HL7 Technical Directorate

- Abbreviated to "Composition and Formation"

Introduction

This document provides specific recommendations from the Technical Transition Task Force (T3F) to the HL7 Board. It includes a complete definition of the Technical Directorate (TD), its composition and relationships, and proposes a plan to elect and establish the Technical Directorate to allow its first meeting at the September 2007 Working Group Meeting in Atlanta.

Responsibilities

• Oversees Execution of Standards Development
• Provides a Coherent Architecture and Development Process
• Oversees the Technical Operations of the Working Group
• Primary Communication Vehicle for the Technical Operations of HL7

Composition

The T3F spent several meetings deliberating the appropriate composition and style of functioning for the Technical Directorate. This section reflects the results of those discussions, and addresses three topics:

• HL7 Committee Structure - Board-to-TD-to-Committees & SIGs
• Composition and Functioning of TD
• Relationship of TD to CTO

The order of these topics is arbitrary and the discussion will, of needs, include both forward and backward references. The T3F did not attack any of these topics de novo. In every circumstance, we built on the guidance provided by earlier Strategic Initiative, ORC and Transition documents. We sought to recognize the principles and objectives that underlay each of those documents and to maintain those principles and objectives while improving, we hope, the resulting framework.

HL7 Committee Structure

The HL7 Working Group is made up of a number of volunteer-driven Committees and SIGs that have been highly successful, to both their own and to HL7's credit and benefit. Simultaneously, however, as the numbers of groups expanded, their breadth, number and diversity posed major challenges for coordination and collaboration between them. Discussion and debate on such issues in the forum of the Technical Steering Committee (TSC) became difficult and unproductive in recent years, and failures in coordination have begun to threaten the effectiveness of HL7.

The challenge of the Strategic Initiative was to address these coordination and collaboration issues while retaining the essential vitality of a Working Group made up of and driven by the best, brightest and most dedicated medical informaticists and information scientists available. The essence of the Strategic Initiative proposal was to revise the leadership of the Working Group from a single TSC with representation from each Committee and SIG to a two-level hierarchy of a Technical Directorate (TD) and a small set of Steering Divisions (SD, a new term). This was the foundation from which the T3F developed this proposal.

The starting point for this discussion was a previously developed Strategic Initiative document titled //"Creation of the Transitional Technical Task Force (T3F)". The final proposal can be summarized with the "nested list" of bullet points at the end of this paragraph. The remainder of the topics in this "HL7 Committee Structure" section discuss the rationale and principles behind this proposal, specific responsibilities of the TDs and SDs, and the definition and committees in each Steering Division. The proposed hierarchy is:

• HL7 Board
  • Technical Directorate -

    6 elected voting representatives, 4 appointed voting members

    TD-elected Chair

    • Foundation & Technologies Steering Division

      9 existing TCs and SIGs

      2 Elected SD Co-Chairs plus Co-Chairs of TCs & SIGs in SD

    • Structure & Semantic Design Steering Division

      10 existing TCs & SIGs

      2 Elected SD Co-Chairs plus Co-Chairs of TCs & SIGs in SD

    • Domain Experts Steering Division

      17 existing TCs and SIGs

      2 Elected SD Co-Chairs plus Co-Chairs of TCs & SIGs in SD

    • Technical & Support Services Steering Division

      9 TD-appointed Committees (7 formerly Board-appointed, 2 new)

      2 Elected SD Co-Chairs plus Co-Chairs of Committees in SD

Organizing Principle

During its deliberations, the T3F made the following observations:

• HL7 members join committees because of their personal (or corporate) interest in the subject matter content of the committee, regardless of whether their interest stems from academic, development or implementation activities.
• The original break-out of committees (provided in the SI document) aggregates the committees by commonality of what they produce and the relationship of that work product to the other Working Group committees. The T3F found this is to be a sound approach.
• One of the key activities of the TD will be to identify and reduce those places where committees are "stepping on each others toes" or "reinventing the wheel." Coordination within the proposed Steering Divisions will facilitate this activity.
• The existing relationship between TCs and SIGs may need to be "re-thought", because the Steering Division strategy will clearly place a number of SIGS in a Steering Division that is different from that to which their current "parent TC" is assigned.
• It will be important to not disrupt existing collaboration while establishing this organization, and it is clear that many topics may best be managed, in "matrix fashion" between committees in two or three Steering Divisions.
• A number of committees clearly produce products that fit in two or even three of the Steering Divisions. This may be effective, or it lead the TD to consider whether to recommend these groups be split.

