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Executive Summary of HL7 Meeting – Baltimore, USA (Sept 2012)

IT-014 Health Informatics Committee Executive Summary

HL7 Working Group Meeting

9th - 14th September, 2012 (Baltimore, USA)

Version: FINAL 1.0 Date Issued: 11/10/12 Lead Author: Dr Patricia Williams Collated by: Standards Australia With input from Australian Delegation and other employer funded Australians at the meeting: Dr Trish Williams, Ph.D. (Delegate and Report Coordinator)

Heather Grain (Delegate)

Richard Dixon Hughes (Delegate)

Dr Hugh Leslie, MB BS, FRACGP, FACHI (Delegate)

Dr David Rowed, MB BS, BEng, FRACGP (Delegate)

Dr Vincent McCauley, MB BS, Ph.D. (Delegate)

Nat Wong (Delegate)

Amy Mayer (Mentored Position Delegate)

Dr Andy Bond (NEHTA) Ph.D.

Dr Stephen Chu (NEHTA)MB ChB, Ph.D.

Vin Sekar (NEHTA)

Meya Achdiat (Standards Australia)


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TABLE OF CONTENTS

1. Introduction ......................................................................................................................... 3

2. Objectives of the Meeting ................................................................................................... 3

2.1. Relevance to NEHTA programs........................................................................................ 5

3. Meeting Logistics ................................................................................................................. 5

4. Recommendations Arising from the Meeting ..................................................................... 9

5. Funding Sources Summary and Australian Attendance .................................................... 25

6. Australian Leadership Positions ........................................................................................ 26

7. Acronym List ...................................................................................................................... 27


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1. INTRODUCTION

HL7 is an international organisation with its origins in the USA, and an expanding group of international users participating in its standards development processes. HL7 provides international standards for inter-system and inter-organisation messaging, decision support, clinical text documents mark-up, user interface integration, EHR/PHR systems functionality as well as for a health data model and message development methodology. It produces global health informatics standards through a process of collaboration, which involves its local affiliate, HL7 Australia.

HL7 International Working Group Meetings (WGMs) are held three times per year at varying locations. These WGMs serve two important purposes: giving the HL7 International work groups a chance to meet face-to-face to work on standards, as well as the opportunity to network with industry leaders from around the world; and providing an invaluable educational resource for the healthcare IT community.

HL7 standards are the dominant health-messaging standards in the USA, Canada, Germany, Holland, Finland, Japan, Korea, Taiwan, New Zealand, and Australia, and are being adopted as health-messaging standards by many other countries.

The September 2012 HL7 International Plenary and Working Group Meeting was held in Baltimore, Maryland, USA, with activities scheduled over 6.5 days. There were 507 attendees at this meeting.

The main activities ran from Sunday, 9 September to Friday, 14 September, 2012. On weekdays formal meetings were scheduled from 9am to 5pm; however, some meetings were scheduled from 7am and ran as late as 10pm. Over the last nine months, HL7 has been examining its priorities and principles. This period has seen significant changes and growth and has culminated in the announcement of HL7 free access to Intellectual Property (IP)1. This meeting welcomed the new membership ‘caregivers’ category and saw the Mobile Health Work Group, established in May, realise more interest and engagement with the community. The plenary session that focused on “HL7 in the Era of Patient Empowerment” was held on Monday, 10 September and is reported on separately in the HL7 September Final Report.

It should be noted that the HL7 International standards work is not structured as "Work Items" that are put forward to the HL7 body for approval; rather, most projects arise from the work within the many domain specific and specialist committees. However, these proposed projects need to be well-defined and documented and require approval by the relevant Steering Division and the Technical Steering Committee to ensure appropriate internal (HL7) and external (international standards development organisations) harmonisation.

This report summarises the committee proceedings, issues and actions for consideration by Australia arising from this HL7 International Standards and Education Meeting.

2. OBJECTIVES OF THE MEETING

HL7 meetings are true working meetings, not conferences, with many experts and individual groups meeting to develop, discuss and improve HL7 standards, processes and implementation guides and to determine the most effective way to meet the needs

1 Further information can be found in the HL7 September Final Report.


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of the stakeholders – both those present at the meeting and those in the wider community of interest. While HL7 engagement with stakeholders in other forums is also strong (through regular, often weekly, teleconferences), the ability to influence the work program, outcomes and strategic direction requires physical presence at working group meetings.

The overarching objectives of HL7 meetings are to benefit the Australian health system and wider community by:

Improving Australian capacity to implement health informatics standards and e-health systems, through expanding local knowledge and expertise based on international best practice;

Promoting free trade and its benefits to health ICT, by lowering the cost of integrating and implementing local health information systems, many of which are imported, and by reducing costs to Australian exporters; both of these outcomes require Australian requirements to be embedded in global standards so that they can be adopted in Australia, rather than having different standards across domestic and international markets; and

Improving Australian health information systems by facilitating a standards-based approach to development and implementation, and achieving interoperability between systems.

Other more specific objectives for Australian engagement in international standardisation via HL7 International include:

Monitoring and influencing HL7’s strategic positioning as a global SDO, encouraging its collaboration with other international and global SDOs and assessing and contributing to the strategic positioning of its key products (HL7 V2.x, V3, CDA, EHR, etc.) so as to encompass Australia’s health information interchange and related requirements.

Negotiating the inclusion of Australian healthcare messaging requirements into HL7 V2.8, CDA and V3 specifications for:

Patient administration;

Diagnostics (pathology, radiology); and

Collaborative care initiatives, such as, but not limited to, e-discharge and e-referral, so that Australian requirements become a formal part of these Standards.

Negotiating the inclusion of Australian health sector requirements in the HL7 Standards so that Australian EHR developments are supported by the upcoming HL7 and related ISO EHR Standards.

Negotiating the harmonisation of ISO, HL7, CEN and other established standards development organisations (SDO) to achieve progressive inter-SDO e-health standards, with the long-term goal of a unified set of global health informatics standards.

Monitoring, and influencing as necessary, new initiatives for standardising clinical data content so as to improve Australia’s ability to unambiguously and safely exchange semantically interoperable clinical data.


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Assessing and influencing HL7’s work on service oriented architectures (SOA), as required by Australia’s national direction setting, and negotiating the inclusion of Australian health sector requirements (in particular, those described by NEHTA) into service specifications being jointly developed by HL7.

Assessing and influencing the positioning, development, implementation, utility and effectiveness of CDA (including CDA Release 3), to support Australia’s interest in CDA in its national eHealth program.

Assessing, exploring and proposing approaches to the embedding and transportation of archetypes in HL7 V2.x messages for referral, diagnostic results and collaborative care to support Australian interest in the use of archetypes for the exchange of clinical information.

Progressing the international harmonisation of common data types and vocabulary for healthcare information that will meet Australia’s identified requirements.

Additional Australian interests may be pursued opportunistically as and where formally agreed upon by the community, Standards Australia and the Department of Health and Aging (DoHA). Additional specific objectives may arise from time to time as a result of the development of Australia’s national eHealth agenda and other national interests.

2.1 RELEVANCE TO NEHTA PROGRAMS

NEHTA has endorsed a range of Australian Standards derived from international standards work by including them in the National e-Health Standards Catalogue. As the implementation of NEHTA’s domain-specific initiatives are based on many of these standards, it is important that Australia continues to be involved in the international forums that develop, manage and maintain these, and other potentially relevant, health informatics standards.

3. MEETING LOGISTICS

The table below shows the meeting schedule for all of the meeting groups. Most USA based meetings have more than 60 separate working groups and committee meetings. In addition to the working groups listed, members also attended tutorials and project specific workshops.

