problem. I failed to crack that problem on two different attempts in two different organizations.