Wherein Stumping around becomes Stomping Around

The HL7 Board Election results were announced this morning to the membership, and last night to the board.

Don Mon is the incoming Chair.  Catherine Chronaki has been relected as an Affiliate director, and Jill Kaufman was reelected as Secretary.  Ed Hammond steps down from his role as outgoing chair and has been elected as a board member.  Stan Huff will be stepping down from the board after honorable service.

I too was elected to the HL7 Board, and I must thank all of you who supported me in reaching this position.

What I said in Stumping Around still applies, but now I need to start doing it.  I will need your input and your help.  Thank you for your continued support.

     Keith

The next Ad Hoc Motorcycle Guy Harley Award ...

About the award

Wednesday morning at HL7 is the day that we recognize contributions from the HL7 community through the Ed Hammond Awards.  If Ed can do it, I figured that I could to.  It might have started as a lark, but I really mean it.  The rules of who gets the Ad Hoc Motorcycle Guy Harley award are completely arbitrary. There is no nominating committee, although nominees are always welcome. The bar to recognition is fairly high if the first, second, third and now the fourth recipients are any evidence.  I hope to maintain the quality of recipients in subsequent awards. I won't award more than one a year for the same type of industry service, and I expect to award no more than five a year.

Given activities at HL7 this week, I too am giving out an award this morning.  This next awardee is has built a tool that I've been seeing more and more of lately in HL7 meetings.  It first came to my attention a little over a year ago when one of my colleagues pointed me to it as a good place to find documentation about CCD, IHE, and HITSP specifications ALL IN ONE PLACE.  Since then the tool has gone on to be used to develop an HL7 CDA based Implementation guide.  You heard about this tool in yesterday's post.

This certifies that

Dave Carlson of the VA

Has hereby been recognized for outstanding contributions to the forwarding of Healthcare Standardization

Dave, congratulations and thank you for leading the efforts on development of CDA Tools and the Model Driven Health Tools.  One of the things that I think you will soon learn if you haven't already is that the reward for a job well done is another job.  For the work that you have done on this project, you deserve at least a much bigger computer display and a lot more help.

IHE North American Connectathon and Showcase Registration Deadline this Friday, October 8

Crossed my desk today while at the HL7 Working Group Meeting...

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IHE Community,

IHE North American Connectathon Applications Due October 8
The registration deadline is this Friday for testing participants in the North American Connectathon 2011. The Application is available online at www.ihe.net/north_america/connectathon2011.cfm.

The IHE North America Connectathon will take place January 17-21, 2011 in Chicago and is the healthcare IT industry's largest face-to-face interoperability testing event. IHE profiles enable effective interoperability in a wide range of clinical settings, including health information exchanges. They also support many of the objectives for "meaningful use of electronic health records" advanced by the Health IT Standards Committee of the US Office of the National Coordinator for Health IT.

HIMSS11 Interoperability Showcase Registration Also Closes October 8
Friday is also the last day to register to participate in the Interoperability Showcase, taking place February 21 – 24 at HIMSS11 in Orlando, FL. Demonstrate your leadership in interoperability and connect with thousands of healthcare IT buyers and end-users in one major venue.

At HIMSS10 nearly 5,000 visitors tours the HIMSS Interoperability Showcase- 16% of conference attendees! View the results from HIMSS10.

Interested organizations can view all registration information online or contact the HIMSS Sales staff directly for more information.

Structured Documents and ITS Project Update

The HL7 Structured Documents and Implementation Technology Specification Workgroups held a joint meeting today to discuss status on a number of projects related to both groups, and to perform ballot reconcilliation on the Green CDA specification.  This post is a short summary of where some of those projects are.  A number of these projects have relevance to some of the work items that are expected to be addressed as part of the ONC Standards and Interoperability Framework.  On that note, we were joined by Dr. Doug Fridsma of ONC who heard our status reports, and stayed through the ballot reconcilliation of greenCDA that followed.

The hData (YouTube)project is intended to provide a RESTful API using commonly available technologies to support the exchange of a wide variety of content.  The API would address transport of content appearing in HL7 Message or document specifications.  The transport is content neutral.  The ITS workgroup has been working exensively on the document that they plan to ballot in the next cycle.  From their perspective, they feel that the content is ready to go out for ballot.  Next steps are to complete the appropriate notification of intent to ballot, and prepare the content for balloting.  The committee is seeking input on the current specifications prior to final publication and is asking others to review it.

Dave Carleson's work on the CDA Tools project has been recieving quite a bit of attention across the organization.  There are thoughts that this tool could be used to develop the publication that would be balloted from Structured Documents on the complete set of Common Document Types developed by the Health Story project.  The beauty of this work is that

1. You have computable models of the templates in UML
2. These models can be used to produce:


1. Template Specifications
1. DITA
2. XHTML
3. PDF
4. Others
2. Conformance/Validation Tools
3. Model Driven Code Generation (Java Now, .NET possible in the future)
4. Schematron
3. 
   
   The project has already built models from the following specifications:
1. HL7 Continutity of Care Document
2. HITSP C83 Sections and Entries
3. IHE Patient Care Coordination Technical Framework
4. HL7 Common Document Types

The MicroITS project is a specification that describes what a microITS is and the core capabilities it must support.  This project has not progressed further since the last working group meeting, but will go through a (likely informative or comment only) ballot process in the next cycle. Key tasks are to file for ballot, and to update the requirements (see link above) to incorporate feedback from TSC Chair Charlie McKay and other interested parties.
 
Green CDA is a project that is identifying the process to produce simpler XML from CDA Templates.  It started from the HITSP C32 specifications and worked out a method to generate simpler XML from the business names found in those specifications.