The Australian delegation is denoted as follows in the table below:

AB – Andy Bond HG - Heather Grain SC – Stephen Chu

AM – Amy Mayer MA- Meya Achdiat TW - Trish Williams

DR - David Rowed NW - Nat Wong VM - Vince McCauley

HL - Hugh Leslie RDH - Richard Dixon Hughes VS – Vin Sekar


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Working Group Sat Sun Mon Tue Wed Thu Fri Affiliate Due Diligence Committee

RDH

Ambassador Presentation

Anatomic Pathology

Architecture Review Board (ArB) AB AB AB

Arden Syntax DR DR

Board of Directors’ Meeting RDH, MA

Clinical Decision Support AM, DR

AM, DR, MA

Clinical Genomics

Clinical Interoperability Council HL

Clinical Statement SC

Co-Chair Information Session HL, RDH, TW, VM

TW, VM

Community Based Collaborative Care

TW

Conformance and Guidance for Implementation/Testing

VM HG

Detailed Clinical Models HL HL HL HL

Education (&marketing) HG HG HG, NW

Electronic Health Records AM, NW, RDH

AM AM, TW, SC

RDH, MA

Electronic Services NW

Emergency Care

FHIR Connectathon SC, VS

FHIR Project DR DR VM, VS

VS RDH

Fresh Look Taskforce NW

Governance & Operations NW

GS1 Education Session MA

HL7 Activities with other SDOs RDH, TW, MA

HL7/OMG Joint Meeting VM

Health Care Devices VS VM

Imaging Integration

Implementation Technology Specification

Infrastructure and Messaging VM

International Council & Affiliate Chairs

AM, DR, HL, NW, RDH, TW, VM, HG, MA, VS, SC

RDH

International Membership & Affiliation Taskforce

RDH


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Working Group Sat Sun Mon Tue Wed Thu Fri Joint Initiative Council (JIC) liaison

VM RDH

Marketing

Mobile Health AB, MA

Modelling and Methodology (MnM)

DR HL RDH

Open Health Tools AM, TW, VM

Orders and Observations NW

OO/Lab/Composite Order SC SC

Patient Administration AM, NW, MA

AM, NW

AM, NW, MA

Patient Care HL, SC

HL, SC

HL, SC

HL, MA, VS, SC

Patient Safety

Plenary Session AM, AB, DR, RDH, TW, VM, MA, NW, HG SC, VS

Pharmacy SC SC SC

Physician’s Meeting DR

Public Health Emergency Response

Publishing NW HG NW

Regulated Clinical Research Information Management & CDISC/BRIDG

NW

Services Aware Interop Architecture

DR AB

Security TW TW TW, VM

TW

Services Oriented Architecture AB, VM

AB, VM

TW, VM

VM

Steering Divisions – Domain Expert, Foundations & Tech, Structure & Semantic, Tech Services

Structured Documents VS VS AM, VS

VS VS, SC

VS

Templates

Terminfo Project / Terminology HG

Tooling VS

Vocabulary HG HG AM, HG, VM, MA

HG


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Tutorials are also offered and these are of great value, both to newcomers and to older hands, to bring them up to date on generic changes made that may not be discussed in their individual committee areas. At this meeting 30 tutorial sessions were held concurrently with 56 work group and task force meetings. Additionally, there were meetings for the Ambassador Program, Co-Chairs, Board of Directors, First Time Attendees, GS1 Education session, and HL7 Activities with other SDOs.

The number of concurrent sessions makes it difficult for a small delegation to effectively follow all the issues and to influence change. It is noted that delegates funded by their employer, or individually, to international meetings have no obligation to work with or relate information back to the Australian delegation, though some have done so in the past. It is clearly desirable that there be a cohesive Australian position.

Given the participatory natures of the HL7 committee work, it is vital that Australians are present, and participate in the committee work. Intensive work is done in the committees, and often two or three Australian subject matter experts are required to get the Australian requirements into the consensus-based processes. In most cases, preparation beforehand of "Australian positions" on the matters to be worked on is not effective, as the discussions and views often substantially change during the consensus-building process. Most of the work done in committee is "leading edge" standards development work that often cannot be locally previewed, assessed and commented on beforehand. As a result, the selection process of the funded participants focuses on their expertise and interests as well as their ability to effectively communicate complex technical issues and achieve the desired outcomes for Australia in a collaborative, consensus-based committee environment.

As is customary, the Australian participants met on a daily basis to plan and monitor their involvement, identify any additional sessions and/or activities that should be covered and identify emerging issues, particularly those that are relevant to Standards Australia IT-014 and/or NEHTA work plans. Australian participants also coordinate their activities through Skype.


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4. RECOMMENDATIONS ARISING FROM THE MEETING

The principal issues/actions and recommendations identified by the Australian delegation at the September 2012 HL7 Meeting are summarised in this section. The alignment to the IT-014 Committee Structure is also listed.

Topic Issue / Action / Recommendations for Australia Recommended for

Action by

Advisory Council

input:

FHIR

Issue: Application and investigation of Fast Health Interoperability

Resource (FHIR) in the Australian context.

Action: Discussion and investigation of the application and development of FHIR in the Australia context.

Action: Investigate the possibility of establishing a FHIR interest group.

Action: Continue to monitor and contribute to the development of FHIR resources through active participation and support of the Patient Administration work group.

Action: Monitor the Healthcare Community Services Directory to inform decisions about code set use.

HL7 Australia

IT-014

Affiliate Due Diligence Committee

Issue: Continuing support by HL7 Australia of the work of the ADDC

through Richard Dixon Hughes as an active member.

Action: HL7 Australia to note progress with ADDC activity at HL7 International and assist with follow up in Indo-Pacific region where requested.

HL7 Australia

Richard Dixon Hughes

Architecture Review Board (ARB):

Business Architecture Model (BAM)

Issue: Governance of HL7 International Products and Product Lines.

Action: Monitor development of BAM so that HL7 governance of products meets Australian requirements.

NEHTA

Arden Syntax:

Version 3.0

Issue: Arden 2.9 is an extremely comprehensive standard for

knowledge representation as well as procedural processing with workflow support and clear identification of integration points for external applications. Its utility is not well understood across the health informatics community.

Action: Review Arden 2.9 and identify and support new requirements for version 3.0, particularly:

- Transition from its informative to normative XML representation; and

- Development of simplifying, task-suitable reduced sets of Arden covering its operators as well as declarative representations and work-flow functionality.

Action: Contribute to the new Arden Implementation Guide Project and monitor the ‘Why Arden’ authoring.

IT-014-013

IT-014

RACGP NSC for eHealth

Other professional colleges

MSIA


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Topic Issue / Action / Recommendations for Australia Recommended for Action by

Arden Syntax:

Version 3.0

Issue: Arden has capability to provide standards-based CDS as

currently needed in immunisation, Drug-Drug Interaction, (DDI) and clinical guidelines by Australian primary care and nursing practitioners. Action: Identify and engage Knowledge suppliers in high priority areas including immunisation, DDI, pathology ordering, therapeutic guidelines, and travel health, and encourage them to consider Arden representation for interoperable knowledge deployment and application workflow integration.

IT-014-013

IT-014

RACGP NSC for eHealth

Other professional colleges

MSIA

Arden Syntax:

Version 3.0

Issue: To date there has been inadequate input of Australian

requirements and validation of the Arden Standard against Australian needs. Action: Circulate and take part in ballot for version 3.0.

IT-014-013

IT-014

FHIR Project Lead (Australian)

Arden Syntax:

Version 3.0

Issue: Arden is not aligned with the HL7 v3 RIM, although this has

often been explored. Such alignment is under consideration as is alignment with FHIR, the latter appearing to offer more promise for Australia, but being untested in CDS applications.

Action: Advocate for thorough assessment of FHIR for Arden and CDS generally by standards working groups and the FHIR project.

IT-014

HL7 Board:

Free IP

Issue: Access to HL7 IP has normally been available only to HL7

members. This has been the primary driver for many organisations and individuals joining a local Affiliate. Free access to this HL7 IP will likely impact Affiliate membership, and may impact on HL7 Australia’s corporate documents and contractual relationships.

Action: HL7 Australia to analyse the impact of free IP on its membership model.

Action: Provide a statement on the impact of this announcement to the IT-014 community noting under which circumstances free IP can be used.

Action: HL7 Australia to review its Governance and Operations documents and MoUs to assess the impact of free HL7 IP.

HL7 Australia

HL7 Board (CEO Report):

Formation of HL7 Asia

Issue: HL7 International has entered into negotiations with North Asian

countries about the formation of HL7 Asia. It is proposed that it be based in Japan and include HL7 China, HL7 Hong Kong, HL7 Japan, HL7 Korea and HL7 Taiwan. The North Asian countries had previously extended to the Chair of HL7 Australia the courtesy of advising him of their plans to do this on a local basis, and there is some interest among the Australian, NZ and Singapore Chairs on forming an Indo-Pacific or South East Asian grouping.

