T3F Cologne Deliverable

HL7 Technical Directorate - It's Mission, Responsibilities, 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.

Background

The T3F began work in earnest at the Winter Working Group Meeting in January 2007. The T3F met three times face-to-face at that meeting and has held a conference call every week but one since then. The group used a number of sources in its efforts -- Strategic Initiative documents, ORC reports, work from the project life-cycle team, etc. In addition, the group has benefited greatly by having consistent attendance at its meetings from the TSC (Quinn and Hammond), the ARB (Walker) and the project life-cycle group (McCaslin), and wishes to thank each of these groups for their support.

Early on in its efforts, the T3F determined that its primary initial task was to provide a complete definition of the roles and composition of the Technical Directorate that could be adopted at the May Working Group Meeting. This would afford the opportunity to review these recommendations in Cologne and allow the Technical Directorate to be formed as rapidly as possible thereafter.

Status of this Document

The T3F regards this document as a draft of a "contract" between the Technical Directorate and the HL7 Board of Directors. It should be a "living" document that evolves as the TD evolves. It should not be replaced by a "Charter" for the Technical Directorate, but rather the Charter should be drawn from this document and evolve as this document and the TD itself evolves.

Mission

Mission Statement (Woody)

The HL7 Technical Directorate oversees and coordinates the technical effort contributed by the HL7 volunteers who make up the HL7 Working Group. Its mission is to assure that the efforts of the Working Group are focused on the overall HL7 mission established by the HL7 Board.

The Technical Directorate and the HL7 Working Group operate in such a way so as to:

• respect the contributions and ideas of the talented individuals who make up the Working Group;
• maintain an effective focus on the goals of HL7;
• assure that the all major decisions are based on consensus of the stakeholders;
• maximize sharing and "re-use" of work products between elements of the Working Group;
• use project management to assure that project goals are articulated and met;
• reduce competition and conflict between the elements of the Working Group; and
• assure that HL7 standards are developed on a solid architectural foundation that assures consistency and interoperability.

The Technical Directorate criteria for success must center around three concepts -- assuring the continuity and vitality of the HL7 volunteer-based Working Group; maintaining coherent inter-operable standards while minimizing duplication of effort; and providing sound consensus-based standards that meet the needs and schedule requirements of HL7's clients.

Success Criteria (Charlie)

The Technical Directorate will be successful if HL7 members can easily find answers to the following sorts of questions:

• What is HL7 doing in the area of xxx? Where xxx is an area of interest to a member
  • what publications exist?
  • what active projects / workitems are there?
  • what committee is responsible for that area?

• What is happening on this project?
  • When will it deliver?
  • What can I do to make that faster / more likely to deliver on time?
  • What has happened recently (is it really active?, has it delivered on schedule?) What is happening to this publication?

• How do I know what to do at a WGM?

• What is the status of a particular HL7 specification or document?
  • Who is using / plans to use this publication?
  • What feedback was received to this DSTU?
  • What change proposals are open for this publication?
  • Who maintains this document, and where do I send comments / questions
  • What is the ballot history for this document (when was it balloted, and what were the comments and resolution, and what was the ballot pool)
  • Are there any plans to produce a revision for this document?

Defining success criteria in this way shows how the TD is mandated to expose the information that is needed for the board and membership to be able to plan effectively and to support the promotion of the consensus-based products. It also underpins the importance of work reuse, and only having as many projects and committees as are needed. Finally it defines success in a way that reflects the questions that led to the formation of the TD.

Responsibilities (Virginia)

(draft based on editing of Charlie's/and Woody;'s edit of the strat initiatives. also based on Woody's mission. Also includes pulling forward TSC responsibilities from Bylaws and Policies and Procedures.)

Oversees execution of standards development

Assures that the efforts of the Working Group (WG) is effectively focused on accomplishing the product and services strategy set forth by the board.

• Participates in development of an HL7 Product and Services strategy for adoption by the HL7 Board
• Oversees the TD sub-groups in the establishment and management of projects and project teams to accomplish the product and services strategy set by the Board. To that end, it works through the sub-groups to:
  • Approve new work groups based on priority projects
  • Dissolve work groups no longer required based on the HL7 Products and Services strategy
  • Works with sub-groups to align and prioritize projects in accordance with the products and services strategy
  • Working with the subgroups, helps to ensure the availability of project resources
    • helps with resource provision (people, rooms, tools, etc)
    • includes ensuring the continuity, vitality, and effectiveness of the HL7 volunteer-based Working Group
• Approve, monitor, and perhaps intervene in overall product development
  • Works with the sub-groups and the PMO to oversee the tracking of projects to meet HL7 objectives. The sub-groups will function to assure that they or the committees under them set milestones, monitor and ensure that quality assurance has been done
• Performs top-level review and authorizations as specified in the formal development process:
  • Working with the subgroups, reviews, approves, and prioritizes requests for new projects.
  • Working with the subgroups, recommends project probation or dissolution to the Board
  • Sets remit for ARB and project office and serves as escalation point for issues not resolved at commitee or subgroup level.
  • ensures that quality checks in the project development process are satisfied.
  • Reviews and approves requests from Technical Committees to initiate a ballot and serves as escalation point for ballot response handling.