The Neutral Mapping Project is intended to support tools and identify standards to enable HL7 models to be mapped to domain specific markup languages.  The hope is that these tools and standards will assist in development of specifications that conform to HL7 models, or to map existing messages or models to HL7 models.  Robert showed one slide which explained that these tools, with the human input required to do the mapping could generate transforms, schemas and other artifacts that support mapping from and to the different formats.

The RIM ITS project developed a W3C XML Schema that supports serialization of content using RIM-based modeling.  It is an alternative ITS that uses a concistent set of XML elements for all RIM-based models, rather than clone names.  It provides one form of simplification of HL7 XML based content.   The Structured Documents Workgroup agreed that RIM ITS would be worth looking at for the "Right hand side" of the CDA, essentially the level 3 content.  This material passed ballot without substantivew and will be moving forward through the process.

Dr. Fridsma had some good feedback on these projects (we warmed his heart), and as I said, he also stayed through the ballot reconcilliation for green CDA.  I won't go into details on that part of the meeting.  If you want the details, please read the minutes which will be posted to the Structured Documents page following the WGM.

HL7 International Council Meeting Updates

I attended the HL7 International Council meeting today (Sunday), and have some updates from the HL7 affiliates.  Before I list the high points, I must appologized to Australia, Brazil and any others I missed at the very start.

• France:  Discussed their Dossiér Medical Paragé project which is a combination of #HL7 #CDA and #IHE XDS
• Germany: Developed XDS.d2d which is #IHE #XDS over German developed Doctor to Doctor (D2D) protocol
• Italy: Develops #CDA Patient Summary similar to epSOS work, looking at digital signatures for #CDA and developing a Discharge Summary
• India: Has a very strong strong HL7 V2 and #CDA Certification program and HL7 eLearning Programs
• Japan: The Japanese MOH recognizes HL7 CDA R2 and V2.5 for eRX, lab Results for Japanese Healthdare System for subsidy ellible use.  They also also recognized #IHE PDI profile.  About $3B US (300B yen) to be awarded to 90 regions for Regional Healthcare Revitalization, 10-15% devoted to HIT
• Nearly 600 systems in Japan can support #HL7 V2.5 CPOE, representing about 60% of all systems installed.
• New Zealand: gp2gp is #CDA representation similar to CCD and also reports interest in #IHE #XDS
• HL7 Norway was just established this year, and is now accepting applications for membership, and has already lined up several benefactors.
• Norway is also supporting #CDA R2 and #IHE #XDS  They  report some of the same old political challenges with CEN 13606 and HL7 #CDA even though HL7 and CEN harmonzied these in 2005!
• The Netherlands expressed interest in HL7 CCD, CDA and DCM, and also first time mention of CCR on an International slide, and a desire to understand these different creatures.  They also expressed that the  pendulum is swinging from Best-of-breed to All-in-one.  Joint IHE, HL7 and OIZ board meetings have now been established in the Netherland SDOs.
• Pakistan has very nice web site, nice space at Technology Innovation Center at NUST, is developing their organizational structure.
• HL7 Spain focused on eLearning efforts.
• Taiwan is working on a discharge summary, imaging reports, lab test results, and medications. They point out that there only one payer in Taiwan, simplifying things dramatically. About 20% of hospitals and 10% of cliinics using EHRs now, pushing for around 75% of both by 2012
• The UK focused on standards development and training rather than implementation
• There is still no US Affiliate, but that could change.  There is at least US representation on the Affiliate council.

I also presented an update on IHE activities related to HL7 in my role as the HL7 Liaison to IHE at the joint TSC/International Council Meeting.

 

My report appears below.

IHE Technical Framework Documents Published for Trial Implementation

IHE Community:
 
Patient Care Device Technical Framework
The IHE Patient Care Device Technical Committee has published revised versions of its Technical Framework volumes. The profiles defined in these Trial Implementation Technical Framework volumes will be available for testing at IHE Connectathons beginning in January 2011. The documents are available for download at http://www.ihe.net/Technical_Framework/index.cfm#pcd. Comments should be submitted by to the online forums at http://forums.rsna.org/forumdisplay.php?f=347.

Quality, Research and Public Health Supplement
The IHE Quality, Research and Public Health Technical Committee has published the following supplement to the forthcoming Technical Framework for Trial Implementation:

• Early Hearing Detection and Intervention: Short-term Care and Clinical Surveillance for Hearing Loss (EHDI)

This profile will be available for testing at IHE Connectathons beginning in January 2011. The document is available for download at http://www.ihe.net/Technical_Framework/index.cfm#quality. Comments should be submitted to the online forums at http://forums.rsna.org/forumdisplay.php?f=371.

Radiology Supplement
The IHE Radiology Technical Committee has published the following supplement to the IHE Radiology Technical Framework for Trial Implementation:

• Multiple Image Manager/Archive (MIMA)

This profile will be available for testing at IHE Connectathons beginning in January 2011. The document is available for download at http://www.ihe.net/Technical_Framework/index.cfm#radiology. Comments should be submitted to the online forums at http://forums.rsna.org/forumdisplay.php?f=12.

Top O' the Month

This will probably be the last regular installment of Top O' the ..., because I have a new widget on my side bar which now shows the top 10 posts for the last 30 days. 

The top 3 for last month (another record breaker) are (without further comment, because I've already talked about them before are):

1. In which I have something positive to say about ONC
2. I wanna be an ePatient
3. Meaningful Use Standards Summary

And I guess people are still stunned that I have something positive to say about ONC because it is also still top of the week.  On that note, I hope those of you in the US who had the opportunity, did listen to Doug speak about the ONC Standards and Interoperability Framework in the Educational webinar today from the National eHealth Collaborative.

This was mostly review of the top post for this month (and week), but at least you could hear it from Doug rather than me.