Action: HL7 Australia to note the proposed establishment of HL7 Asia, with an initial focus on North Asian affiliates, and consider the potential for greater collaboration among affiliates in Southern Asia and Oceania.

HL7 Australia


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HL7 Board:

Making standards and other IP available without charge

Issue: HL7 International has announced that it will make all of its

standards and some other selected intellectual property available without charge from early 2013. This is a significant change from the current position where anyone using HL7 Standards in developing systems or delivering product was required to be a paid-up member of HL7 International or one of the affiliates. The change therefore has potential significant impact on the business models of both HL7 International and the affiliates (including HL7 Australia). The Chair and CEO have invited a small group of leading HL7 members to assist in redefining HL7 International member benefits. Richard Dixon Hughes is among that group, and will participate.

Action: HL7 Australia is aware of the change and has publicly supported it. The sub-licensing arrangement between Standards Australia (SA) and HL7 Australia for use of parts of HL7 intellectual property in SA publications still requires action.

HL7 Australia and Standards Australia

Action: Richard Dixon Hughes to participate in HL7 International's Membership Task Force, advising HL7 Board on restructure of member benefits following HL7 decision to make its standards available without charge.

Richard Dixon Hughes (in progress)

CDS:

Clinical System capabilities to enable Services Oriented CDS operation

Issue: CDS deployments must work-in with point of care systems both

at the levels of standardised data interchange and the more difficult area of workflow integration. The CDS WG has researched and identified the key services and capabilities of clinical information systems to enable this deployment. This is in the form of a paper for presentation at American Informatics Association (AMIA) and not yet a HL7 publication. It needs to be a HL7 product. Action: Support and facilitate the development of this work as a HL7 publication, preferably a DSTU. Circulate the current WG’s paper to the Australian CDS community where it aligns with one of the proposed IT-014-13 projects that it will facilitate.

IT-014-13

MSIA

CDS:

Current standards for Order Sets, vMR and Infobutton

Issue: These standards are in varying stages of development

(normative and DSTU in later releases). They are ready for purpose and adoption by implementers but need to be better understood and assessed for different purposes.

Action: Monitor uptake and further work. Consider comparatively in the CDS implementation Guide project and the related IT-014-13 project proposal.

IT-014-13

CDS:

Harmonisation with HL7 Standards and ISO work items

Issue: Coordination with existing HL7 publications and ISO work items.

Action: Identify how this harmonisation is to occur and who has responsibility.

IT-014

CDS:

Health e-decision Standards and Interoperability Framework Initiative

Issue: To identify and harmonise standards that facilitate the

emergence of systems and services whereby sharable CDS interventions can be implemented.

Action: Monitor this project for potential application to an Australian context.

IT-014

HL7 Australia


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CDS:

Health Quality Measure Format (HQMF) Release 2 Implementation Guide

Issue: HQMF is relevant to CDS in population-based applications and

knowledge development that affects pro-active care and resourcing. EHR systems need to be appropriately structured to represent quality measures, especially to support queries around these. The implications for Australia include that HQMF could provide input to EHR requirements for quality and CDS.

Action: Alert Safety monitoring groups to this work and offer engagement. Monitor the project to gain a clearer picture of how process and outcome based quality measures are queryable when represented in EHRs and used for CDS.

Standards Australia

IT-014

IT-014-13

CDS:

Implementation Guide (IG) for CDS

Issue: There are several unrelated HL7 CDS standards with

overlapping functionality and task suitability, making it difficult for knowledge authors and vendors to adopt the best for their purposes. The ONC has recently specified very comprehensive requirements to be met by a unified approach. Australia is greenfield with respect to CDS standards adoption and stands to benefit from a CDS roadmap and Implementation Guide Action: Review and contribute to the IG Project Scope Statement and actively take part in the consequent project. Engage industry, professional colleges, and academic stakeholders.

IT-014-13

Professional Colleges

Knowledge Authors

MSIA

CDS:

OpenCDS

Issue: OpenCDS uses standards, with a modern services approach,

and is aligned to MU3. It provides a low cost entry to interoperable CDS for vendors whether they are established or new to CDS. It accommodates different knowledge bases and can be used for a wide variety of clinical needs. It is being used successfully with immunisation CDS.

Action: Review OpenCDS at IT-014-13 and advice implementers. Monitor the immunisation implementation.

IT-014-13

MSIA

CDS:

OpenCDS – Immunisation Calculation Engine (ICE)

Issue: The Immunisation Calculation Engine (ICE) is an immunisation

evaluation and forecasting engine using openCDS. This project informs the needs of CDS standards and facilitation of systems design and deployment.

Action: Monitor project development.

HL7 Australia

IT-014

CDS:

Virtual Medical Record (vMR) for Clinical Decision Support

Issue: CDS systems rely on data in EHRs and on inputs and outputs in

different formats. Standards for content are required to bridge this gap. The vMR forms the basis of one project proposal coming through IT-014-013. This project is important in ensuring that Australia’s initiatives across messaging, CDA, EHR can be brought together to enable improved care and safety through standardised CDS.

Action: In light of recent proposals concerning clinical content of v2 messages to HL7, and the work of IT-014-13 on v2 messaging, review the CDS vMR HL7 specification to access impact on Australia’s v2 messaging requirements for clinical content.

IT-014-06-06

IT-014-13


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CDS with Patient Care and SOA:

Health Care Coordination Project

Issue: Care planning is an important process in Australian primary

care, where it attracts significant government funding both at GP and allied health levels; however, current implementations are not standards-based and rarely employ electronic communications. There is a need for functional modularity via services at the point of care and integration with CDS. Australia does not use v3 messaging so deliverables as abstract models are important. Action: Monitor this project via members (including Co-Chairs) of PC, CDA and SOA, the 3 WGs sponsoring the project, and ensure our Care Planning work takes this into account. Ensure the project has useful deliverables at the DAM level. Action: Engage IT-014-06-06 and IT-014-13 in the Patient Care Services co-ordination project to leverage it for our projects and ensure it meets our requirements.

IT-014-06-06

IT-014-13

HL7 Delegates to PC, CDA, SOA WGs

CDS/SOA:

Cross-paradigm interoperability implementation guide for Immunization

Issue: Immunisation is monitored and recommended by GP point-of-

care systems, but the underpinning knowledge is complex and expected to be difficult for general system vendors to provide. Jurisdictions and health advisory bodies provide guidelines for this and some have in the past provided on-line recommendations including those in the problematic areas of catch-ups. A group of standardized services available to point-of-care applications could improve overall achievement of immunisation targets. Australia could benefit from international resources being committed here.

Action: IT-014-013 to continue consideration of a project in this area to bring Australian requirements into this work with view to deployment into point-of-care systems, immunisation registries, and knowledge source applications.

IT-014-013

MSIA

Jurisdictions

Immunisation Guideline Authorities

CDS/SOA:

Cross-paradigm interoperability implementation guide for Immunization

Issue: As there is no decision support in v2 standards, this raises the

question of whether v2 referral messages may be a candidate for decision support in Australia, and how international developments relate to this.

Action: Discussion on and possible development of decision support for V2 referral messages within the Australian context.

IT-014

HL7 Australia

Conformance and Guidance (CGIT):

HL7 V2 table content quality review and v3 / CDA harmonisation

Issue: During a harmonisation review and comparison with v3 data

model and content, there were some errors found in existing v2 tables. Consistency is required to support migration and integration with legacy systems as well as information exchange. Problems identified include actual errors as well as poor data structure and content.

Action: Review of the problems identified in the spreadsheet (this was provided to Heather Grain at the WGM) should be undertaken by the IT-014-06 and HL7 Australia to identify appropriate actions required for updating Australian standards. Consideration should also be given to whether Australia specific existing standards require review. It is noted that this may require some assistance with vocabulary expertise.

IT-014-06

HL7 Australia


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HL7 v2.8/2.9 Conformance Requirements

Issue: New segment proposals for v2.9 will be finalised at the May

2013 WGM.

Action: Consider submission for signature segment and display narrative segment by the January 2013 WGM. Submit Standards Australia ATR on HL7 v2 signatures as part of documentation.