Ultimately, the T3F recognized that the organization as proposed is imperfect, not by design, but by the nature of the HL7 Committees and SIGs that do not permit simplistic classifications. Regardless of what is proposed, someone will question the result. The key element however is to establish the three-tier structure first, gain the advantages of focusing critical organizational thinking into smaller meetings so that the work can get done, and then evolve the structure over time.

Technical Directorate Role

The technical Directorate (TD) will be the focal point for decision making, harmonization, issue resolution, project and committee creation and dissolution within the Working Group. The TD will be a representative consensus body of elected and appointed members. (Specifics are in a later section of this document.)

The T3F notes that however the Steering Divisions are defined, and whatever additional relationships may exist between committees, the Technical Directorate will not be successful in meeting HL7's objectives unless it can assure the harmonization of content and design across HL7 standards.

As a consequence, the notion of required harmonization and shared stewardship must clearly be a fundamental principle of the TD, of the Steering Divisions, and of each TC and SIG. Overall, it is the TD that must define and manage the processes that bring about such harmonization and then must delegate similar responsibilities to the Steering Divisions and to the committees.

Further, the TD must have a central role in project management. It is assumed that the project life cycle strategy being developed will be a fundamental process for all HL7 work. The TD will incur responsibilities:

• to approve projects (after they are vetted in the Steering Divisions)
• to initiate projects to carry out its mission (such as harmonization)
• to oversee the functions of the Project Management Office, and
• to maintain the project life cycle definition

Certainly, several of these responsibilities will need to be delegated in whole or in part to the Steering Divisions or to specific committees.

Steering Division Definition and Composition

In keeping with the original Strategic Initiative document, T3F proposes to divide the existing Technical Committees, Special Interest Groups and Board-appointed Committees into four functional groups called Steering Divisions (SD). Each Steering Division will be a committee in its own right made up of the Co-Chairs of the groups in the SD. It is expected that each SD will meet face-to-face during each Working Group Meeting and will conduct conference calls, as needed. A partial list of specific SD responsibilities includes:

• nominate and elect the representative from that SD to the TD, who will also serve as a Co-Chair of the SD
• nominate and elect an Alternate representative to the TD, who will also serve as a Co-Chair of the SD
• review proposed projects and make recommendations for action to the TD
• monitor project status within the SD
• review proposals to create, modify or dissolve Committees and SIGs in their SD and make recommendations for action on same to the TD
• identify coordination issues within and between the committees of the SD and resolve these or recommend resolutions to the TD
• identify coordination issues between SDs and their committees and recommend resolutions to the TD
• undertake harmonization tasks as delegated by the TD

Foundation & Technologies Steering Division

Committees and projects in this space focus on providing the fundamental tools and building blocks that other Committees should use to build the standards, and upon the technology infrastructure that implementers of HL7 standards must manage.

• Conformance and Implementation
• Infrastructure & Messaging
• Implementable Technology Specifications (ITS)
• Java
• Modeling & Methodology
• Security
• Service Oriented Architecture (SOA)
• Templates
• Vocabulary

• Related multi-committee projects:
  • Dynamic Model
  • Harmonization
  • HL7 TermInfo

Structure & Semantic Design Steering Division

Committees and project in this space focus on creation of basic patterns and common messages that could exist on their own, but are mostly used by others.

• Clinical Context Object Workgroup (CCOW)
• Clinical Decision Support
• Electronic Health Record (EHR)
• Financial Management
• Genomics
• Orders & Observations
• Patient Administration
• Personnel Management
• Scheduling & Logistics
• Structured Documents

• Related multi-committee projects:
  • Clinical Statements
  • Common Message Element Types (CMETs)

Domain Experts Steering Division

Committees and projects in this space focus on creation of messages, services, documents using many of the common structures in place, yet expanding it in key areas as well.

