Cross-committee Balloting Issues

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Historically, there have been a number of ballot issues that have seemed to be intractable, and that have frustrated (equally) both the voters and the committees. Most notable of these (of late) have been:

  • Attribute-level documentation of message designs, which are viewed by many as being a sine qua non for a standards that can be interpreted and implemented.
    Until relatively recently, technical limitations in the publishing process made such documentation difficult to generate and maintain. As a consequence, a number of specifications with lesser levels of documentation became "normative."
  • Code system specifications for coded attributes
    This issue is further exacerbated by two other factors.
    1. Vocabulary code system specification through "Harmonization" is intended to approve only those code systems and value sets that must be used wherever the standard is implemented. In general, this applies primarily to the "structural attributes," leaving the remainder for realm-level binding or implementation-level binding. However, these policies have not yet been widely promulgated nor voted upon,
    2. The publication process for HL7-harmonized code systems has lagged significantly behind the review and approval process.

Core Issue

The key question is not so much how to answer these specific problems, but to establish formal review process wherein such issues can be raised and resolved, and, where necessary, appropriate policies can be established.