IT-014-06


HL7 V2 table content quality review and v3 / CDA harmonisation

Issue: Need for alignment of code sets, value sets and vocabulary

models used in v2 and v3/CDA to facilitate interoperability.

Action: Australia to obtain master spreadsheet (this was provided to Heather Grain at the WGM) to track v2 errors and resolve where necessary.

HL7 Australia

IT-014

Education and Marketing:

Communication and development of understanding and skills

Issue: Quality of HL7 education. Education is being recognised as

different to presentations or information sessions in that it aims to develop a specific set of skills. HL7 Australia provides many presentation and information sessions, but if considering moving towards education provision, should consider how to ensure the skills of presenters. Heather Grain is happy to provide the free tutorial in Australia if this is seen as helpful.

Action: Consider the needs to develop educator skills within the HL7 community in Australia to support improved education provision.

HL7 Australia

IT-014 (community to consider priority for Australia)

Education:

Strategic Plan

Issue: Tools for use when training.

Action: Identify and inform the next HL7 delegation (January Meeting) through Standards Australia or Heather Grain (member of Education WG) the tools required for training about HL7 standards in Australia and our priorities for their use.

HL7 Australia

NEHTA

Education:

Strategic Plan

Issue: The development and offer of an Australianised version of

HL7 International e-Learning courses.

Action: Decide whether to proceed with e-Learning for HL7 and determine method and partner/s to achieve this.

HL7 Australia

Education and Marketing:

Communication and development of understanding and skills

Issue: Education requirement specification.

Action: Identification of the roles and related competency requirements in the Australian health messaging environment need to be determined in order to prioritise the development and availability of educational materials, courses and competencies. Heather Grain is able to assist HL7 in this activity.

HL7 Australia

Consideration by IT-014, DoHA and NEHTA

Electronic Health Record (EHR):

Personal Health Record System Functional Model (PHR-S FM)

Issue: Privacy and security direction and advice are needed by HL7

International as part of the Personal Health Record System Functional Model development. Other issues identified to date include:

- Jurisdiction-specific legislative issues regarding privacy and security.

- Storage, management and retrieval of extremely large amounts of data generated by a life-long PHR.

Action: Monitor the lessons learnt from the PCEHR development to support progress of the international standard.

IT-014

HL7 Australia

NEHTA


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Electronic Health

Record (EHR):

Allergies and

Intolerances

Issue: Despite the presence of Australian Co-Chairs driving this

project, its visibility to Australian Software Developers is limited.

Action: Increase awareness of this Domain Analysis Model.

HL7 Australia

MSIA

Electronic Services:

HL7 CRM System

management of

members of affiliates

Issue: HL7’s International electronic services platform is not

sufficiently flexible to retain the details of members of affiliates when they are nominated as voters for HL7 Australia.

Action: HL7 Australia to participate in HL7’s International Electronic Services working group and seek resolution on problems affecting voting members of international affiliates.

HL7 Australia (Nat Wong)

Governance & Operations:

Documents

Issue: Changes to the HL7 International Bylaws and Governance

documents may impact the equivalent documents of International Affiliates.

Action: Pending receipt of the updates to the GOM and Bylaws, HL7 Australia needs to review this in relation to its Constitution and other Governance documents.

HL7 Australia

International Council:

IHIC 2013

Issue: HL7 Australia explored International Council interest in

conducting IHIC 2013 in Sydney in a time period either prior to or preceding the ISO/TC215 meeting planned for October 2013. This suggestion was considered and strongly supported by the International Council, with agreement that HL7 Australia should develop the concept and formally request funding support of up to US$5,000 from the International Council toward running the event.

Action: HL7 Australia to proceed with consideration of running IHIC 2013 in Australia in October 2013 either prior to or preceding the proposed ISO/TC215 meeting and to submit request for International Council budget submission.

HL7 Australia

International Council:

Leadership

Issue: Heather Grain has been requested by a number of the current

members from different countries (Canada and UK in particular), to stand as a Co-Chair of the International Council to represent the interests of improved process, education quality and overall governance.

Action: Identify priority and provide guidance on proposal to stand for Co-Chair of the International Council.

HL7 Australia

IT-014

International Membership & Affiliation Task Force (IMATF):

International Council Membership rights survey

Issue: Richard Dixon Hughes to submit updated final version of

International Council membership/customer survey.

Action: Richard Dixon Hughes to submit updated final version of International Council membership/customer rights survey on behalf of HL7 Australia and assist in compiling results.



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International

Membership &

Affiliation Task Force

(IMATF)

Issue: Given the extent of changes brought about by the HL7

International decision to make its standards and related IP available free of charge and the formation of a Membership Task Force at HL7 Board level, the IMATF resolved to recommend to the International Council that the IMATF be disbanded, which was done.

Action: Standards Australia to delete IMATF from list of activities for future delegations.

Standards Australia

Joint Initiative Council (JIC):

IHE

Issue: The establishment of IHE as an SDO now puts the IHE

specifications on the same international level as HL7.

Action: IT-014 should examine IHE specifications and consider their relevance and applicability in the Australian context e.g. CDA content for ETP, referral care planning as well as, infrastructure such as XDS.b and XDR.

IT-014

Modelling and Methodology (MnM):

FHIR

Issue: Emergence of FHIR as a disruptive modelling and technical

approach.

Action: Australia needs to invest in some early R&D support behind the FHIR initiative both to grow recognition of the Australian origin of FHIR and to prepare itself for the emergence of FHIR commercially.

HL7 Australia

NEHTA


FHIR Project – Collaborative Care Messaging

Issue: HL7 v2 is implemented widely in systems deployed in Australia

where we have Australian Standard Implementation Guides for Referral and Discharge. Its messaging capabilities, and implied dynamic model, with defined sender –receiver responsibilities, is adequate for our existing use cases in Collaborative Care Communications. It is inadequate for Clinical Content representation and no agreed solution has been found. Action: Assess FHIR messaging capabilities and content solutions at the level of segment mapping against our collaborative care requirements, particularly for concepts of Problem-Diagnosis, Goal, Pathway, and their contexts and relationships.

IT-014-06-06


FHIR Project – Clinical Decision Support

Issue: Clinical Decision Support needs Clinical Data Mapping for its

access to health information in the EHR, most notably through the vMR Standard and the Arden curly braces inter-operation path as well as resources in the form of data structures such as Medical Logic Modules. Much of this is greenfield, as HL7 RIM-based models have made limited inroads into Arden and other HL7 CDS, with the resulting need for harmonisation across CDS standards. Action: Assess FHIR for CDS needs and ensure that, if it is to go forward as a major representation in HL7, that CDS is well-covered.

IT-014-13

HL7 Delegates to CDS, Arden Syntax, and MnM WGs


17



FHIR Project – Clinical Requirements

Issue: Clinical resources need to be developed as soon as possible to

prove FHIR’s capability and to ensure an early switch over to FHIR, if it this turns out to be the way forward. There has been some clinical engagement to date but work has been initiated for some resources and needs to be picked up by a wider group of experts. Action: Influence HL7 Clinical WGs, particularly PC, Arden Syntax, and CDS to engage with the FHIR project (via. joint sessions) to identify their clinical resources needs and jointly develop these resources. This engagement should begin with Condition, Health Issue, Health Asset, Problem, Diagnosis, Goal and Care Plan.

HL7 Delegates to PC, CDS, and Arden Syntax WGs

FHIR Project Lead


Orders & Observations (OO)

Issue: Australian is not actively represented in the Orders &

Observations WG, resulting in Australia requirements for Pathology and Radiology Ordering and Reporting not being advocated for.

Action: Increase focus on the OO WG through future Australian delegations to HL7 WGMs. Standards Australia to be aware of this gap in expertise.

Future HL7 delegates

Standards Australia


FHIR – Resources

Issue: Australian participation in development of FHIR Resources is

limited to Grahame Grieve.

Action: Encourage Australian representation in WGs developing FHIR resources.

HL7 Australia

MSIA

Standards Australia

Orders and Observations:

Laboratory Order Specification

Issue: Need to ensure that the contents of the laboratory order and

reporting model and specifications can be profiled into templates for use in CDA implementation guides for use in Australia to avoid retrofitting Australian work into the new HL7 International standards downstream.