• Anatomic Pathology
• Anesthesiology
• Attachments
• Cardiology
• Clinical Guidelines
• Community Based Health Services
• Emergency Care
• Government Projects
• Health Care Devices
• Imaging Integration
• Laboratory
• Patient Care
• Patient Safety
• Pediatrics Data Standards
• Public Health Emergency Response (PHER)
• Pharmacy
• Regulated Clinical Research Information Management (RCRIM)

Technical & Support Services Steering Division

These committees are currently Board-appointed. In future, the T3F recommends that they be appointed by the TD, subject to Board approval. The committees will elect their own Co-chairs, subject to TD approval. For the most part, these groups are functioning on volunteer effort, although each has strong support from a designated staff liaison. The primary feature of these committees is that their projects and products provide direct support to the Technical Committees and SIGs of the Working Group and thereby enable the Working Group to function efficiently.

• Education
• Electronic Services
• Implementation
• Marketing Committee (T3F needs consultation during the Cologne meeting with the Board and the Marketing Committee to ascertain whether inclusion of the Marketing Committee in this Steering Division is appropriate)
• Process Improvement Committee (PIC)
• Product and Services Committee (T3F needs consultation during the Cologne meeting with the Product & Services Committee to ascertain whether inclusion of the Products and Services in this Steering Division is appropriate)
• Project Services -- a new group that will take responsibility for the Project Life Cycle and will serve as the primary support for the PMO
• Publishing
• Tooling

Architecture Review Board

The T3F believes the Architecture Review Board (ARB) fulfills a critical mission that must continue under the TD. To that end, the T3F is proposing that the ARB become a TD-appointed committee that "stands alone" (independent of the Steering Divisions), and (see below) that the ARB have a voting representative on the TD. Normally this representative will be the ARB Chair, but in the circumstance that the ARB Chair is already a member of the TD, a different ARB member will also be named to the TD.

Composition and Functioning of TD

The makeup of the proposed Technical Directorate is illustrated in the following chart. It includes ten voting members -- six elected representatives, two Board-appointed positions (the CTO and a liaison), and up to two TD-appointed positions. It also has a non-voting secretary, to be assigned by HQ, and other staff support positions. Specifics of the election processes, terms, etc. are in following sub-sections.

TD Membership

Steering Division Representatives

Each of the four Steering Divisions (SD) will have an elected voting Representative on the TD. Further, each SD will elect an Alternate Representative who is authorized to attend TD meetings and vote in the event the elected Representative from that SD is unable to participate. This assures strong, consistent representation from each SD. In addition, the primary and alternate representatives will serve as Co-Chairs of the Steering Division itself.

The election process for SD Representatives is patterned after the process used in 2006 to elect the T3F representatives:

1. During a nomination period of at least two weeks, nominations for representatives of the SD will be accepted from the Co-Chairs of the Committees and SIGs that make up the SD.
2. The nominees are expected to be individuals who are either current Co-Chairs or a past Co-Chair of one of the Committees or SIGs in the SD. Effective service on the TD will require such experience. Nominees should be prepared to commit one to two hours a week to the TD, if elected.
3. HL7 staff will contact nominees to verify their willingness to stand for election, and to solicit a brief nominees "statement" for distribution.
4. Individuals who are nominated to represent more than one SD will be asked to choose which nomination they wish to accept, and must reject the other(s).
5. An election period of at least three weeks will follow the nomination period. The votes will be cast by the Committees and SIGs in the SD, using their normal decision-making practices.
6. Each Committee will cast votes for two of the candidates, and will be asked to state a preference for one of the two as their primary representative. (This preference will be tallied only if there is a need to resolve a tie.)
7. The candidate receiving the most votes will be named the Representative for that Steering Division. The candidate receiving the next higher number of votes will be named the Alternate Representative for that SD. Both the first and second place candidates will be named Co-Chairs of the SD.
8. Tie votes will be resolved by tallying the primary representative preferences for the candidates involved in the tie. If tally also results in a tie, the decision will be made by drawing lots, unless one of the candidates involved wishes to defer to the other(s).