Provides a Coherent Architecture and Development Process

Establishes (or reviews) the Technical Architecture, the development methodologies, and the work processes to be used by the WG in developing HL7 consensus-based standards specifications

• has overall responsibility for the development and adherence to an HL7 Technical Architecture and the development, maintenance, and execution of an HL7 standards development process
  • working through sub-groups, makes sure that architecture and process is developed, communciated (documented, etc), maintained and enhanced.
    • through Committees such as MnM, Vocabulary, and PIC as well as the ARB.
• defines and manages international harmonization mechanism
• ensures that the balloting of any HL7 specification, or portion thereof, is carried out in accordance with HL7

Bylaws and ANSI rules.

Oversees the technical operations of the Working Group

Assures that the WG works smoothly together and covers the work scope in a consistent manner.

• Ensures that Working Group policies and procedures and bylaws are followed
  • With the subgroups, oversees execution of procedures for committee creation, dissolution, and co-chair elections.
  • ensures that meetings and calls are carried out according to policy
• Oversees continuous quality process
• Works through sub-groups to identify cross-domain and cross-function gaps, overlaps, discrepancies, potentials for collaboration, and conflicts and recommends resolution
• responsible for any official interpretation of the HL7 standards.
  • resolves conflicts within the Working Group and prioritizes resources according to project priority (example, room balancing at WGMs)
  • ensures the impartial handling of substantive and procedural

complaints regarding any action or inaction as related to the production of HL7 specifications.

Primary Communication Vehicle for the Technical Operations of HL7

Serves as technical authority of HL7, communicating status and guidelines regarding standards and operations.

• serves as technical escalation point for any questions related to the technical operations of HL7
• reports to the Board, the WGM, and the membership on Technical operations news, status, and issues as appropriate
• responsible for any official interpretation of the HL7 standards.

Composition (Woody - based on minutes)

The T3F spent several meetings deliberating the appropriate composition and style of functioning for the Technical Directorate. The 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 group of volunteer-driven Committees and SIGs that have been highly successful to both their own and HL7's credit and benefit. Simultaneously, however, as recognized in the Strategic Initiative, as the numbers of groups expanded, their breadth, number and diversity posed major challenges for coordination and collaboration between them. Discussion and debate on these 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)".

Organizing Principle

During the discussions today, 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 this 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 will 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 will undoubtedly cause the TD to consider whether to recommend that these groups be split.

Ultimately, the T3F recognized that the organization as proposed is imperfect, not by design, but by the nature of 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 focus critical organizational thinking into smaller meetings so that the work can get done.

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 TD 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, this notion of required harmonization and shared stewardship must clearly be part of the mission statement 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 committees beneath it.

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 have the following 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 other groups.

Steering Division Definition and Composition

Following on from the original document T3F proposes to divide the existing Technical Committees, Special Interest Groups and Board-appointed committees into four functional groups called Steering Divisions. The SDs will be committees in their own right made up of the Co-Chairs of the groups in their division. It is expected that each SD will meet face-to-face during each Working Group Meeting and will conduct conference calls, as needed. Specific responsibilities include:

• 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 SD Co-Chair, who will act as an alternate representative to the TD
• review proposed projects and making recommendations on same 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 on same to the TD
• identify issues within and between the SDs and their committees and propose solutions 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)

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. TD will also approve They are, for the most part functioning on volunteer effort, although each has strong support from a designated staff liaison. The primary feature of these committees is that their projects provide direct support to the other committees of the Working Group that enables the remaining committees to function efficiently.

• Education
• Electronic Services
• Implementation
• Marketing ????
• Process Improvement Committee (PIC)
• 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 (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 be named to the TD.

Composition and Functioning of TD

Composition Chart for Technical Directorate

Note: In the final this should be an in-line diagram

Remains to be extracted from minutes. Include:

1. Tabulate the membership, as represented in the chart
2. Election process and timing for SD and Affiliate reps
3. TD appointed positions
4. Election of TD Chair
5. Decision making and Consensus Decisions
6. Terms
7. Other?

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."

Relationships (Woody - based on minutes)

Clearly, with the central role that the Technical Directorate will play within HL7 demands an understanding of the relationships of that group to the rest of HL7. To this end, the T3F has created:

Chart of TD Relationships within HL7

(Note: This chart should appear "in-line" in the final report]

The Technical Directorate (TD) and its four Steering Divisions (SD) are shown in relationship to the Board of Directors (BOD) on the right. The TD and SDs make up the "Working Group" of HL7, and the relationships between them are discussed in the earlier sections of this document.

The left hand portion represents the employees of HL7 and the Staff of AMG, and these relationships are shown for example here and are not considered further in this report.

The committees and SIGs that make up three of the four SDs are entirely made up of volunteers and are formed by petition to and approval of the TD. (At present by the TSC.) The fourth SD, the Support Services Steering Division (OT on the chart) is made up of committees appointed by the TD, chaired by a volunteer, but made up of a mix of volunteers, employees and staff. Hence, they sit on the boundary between the Employees and Volunteers, as do the Board-appointed committees.

The most critical concept exposed by this chart, is that the TD, SDs and committees on the right, and the Staff and Employees on the left cannot be successful in their endeavors without robust productive collaboration between them. HL7 has always been fortunate to have minimal contention and maximum cooperation between its employees, staff and volunteers, and this T3F report is predicated on the continuation of that relationship.

Tactical Plan to Establish Technical Directorate (Craig)

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.
• Division of committees into 4 Steering Divisions (SDs).

June through August 2007

• Three weeks for nominations. (open June 5; close June 24)
• Three weeks for election of SD leadership. (close July 15)
• Three weeks for nomination affiliate representative election. (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 straws.

QUESTIONS:

Do we need any changes to HL7 bylaws or other binding documents to allow the creation of the TD?

When do we expect to have a CTO?