Action: IT-014-06-05 and IT-014-06-06 to work closely with NEHTA and provide inputs to the ongoing work on this new Laboratory Order modelling and specification project.

IT-014-06-05

IT-014-06-06

NEHTA (through Stephen Chu)

Patient

Administration:

FHIR

Issue: FHIR Patient Administration resource development needs

Australian participation.

Action: Notify IT-014-06-03 committee members of FHIR resource development, and encourage participation in HL7 PA teleconferences and mailing lists.

Standards Australia

IT-014-06-03

Patient Care:

Allergies and

Adverse Reactions

Issue: The HL7 allergy/intolerance model is likely to become a

standard way of sharing this critical clinical content.

Action: Australia should continue to be involved in development of this clinical model for use in sharing allergy information. IT-014-06-04, IT-014-06-06, IT-014-13 and NEHTA should monitor progress of this project closely and contribute actively to the development of the allergy/intolerance model and related contents. IT-014-06 should consider taking on a cross subcommittee coordinating role.

Hugh Leslie & Stephen Chu

IT-014-06-04

IT-014-06-06

IT-014-13

IT-014-06 to consider cross coordination role


18


Patient Care:

Detailed Clinical

Models

Issue: HL7 DCM representation for CIMI models.

Action: Australia to contribute and be involved in this task. IT-014-06-04, IT-014-06-05, IT-014-06-06, IT-014-13, and NEHTA should provide Australian representatives with inputs for active contributions to CIMI modelling works. IT-014-09 should consider taking on a cross subcommittee coordination role.

Hugh Leslie & Stephen Chu

NEHTA

IT-014-06-04

IT-014-06-05

IT-014-06-06

IT-014-13

IT-014-09 to consider cross coordination role

Patient Care:

Care Plan Topic

Issue: International involvement is required.

Action: Australia to continue to be involved in developing this standard. This project has high relevance to care plan projects initiated and currently underway in Australia jurisdictions (e.g. North Territories and Victoria). IT-014-06-06 and IT-014-09 should take on coordinating roles to coordinate inputs from Australia and inputs via Australian delegates to this international project.

Stephen Chu

IT-014-06-06

IT-014-09

Patient Care:

FHIR clinical content

Issue: Clinical content for FHIR needs a process for clinical review

that is unlikely to be met by the HL7 ballot process.

Action: Australia to work with the FHIR working group to develop a better way to develop clinical content.

Hugh Leslie

Pharmacy

Issue: Alignment between Australia’s medication management

programs and HL7 / IHE pharmacy model, technical specifications and profiles are required.

Action: Australia should stay highly engaged with HL7 and IHE Pharmacy project works. They are extremely important to IT-014-06-04 development of national electronic medication management programs. IT-014-06-04 and IT-014-06-06 should collaborate closely to provide coordinated inputs to international pharmacy projects.

IT-014-06-04

IT-014-06-06

Pharmacy:

ISO WG6

Issue: Almost complete disconnect between ISO WG6 projects and

new project proposals from other international works in this domain, resulting in duplication or even divergence of work with highly counter-productive outcomes.

Action: IT-014-06-04 and IT-014 must liaise more closely with Australian ISO delegates to prevent such counter-productive divergence between the groups.

IT-014

IT-014-06-04

Future ISO Delegates to WG6

Pharmacy:

R2 Ballot

Issue: Pharmacy topics R2 (Jan 2013) ballot requires Australian

inputs.

Action: IT-014-06-06 should collaborate with NEHTA to provide ballot comments to Pharmacy topics R2 ballot.

NEHTA

IT-014-06-04


19


Pharmacy:

V3 Nutritional Order

Clinical Message

Issue: Substantial international development is taking place within the

realm of HIT for nutrition and dietetics.

Action: Introduction of HL7 work on nutrition to Dietetics Association of Australia (DAA) via Allied Health Professions Australia (AHPA) may support development in Australia. AHPA to be made aware of this work.

Action: HL7 Australia to monitor the ongoing developments of nutrition models internationally and consider application to Australia.

NEHTA

Allied Health Professions Australia

HL7 Australia

Pharmacy:

Patient Medication

Profile

Issue: Medication Profile modelling direction needs broad

international inputs to ensure universal usability.

Action: This project is highly relevant to Australia / NEHTA electronic medication management program. Australia should play a leadership role. IT-014-06-04 and IT-014-06-06 should work with NEHTA to provide significant contributions to the HL7 and IHE work on this topic.

NEHTA

IT-014-06-04

IT-014-06-06

Physicians Group:

New group

Issue: The mutual benefits of HL7 and non-technical clinicians coming

together are not adequately realised. HL7 needs to promote its benefits to non-technical clinicians and to gain their input via its clinician-focused standards. Action: All future HL7 delegates who are physicians to be encouraged to attend the Physicians WG session at the next meeting. Standards Australia to be aware of this in order to assist logistically. Action: Advocate for greater pre-registration promotion of the meeting by HL7 HQ. Identify HL7 products that might be of interest to Australian physicians, such as Functional Profiles, with a view to alerting the communities to their availability. Promote local Care Giver membership of HL7.

IT-014

HL7 Australia

Standards Australia

Policy Advisory

Committee

Issue: The HL7 Policy Advisory Committee is seeking input from

Affiliates on security and privacy issues as well as governance of secondary use of data from Affiliates.

Action: Provide a briefing document on Australian policy in these areas

DoHA

HL7 Australia

Richard Dixon-Hughes

IT-014-04

Security Workgroup:

Data Segmentation for Privacy (DS4P)

Issue: Whilst Australia is not yet in a position to embrace data

segmentation in the national eHealth system, as the system evolves it will become increasingly important due to privacy concerns relating to the sharing of patient healthcare and personal information.

Action: NEHTA should review the DS4P pilot project to anticipate the use of its concepts for the Australia eHealth system.

Action: Standards Australia should note that the DS4P is being developed through HL7 and taken to ISO with a view to being formulated into an international specification in the future.

NEHTA

Standards Australia


20


Security Workgroup:

Data Segmentation for Privacy (DS4P)

Issue: The Australian healthcare and health informatics community

should be made more aware of the issues and potential solutions of both primary and subsequent data sharing, and the data segmentation terminology and concepts being developed worldwide.

Action: NEHTA should consider an awareness and education program on DS4P concepts and potential impacts for the healthcare community.

NEHTA

Security Workgroup:

Security and Privacy Ontology - Project No: 646

Issue: Recommencement of the project and international input

requested.

Action: IT-014-04 to be advised of the project status and to provide feedback through the HL7 Security WG Co-Chair or though HL7 Security WG List.

IT-014-04

Security Workgroup:

e-measures and Quailty.

Issue: In Australia, e-measures and quality measurement is not being

addressed.

Action: NEHTA and IT-014-04 to review the e-measures project for consideration of adoption and input to international work in this area.

NEHTA

IT-014-04

Security:

New Co-Chair

Issue: New Co-Chair position recording.

Action: Standards Australia and IT-014 to note election of Dr Trish Williams to HL7 Security WG Co-Chair.

IT-014

Standards Australia

SOA:

Cross Platform Interoperability Implementation Guide for Immunisation.

(Sponsor SOA, Co-Sponsor PHER & ArB).

Issue: This project provides both a generalised guide to implementing

SOA for legacy systems and a specific demonstration of how to apply the approach to immunisation use cases.

Action: Seek wider Australian comment on the next ballot cycle from Government and e-health industry. This will need to be coordinated by HL7 Australia.

HL7 Australia

SOA:

Cross Platform Interoperability Implementation Guide for Immunisation.

Sponsor SOA, co-sponsor with PHER, ArB.

Issue: Commence discussion of how immunisation data should be

aggregated and managed with this project as a potential guide to doing this in the Australian context.

Action: Circulate balloted document for information and discussion at IT-014-06-04.

IT-014-06-04

SOA/Pharmacy:

Medication Statement Service

Issue: This DSTU is now complete and provides a useful mechanism

for accessing medications. Additionally, potentially, it is a service-based approach to medication management.

Action: Circulate to IT-014-06-04 for discussion and potential adoption.