Affiliate Representatives

Two Affiliate Representatives will be elected by the "global" HL7 Affiliates -- the "traditional" affiliate organizations plus the US affiliate. (During the initial election, the HL7 Board is requested to designate a consensus body to nominate and cast votes for the US Affiliate.)

The election process for Affiliate Representatives is:

1. During a nomination period of at least three weeks, nominations for Affiliate Representatives will be accepted from the affiliate organizations.
2. Nominees should be prepared to commit one to two hours a week to the TD, if elected.
3. HL7 staff will contact nominees to verify their willingness to stand for election, and to solicit a brief nominees "statement" for distribution.
4. An election period of at least three weeks will follow the nomination period. The votes will be cast the Affiliates, using their normal decision-making practices.
5. Each Affiliate will vote for one or two of the candidates, depending upon how many Affiliate Representative positions are being filled in that election. (See discussion of member terms, below.)
6. The one or two candidate receiving the most votes will be named the Affiliate Representative(s), depending upon how many positions are being contested.
7. Tie votes will be resolved by drawing lots, unless one of the candidates involved wishes to defer to the other(s).

Representative Election Timing

In order to assure the greatest diversity and balance of the representatives on the Technical Directorate, the election of Representative Members will be phased, with the Election for Steering Division Representatives coming first, election of Affiliate Representatives second, and appointed TD members being designated last.

Board-Appointed Members

The HL7 Board of Directors will appoint two members to the Technical Directorate.

1. The Chief Technology Officer who will hold an ex officio voting position on the Technical Directorate.
2. A Board Liaison to the Technical Directorate, which is also a voting position.

Technical Directorate-Appointed Members

The Technical Directorate will also appoint two members to the TD. They are:

1. An Architecture Review Board (ARB) Representative. The T3F believes that the ARB fulfills a vital "independent" role in HL7 and should have voting representation on the TD. Normally this representative will be the ARB Chair, but in the event that the Chair is already a TD member, or declines to serve, another ARB member will be selected.
2. An ad hoc TD-Appointed Member will be appointed on a variable term, not to exceed two-years, based on requirements or needs for balance or expertise that the Technical Directorate may from time to time identify. This will be a voting position.

Membership Terms

All normal membership terms on the Technical directorate shall be for two years, and will run on a calendar year basis. (See exceptions, below). There are no term limits, members may serve successive terms.

Technical Directorate Elections should be held between the "Spring" and "Fall" Working Group Meetings each year, for candidates who will take office in January of the following year. Each year, representatives for two of the four Steering Divisions will be elected as will one of the two Affiliate Representatives. The appointed positions do not need to be staggered.

Vacancies

In the event that a member must resign from the Technical Directorate, the following procedures shall be used to fill vacancies:

1. For SD Representative positions, the Alternate Representative will be designated to serve the remainder of the vacated term, and the Alternate position will be re-filled in the next election cycle.
2. For Affiliate Representative positions, the Affiliate Council will be asked to name an individual to serve the remainder of the vacated term.
3. For the Board Liaison and the ARB Representative appointed positions, the appointing body will be asked to fill the vacated position as soon as possible. The initial term of the replacement appointee will run until the second year-end following the appointment.

Term Exceptions

The following exceptions exist for the two-year, calendar-term rule above:

1. The CTO holds a standing ex officio membership, and therefore that TD term is dependent upon the term of service as CTO.
2. The term of ad hoc TD-Appointed Member will start when the TD makes the appointment and will end as determined by the TD, but cannot exceed two years.
3. During the summer of 2007, elections are planned for all six elective positions. In order to establish staggered terms, two of the four elected SD representatives and one of the two elected Affiliate representatives will be designated to serve an initial "half-term." This designation will be determined by drawing lots.
4. Because of the desire to have the TD start functioning in September 2007, the initial terms of the elected and appointed members will be extended by to cover the period from September 16, 2007 through to the nominal start of their terms on January 1, 2008.

Election of Technical Directorate Chair

The Chair of the Technical Directorate will be elected by the Technical Directorate itself. The Chair shall be selected from the voting members of the TD. There will be no formal designation of a Co-Chair or Vice-Chair for the Technical Directorate. The Technical Directorate can take whatever steps it wishes to assure coverage when the Chair is unavailable for a particular meeting, including, if it wishes, naming a standing Vice-Chair.