Standards Australia

IT-014-06-04


21


SOA:

Healthcare and Community Services Provider Directory Service (HCSPD)

Issue: ELS needs to be submitted to the OMG.

Action: NEHTA and Standards Australia to provide the ELS specification to OMG.

NEHTA

Standards Australia

SOA:

Healthcare and Community Services Provider Directory Service (HCSPD)

Issue: HCSPD needs to be adopted as an Australian Standard.

Action: IT-014 to consider the adoption of the HL7 HCSPD DSTU as an Australian ATS.

IT-014

SOA:

Record Locate Update Service (RLUS)

Issue: This HL7 standard is now available and provides a general

service based capability for managing Health data. It should be considered for local adoption.

Action: IT-014 to consider adoption of the HL7 RLUS Standard. Infrastructure services such as the RLUS Standard do not, at present, have a natural ‘home’ within the IT-014 structure. Consideration may need to be given to forming a new Services Committee to mirror the HL7 SOA committee.

IT-014

SOA:

SOA Service

Ontology

Issue: This important white paper will pave the way for the

development of a rich set of discoverable and interactive electronic services. When balloted it needs to be explained, discussed, socialised and commented upon by a wide audience within the health standards and software community. NEHTA is a co-author of this paper.

Action: Plan a seminar to present this paper in December to prompt feedback and comment. This may be best managed by establishing a new committee or task force to mirror the HL7 SOA committee. IT-014 to review how best to approach this task. HL7 Australia to manage a seminar in conjunction with NEHTA, as part of its education program and marshal ballot response.

HL7 Australia

NEHTA

Standards Australia

SOA:

PASS

Issue: Expertise in security required to review the SOA Audit project

within PASS. Decision to be made on progression or removal of project.

Action: Trish Williams is reviewing the SOA Audit project on behalf of IT-014-04 to ensure that the project is not relevant for Australia or not catered for elsewhere.

IT-014-04

SOA:

PASS

Issue: Advanced access control features using metadata tags that

move with the data would provide a rich mechanism for maintaining data privacy following download from shared data stores such as the PCEHR.

Action: IT-014-04, NEHTA and DoHA need to be aware of this work and its potential ramifications for Australian healthcare data security and privacy.

Trish Williams, HL7 Security WG Co-Chair & IT-014-04 Co-Chair, to report to IT-014 on this work

Standards Australia to organise an educational seminar for NEHTA/DoHA on this topic


22


SOA:

Patient Care Services Co-ordination Project

Issue: CCS Project statement to be finalised and potential

implementers engaged.

Action: IT-014-06-06 to request expressions of interest from the Australian community in contributing to this project.

IT-014-06-06

Structured Documents:

CDA R3

Issue: CDA R3 is logical successor to CDA R2, retaining the tight focus

on patient centric document requirements which supports participation CMETs (Common Message Element Type) such as subject, participation, informant assignedDevice, accreditedLocation etc. to satisfy exchange of financial, veterinary, public / population health, medical device, and credentialing requirements.

Action: NEHTA and Australia should monitor the development of CDA R3 closely to ensure that the known Australian requirements are catered for. Especially the new project for consolidated clinical templates for CDA R3; this new project may serve the upcoming requirements for financial, veterinary and Medical devices.

NEHTA

IT-014


CDA R3

Issue: The CDA R3 includes many use case specific (RIM) ACT

classes / attribute like Container and Non Person Living Subject. This will cater the requirements of capturing of fine-grained structured information for some use cases without the need for Australian Extension (Ex: like Pathology Investigation information). Action: The adoption of CDA R3 specification will eliminate the drawbacks experienced in the current CDA R2 model. Australia should actively contribute to the CDA R3 CCD templates development and perform a R&D work around applying CDA R3 and its templates to the existing / new use cases.

NEHTA

IT-014


CDA R3

Issue: Australian extension included in CDA R3.

Action: CDA R3 includes some of the Australian CDA extension added to CDA R2; thus the adoption of CDA R3 will enable e-Health system across the world to syntactically and semantically recognize Australian CDA R2 extensions.

NEHTA

IT-014


Implementation Guide for CDA Release 3 - anaesthetic record

Issue: Development of Anaesthetic Implementation Guide.

Action: Monitor project development and implementation guides for CDA Release 3 and their relevance to Australia.

NEHTA

IT-014

Structured

Documents:

Patient Authored

Note

Issue: Capacity for recording and capturing provider vs. patient

authored information. The existence and process of developing Australian unique health identifiers and health provider IDs may contribute to this discussion.

Action: Potential incorporation of patient authored data in Australian e-health programs.

NEHTA

IT-014


23


Structured

Documents:

Patient Authored

Note

Issue: Capacity for recording patient authored information like

neonatal and child health record.

Action: Australia and NETHA should continue to closely monitor the development of Neonatal CCD templates to align the upcoming Australian requirements with HL7 International standard. Australia and NEHTA should also contribute its upcoming Antenatal requirements to the HL7 international standards committee.

NEHTA

IT-014

Structured

Documents:

Patient Authored

Document

Issue: Australian EHR (PCEHR) includes patient author documents

like ‘Consumer Entered Notes’, ‘Consumer Entered Health Summary’ and ‘Advance Care Directive’.

Action: Australian delegates should work towards getting these existing requirements incorporated into the HL7 ‘Patient Authored Document’ Implementation guide. This will provide an opportunity to align Australian Consumer Entered documents with HL7 International standards.

NEHTA

IT-014-06-06

Future HL7 delegates to SD

Structured

Documents:

Quality criteria for

CDA Implementation

Guides

Issue: Quality criteria list for quality assessment of normative and

informative and reference-set parts of a CDA Implementation Guides in navigational, and implementation perspective.

Action: Standards Australia and NEHTA need to pay close attention

to this project. Some of these quality criteria can be utilized to produce quality criteria specific for Australian CDA Implementation Guides. The inclusion of following checklist will increase the readability and consistency for CDA documents and end users.

OID and value set references and the URL of the publically available OID registers.

Minimum requirement of a standalone complete XML examples file for each CDA document.

Minimum requirement of a narrative text for each section/template.

NEHTA

IT-014


CDA Template versioning methodology

Issue: Inclusion of section / entry level templates and versioning of template IDs.

Action: Inclusion of section and entry level template for CDA IG will increase the re-usability of CDA sections (vendor code, schematrons / conformance libraries) across various Health Story specifications.

IT-014


CDA Template versioning methodology

Issue: Inclusion of template ID versioning will increase the re-usability

of CDA artefacts for old and new specifications.

Action: Australia and NEHTA should continue to closely monitor the Templates versioning project to procure the benefits of sustainable (forward and backward compatible) CDA template, Schematron packages and vendor library across all domain packages. The incorporation of the versioning methodology into the Specification development tool chain should be considered to align NEHTA template versioning methodology with the HL7 international standard.

NEHTA

IT-014


24



Continua Health Alliance

Issue: Development of tools for remote patient monitoring and

potential application to similar projects in Australian domains.

Action: Monitor development of tools.

IT-014

Vocabulary:

Common Terminology Server (CTS2)

Issue: CTS2 in the past has not been used extensively in Australia.

Given the significant review and update it would be appropriate to reassess its utility and priority for involvement of Australian resources in the project.

Action: Monitor this work and determine the impact, relevance and priority of this project for Australia.

IT-014

NEHTA

Vocabulary:

Vocabulary Facilitators

Action: Note that this guidance is being developed and provide

information to the HL7 Vocabulary WG if there are issues Australian members would like covered or included.

Action: Inform HL7 delegate to Vocabulary WG of any specific Australian requirements.

HL7 Australia

IT-014-06

Vocabulary:

Use of IHTSDO

workbench for HL7

Content

Issue: If HL7 progress to using the workbench for live data, it is hoped

that Affiliate members of HL7 will maintain their own submission of content requirements. This will require skills in both HL7 models and the IHTSDO workbench.

Action: Monitor progress in this area.

IT-014-02

IT-014-06

Vocabulary:

TermInfo Project

Issue: Lack of resources for the TermInfo Project.

Action: Identify the priority of this project to Australia and consider resources which might be provided to support the activity.

NEHTA

Vocabulary/SOA:

Clinical Terminology Service (CTS2)

Issue: The software industry and government need to become aware of

this service and its potential for unifying and simplifying access to, and management of, Health reference vocabularies including SNOMED, LOINC, HL7 tables, and MBS/PBS items.

Action: Hold an educational seminar for industry and government on CTS2 to demonstrate the benefits that can be easily realised by leveraging the work already completed at PHAST and the Mayo Clinic.

HL7

Standards Australia

MSIA

Clinical Information Modelling Initiative (CIMI)

Issue: CIMI is an important national and international initiative

Action: Australia should continue to support and develop the CIMI work.

Hugh Leslie


25

5. FUNDING SOURCES SUMMARY AND AUSTRALIAN ATTENDANCE

Twelve Australians attended as representatives for the duration of this HL7 meeting, nine of whom were in the formal delegation. The funding source for these delegate numbers is indicated in the table below.

DoHA provided funding assistance for the following delegates:

Heather Grain

Patricia Williams

Vince McCauley


Hugh Leslie

Amy Mayer

David Rowed

Nat Wong

Meya Achdiat

Funding Source Number Change from Previous meeting

Full funding by employer: Private 0 0

Full funding by employer: States/Territories or National Initiatives (NEHTA) 3 +1

Funding assistance – DoHA through Standards Australia contract 9 no change

Total: 12 +1

There was a team of delegates from NEHTA who attended the HL7 meeting; these NEHTA delegates are listed below:

Andy Bond

Stephen Chu

Vin Sekar


26

6. AUSTRALIAN LEADERSHIP POSITIONS

The table below lists leadership positions held by Australians at the HL7 meeting in September 2012.

Attendee Position (held at the meeting)

Funding Source Work Group or Committee

Andy Bond ARB Member NEHTA ARB

Heather Grain Co-Chair Invited Member

Standards Australia via the DoHA Funding Agreement

Vocabulary Policy Advisory Committee

Dr Hugh Leslie Co-Chair Standards Australia via the DoHA Funding Agreement

Patient Care


Co-Chair Non-Voting Member Chair HL7 Australia Invited Member Invited Member Invited Member Chair-elect

Standards Australia via the DoHA Funding Agreement

Advisory Council to the Board of HL7 International HL7 International Board of Directors International Council and Affiliate Chairs Meetings, International Membership & Affiliation Task Force (IMATF) Affiliate Due Diligence Committee (of HL7 International Board) Policy Committee (of HL7 International Board – invited by HL7 Chair) HL7 Membership Task Force – to define new rights of HL7 members post free licensing HL7 standards - invited by HL7 CEO) Joint Initiative Council (JIC) for Health Informatics SDO Harmonisation

Vincent McCauley

Co-Chair Standards Australia via the DoHA Funding Agreement

Service Oriented Architecture

Patricia Williams Co-Chair Standards Australia via the DoHA Funding Agreement

Security

Stephen Chu Co-Chair NEHTA Patient Care


27

7. ACRONYM LIST

Abbreviation Meaning

ACCC Australian Competition and Consumer Commission

ACMA Australian Communication and Media Authority

ACSQHC Australian Commission on Safety and Quality in Health Care

ACT Action

ACTUG Australian Clinical Terminology Users Group

ADA-JDA Australian Design Award James Dyson Award

ADL Archetype Definition Language

AG Advisory Group

AGDA Australian Graphic Design Association

AHIEC The Australian Health Informatics Education Council

AHIMA American Health Information Management Association

AHMAC Australian Health Ministers' Advisory Council

AHML Australian Healthcare Messaging Laboratory

AIDA Australian International Design Awards

AIHW Australian Institute of Health & Welfare

AIIA Australian Information Industry Association

AMT Australian Medicines Terminology

ANSI American National Standards Institute

ANZCTR Australia New Zealand Clinical Trials Registry

ArB Architecture Review Board

AS HB Australian Handbook

AS/NZS Australian/New Zealand Handbook

AS/NZS ISO International Standards adopted by Australia and New Zealand

AU (Australia abbreviation in the Int'l comment form)

AWI Approved Work Item

BAU Business As Usual

BCA Building Codes of Australia

BRIDG Biomedical Research Integrated Domain Group

BRIDG is a collaborative effort of CDISC, the HL7 RCRIM WG, the (US) National Cancer Institute (NCI), and the US Food and Drug Administration (FDA).

BRS Business Requirements Specification

Cal-X The California Exchange (Cal-X) is a data and information exchange to support healthcare, medical, public health, and homeland security needs in a collaborative, shared, secure, and cost-effective manner.

COPOLCO Consumer Policy Committee [ISO]


28


CASCO Conformity Assessment

CBCC Community Based Collaborative Care [HL7 Workgroup]

CCD Continuity of Care Document

CCS Care Coordination Service

CCHIT (US) Certification Commission for Health Information Technology

CD Committee Draft (third stage in developing an ISO or IEC standard)

CDA Clinical Document Architecture

CDC Centre for Disease Control (US Government agency)

CDISC Clinical Data Standards Interchange Consortium

CDS Clinical Decision Support [HL 7 Workgroup]

CDV Committee Draft for Vote

CEN European Committee for Standardization (Comité Européen de Normalisation)

CENELEG European Committee for Electrotechnical Standardisation

CEO Chief Executive Officer

CGIT Conformance and Guidance for Implementation and Testing Committee

CIC Clinical Interoperability Council [HL7 Workgroup]

CIMI Clinical Information Modelling Initiative

CIS Clinical Information Systems

COAG Council of Australian Governments

COM Comment

conHIT2011 European Health Informatics Conference 2011

ContSys System of Concepts for Continuity of Care

COR Corrigendum [to a Standard]

CRM Customer Relationship Management

CTO Chief Technical Officer

CTR&R Clinical Trials Registration and Results

DAFF Department of Agriculture, Fisheries and Forestry

DAM Domain Analysis Model (comprehensive model of a domain) [HL7]

DAM Draft Amendment [Standards Australia]

DCM Detailed Clinical Model

DCOR Draft Corrigendum

DEVCO Developing country matters

DIA Design Institute of Australia

DICOM Digital Imaging and Communications in Medicine

DIISR Department of Innovation, Industry, Science & Research

DINZ Design Institute of New Zealand

DIS Draft International Standard (fourth stage in developing an ISO or IEC standard –


29

Abbreviation Meaning the main opportunity for public input)

DMP Dossier Médical Partagé (Shared Medical Record) (France)

DoHA (Australian Government) Department of Health and Ageing

DSTU Draft Standards for Trial Use (HL7 and ANSI)

DTR Draft Technical Report [ISO and Standards Australia]

DTS Draft Technical Specification [ISO and Standards Australia]

EC European Commission [the administrative arm of the EU]

ECCF Enterprise Compliance and Conformance Framework

EEC European Economic Community

EFMI European Federation of Medical Informatics

EHR Electronic Health Record

EHR-FM EHR Functional Model

EHRS or EHR-S Electronic Health Record System

ELGA Austrian CDA Implementation Guide in Development

ELS End Point Location Service

EMEA European Medicines Agency

EN European Standard (Européen Norm)

ENA Energy Networks Association

EPM Enterprise Project Management

epSOS European Patients Smart Open Services.