Term of Office

The Chair will be elected for a two-year term of office, regardless of how long the candidate's membership term has left to run.

In the not unlikely event that the term of office runs longer than the Chair's term as a member, the TD may use its "TD-Appointed" position to extend the Chair's membership, or may petition the Board to temporarily expand the TD membership to allow the Chair to serve out the term of office.

The Technical Directorate should seek to establish Chair terms of office that run on a calendar basis. As with regular terms, the term of the initial TD Chair shall be extended to cover the period from September 16, 2007 through December 31, 2007.

Decision making and delegated decisions

By and large, decisions of the Technical Directorate will be made by vote. There are however, tactical decisions, such as approvals for ballot, exceptions to ballot rules, etc. that have, in the past been assigned to the Technical Chair of HL7. Such decisions should be delegated to the CTO or to the Chair of the Technical Directorate. The TD will need to take early action to assign such delegation.

Relationship of TD to CTO

In the course of its deliberations, the T3F paid particular attention to the role of a Chief Technical Officer (CTO). Ultimately, the T3F came to the conclusion that the relationship between the CTO and the TD should mirror the relationship between the CEO and the Board of Directors each acting assure the success of the other.

This decision was predicated on the assumption by the T3F that the TD would participate in the Board's selection of the CTO and that the following principles will be applied in making a CTO selection, in priority order:

1. A proven consensus builder
2. Someone who knows and is known to the HL7 Working Group
3. Likely to have been a Co-Chair or “facilitator”, but not necessarily required
4. Have a strong understanding or working knowledge of the technology that HL7 defines and is dependent upon.

In that context, the following motion was unanimously adopted by the T3F.

T3F Motion Unanimously Adopted April 3, 2007

WHEREAS:

• The task of over-seeing and coordinating the technical activities of Health Level Seven requires the full-time attention of a knowledgeable professional, "Technical Officer";
• The effective coordination of the various committees and SIGs requires a restructuring of these into three or four sub-groups reporting to an elected Technical Directorate;
• The Technical Directorate must assure the continued involvement and support of HL7's Core Resource - volunteer-driven Working Group; and
• The success of the Technical Directorate and the success of the "Technical Officer" are inextricably intertwined, and, further, are essential to HL7's success;

THEREFORE, the Transitional Technical Task Force RESOLVES to recommend:

• The "Technical Officer" should be recruited to work with and support the Technical Directorate in its responsibilities to oversee HL7's technical activities;
• The "Technical Officer" should report to the CEO and the HL7 Board, and should be a voting member of the Technical Directorate.
• The Chair of the Technical Directorate should be be elected by the voting members of the Technical Directorate, and selected from within the members of the Technical Directorate.
• The Technical Directorate and its Chair should delegate responsibilities and operational decision-making (to be defined later) to the "Technical Officer."
• The Technical Directorate should have a role in recruiting and evaluating the "Technical Officer."

Tactical Plan to Establish Technical Directorate

The T3F recommends the following time-line to the HL7 Board for the establishment of the Technical Directorate. If the composition and election processes included in this report are approved by the Board before or during the Board's June Conference call, this schedule provides a reasonable time-line for carrying out the TD elections in time to allow the TD to hold its first meeting during the September 2007 Working Group Meeting in Atlanta. (Note that the staging of the nominations and elections are designed to allow the Affiliate constituencies to know who are the Steering Division Representatives before the Affiliate election process begins.)

May 2007 Working Group Meeting

• T3F to present current recommendations for the formation of the TD.

May 31, 2007

• T3F submits a final version of this document based on feedback from the presentation at the May WGM to the Board, and seeks approval of the section detailing the composition and election of TD members.

June through August 2007

• Three weeks for nominations of SD Representatives. (open June 5; close June 24)
• Three weeks for election of SD Representatives. (close July 15)
• Three weeks for nomination of Affiliate Representatives. (close Aug 5)
• Three weeks for Affiliate Representative election.(close August 26)

September 2007

• Board appoints its representative any time prior to September.

September 2007 Working Group Meeting

• First official meeting of the TD. TD to elect a chair.
• Terms will be staggered by drawing lots.