A European initiative (23 countries) to exchange pharmacy and EHR information, including prescriptions, across the EEC using IHE profiles and local standards. See www.epsos.eu

ETP Electronic Transfer of Prescriptions

EU European Union

EudraCT European Union Drug Regulating Authorities Clinical Trials

FCD Final committee draft

FDAM Final Draft Amendment

FDIS Final Draft International Standard (for vote to publish) [ISO]

FHIR Fast Health Interoperability Resources [HL7]

FRS Functional Requirements Specification

FYI For your information

GCM Generic Component Model

GDP Gross Domestic Product

GP General Practitioner

GS1 An international SDO – primarily in the supply-chain domain

GVP Good Pharmacovigilance Practices

HCD Health Care Devices Committee


30


HDF HL7 Development Framework

HI Health Identifiers

HIE Health Information Exchange

HIMSS Healthcare Information and Management Systems Society

HISC Health Informatics Standing Committee

HITSP Health Information Technology Standards Panel

HL7 Health Level Seven (International)

HL7 ELC HL7 E-Learning Course

HPI Healthcare Provider Identifier

HPI-I Healthcare Provider Identifier for Individuals

HPI-O Healthcare Provider Identifier for Providers

HQMF Health Quality Measure Format

HSSP Healthcare Services Specification Project [joint HL7/OMG]

IC International Council (HL7)

ICD10AM The Australian NCCH modification of ICD-10 code set for the coding of diseases and procedures

ICD10-AM International Classification of Diseases, Version 10, Australian Modification

ICD9CM International Classification of Diseases 9 Clinical Modification

ICH International Conference on Harmonisation (of Technical Requirements for Registration of Pharmaceuticals for Human Use)

ICHPPC International Classification of Health Problems in Primary Care

ICNP International Classification for Nursing Practice

ICOGRADA International Council of Graphic Design Associations

ICPC2+ International Classification of Primary Care 2

ICSID International Council of the Societies of Industrial Design

ICSR Individual Case Safety Report [related to Medicines/Devices]

ICT Information & Communications Technology

IDA International Design Alliance

IDEA Industrial Design Excellence Awards

IDMP Identification of Medicinal Products

IDSA Industrial Design Society of America

IEC International Electrotechnical Commission (an international SDO)

IEEE Institute of Electrical & Electronic Engineers (US) (also an SDO)

IF International Forum of Design

IFI International Federation of Architects/Designers

IG Implementation Guide

IHE Integrating the Healthcare Enterprise

IHI Individual Healthcare Identifier


31


IHTSDO International Health Terminology Standards Development Organisation

IMATF International Membership and Affiliation Task Force

InM Infrastructure and Messaging [HL7 Workgroup]

IP Intellectual Property

IS International Standard

ISO International Organization for Standardization

ISO/CS ISO Central Secretariat

ISO/TC 215 ISO Technical Committee (Health Informatics)

IT Information Technology

IT-014 Standards Australia Committee IT-014 (Health Informatics)

ITS Implementable Technology Specifications

ITTF ISO/IEC Information Technology Task Force

ITU-T International Telecommunications Union – Standards Division

IXS Identity Cross Reference Service

JI Joint Initiative on SDO Global Health Informatics Standardization

JIC Joint Initiative Council (responsible for governance of the JI – with current members being ISO/TC215, CEN/TC251, HL7 International, CDISC, IHTSDO and GS1)

JIDPO Japanese Industrial Design Promotional Organisation

JSC-HIS Joint Standing Committee on Health Informatics Standards

JSON Java script Object Notation

JTC Joint Technical Committee

JTC 1 ISO/IEC Joint Technical Committee 1 Information Technology

JWG Joint Working Group

KPI Key Performance Indicator

LB Letter Ballot

LIC Low Income Country

LMIC Low and Medium Income Countries

LOINC Logical Observation Identifiers Names and Codes

LPO Local PCEHR Officer

MBS Medical Benefits Scheme

MBUA Member Body User Administrators (Person who maintain the ISO Global directory in each country)

MDA Model Driven Architecture

MDMI Model Driven Message Interoperability – see www.mdmi-consortium.org

MIC Medium Income Country

MM Maturity Model

MnM Modelling and Methodology [HL7 Workgroup]

MOR Monthly Operational Report


32


MOU Memorandum of Understanding

MSIA Medical Software Industry Association

MT Maintenance committee (IEC)

NASH National Authentication Service for Health

NATA National Association of Testing Authorities

NEHIPC National E-Health and Information Principal Committee

NEHTA (Australian) National E-Health Transition Authority

NH&MRC National Health and Medical Research Council

NHCIOF National Health Chief Information Officer Forum

NHIN (US) National Health Information Network

NHISSC National Health Information Standards and Statistics Committee

NHS (UK) National Health Service

NIH (US) National Institutes of Health

NIST National Institute of Standards and Testing (USA)

NMB National Member Body [of ISO or CEN]

Normapme European Office of Crafts, Trades and Small and Medium sized Enterprises for Standardisation

NP New Work Item Proposal (current ISO/IEC abbreviation)

NPACC National Pathology Accreditation Advisory Council

NPC National Product Catalogue

NQF National quality (measures) framework

NSO National Standards Office

NWIP New Work Item Proposal (obsolete ISO/IEC abbreviation – see "NP")

O&O Orders and Observations [HL7 Workgroup]

OBPR Office of Best Practice Regulation

OCL Object Constraint Language

OHT Open Health Tools Foundation (www.openhealthtools.org)

OID Object Identifier

OMG Object Management Group

ONC Office of the National Coordinator for Health Information Technology (within US Department of Health and Human Services)

OSI Open Systems Interconnection

OTF Organisation Task Force [ISO TC 215]

OWL Web Ontology Language

PA Patient Administration [HL7 Workgroup]

PACS Picture Archive Systems

PAS Patient Administration Systems

PASS Privacy Access and Security Service


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PBS Pharmaceutical Benefits Scheme

PC Patient Care [HL7 Workgroup]

PCEHR Personally Controlled Electronic Health Record

PDAM Proposed Draft Amendment

PDF Portable Document Format

PDTR (Proposed) Draft Technical Report

PHDSC Public Health Data Standards Consortium

PHER Public Health and Emergency Response [HL7 Workgroup]

PHM Powerhouse Museum

PHR Personal Health Record

PHTF Public Health Task Force

PIM Platform Independent Model

PIP Practice Incentive Payment

PIR Post Implementation Review

PKI Public Key Infrastructure

PM Project Manager

PMBOK Project Management Body of Knowledge

PMO Project Management Office

PMP Project Management Plan

PMS Practice Management System

PMTL Project Management Team Leader

PoC Point-of-Care

PSM Platform Specific Model

PSS Project Scope Statement [HL7]

PSUR Periodic Safety Update Report

PWG Pharmacy Working Group [HL7 Workgroup]

RACGP Royal Australian College of General Practice

RCPA Royal College of Pathologists Australia

RCRIM Regulated Clinical Research Information Management [HL7 Workgroup]

RFID Radio Frequency Identification

RHIO (US) Regional Health Information Organisation

RIM Reference Information Model

RIMBAA RIM Based Application Architecture

RIS Radiology Information Systems

RLUS Resource Locate Update Service (HSSP)

RMIM Refined Message Information Model

RM-ODP Reference Model of Open Distributed Processing


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RO Responsible Officer

SA Standards Australia

SAIF Services Aware Interoperability Framework

SC Subcommittee

SD Structured Document [HL7 Workgroup]

SDO Standards Development Organisation

SHIPPS Semantic Health Information Performance and Privacy Standard

SIG Special Interest Group

SKMT Standards Knowledge Management Tool

SLA Service Level Agreement

SMB Standards Management Board (IEC only)

SME Subject Matter Experts

SMTP Simple Mail Transfer Protocol

SNOMED Systematised Nomenclature of Medicine

SNOMED CT Systematised Nomenclature of Medicine - Clinical Terms

SOA Service Oriented Architecture

SOAP Simple Object Access Protocol

SP3 Standards Professional Project Practitioners

STC Technical Steering Committee

T3SD Technical and Support Services Steering Division

TC Technical Committee

TCM Traditional Chinese Medicine

TCP/IP Transmission Control Protocol/Internet Protocol

TEAM Traditional East Asian Medicine – This term, though inadequate, is used to represent Traditional Chinese Medicine, Traditional Korean Medicine, and Traditional Japanese Medicine.

TF Task Force

TM Traditional Medicine

TMB Technical Management Board (ISO only)

TOGAF The Open Group Architecture Framework

TR Technical Report (an informative ISO or IEC standards publication)

TS Technical Specification (a normative standards publication having a lower level of consensus than a full international standard)

UAT User Acceptance Testing

UCUM Unified Code for Units of Measure [Regenstrief Institute]

UHI Unique Healthcare Identifier

UML Unified Modelling Language

UN United Nations


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VMR Virtual Medical Record

VOC Vocabulary Committee [HL7 Workgroup]

W3C World Wide Web Consortium

WCM Web Content Management

WD Working Draft (second stage in developing an ISO or IEC standard)

WG Working Group or Work Group

WGM Working Group Meeting

WHO World Health Organization

WI Work Item

WTO World Trade Organisation

XDS (IHE’s) cross enterprise Data Sharing protocol

XML Extensible Markup Language