Internationalization of HL7
Publication date: Sep 24, 2009
At the HL7 working group meeting this week a number of issues were discussed related to the 'internationalization' of the HL7 organization. On the one hand the work of the HL7 organization is becoming ever more global in nature, whilst on the other hand HL7 will have to ensure that its standards solve local interoperability issues.
This week a HL7 working group meeting is being held in Atlanta (US). During this meeting a number of issues came up related to the internationalization of the HL7 organization. We have an ever increasing participation from a range of countries; the HL7 organization (focused on the US for historical reasons) is catching up. Two new affiliates were approved during this meeting: HL7 Russia and HL7 Hong Kong.
The graph above shows the number of attendees (actually, the number of non-first time attendees) for the 2004-2009 timeframe. In order to remove any seasonal fluctuations in attendee numbers (the meeting in September tend to better attended than the one in May) a sliding averager was applied; each data point represents the average number of attendees during the three ‘last’ working group meetings at that particular point in time. The number of non-US attendees (in blue) is increasing in a linear fashion. The number of US attendees (in red) is slowly decreasing. US based HL7 members I spoke with mostly attribute this to the increasing amount of standardization work (e.g. CDA implementation guides) undertaken in HITSP and/or IHE.
There was also some discussion about the location of the working group meetings. The board has made a decision a couple of years ago that one of the annual working group meetings (there are three such meetings a year) will be held outside of the US. Over the past few years meetings have been held in Canada, the Netherlands, Germany and Japan. In May 2010 the meeting will be held in Rio de Janeiro (Brazil). During the meeting there was discussion about the January or May 2011 meeting to be held in Sydney (Australia). From a global perspective it is a somewhat remote location; we do however already have significant commitments from the HL7 community to attend. For 2012 Paris (France) is a candidate location.
Some of these locations have meeting venues have a different business model than that used by US hotels. Let me illustrate the different business models using some fictitious figures. Let’s assume that the meeting space required during the week would cost USD 40000 if one were to solely contract the meeting space.
A decision to increase the meeting fee for attendees at venues that use the second business model hasn’t been made yet (I’m not sure that it has been discussed at all). As long as a decision to increase the meeting fee hasn’t been taken there will be an artificial “loss/additional costs” to the international HL7 organization of (using our fictitious example) USD 40000. Increasing the meeting fee seems to be the best way to deal with this – after all the total cost of attending will be the same regardless of the business model used by the meeting venue. This’ll need to be sorted out to ensure that all countries could host a working group meeting regardless of the underlying business model.
- In the US hotels provide the meeting rooms for free provided one fills a minimum number of hotel rooms in the same hotel – the price of the room is higher than normal, the attendees that are staying in the conference hotel effectively end up paying for the meeting rooms. If we assume that conference delegates spend a total of 800 nights at the hotel, they’re effectively paying an additional USD 50 per night which goes towards the cost of the meeting rooms.
- Outside of the US one has to pay for the meeting rooms – attendees are free to book at any hotel they wish. The USD 40000 has to be financed in a different way - maybe by increasing the fee for the meeting – which is unattractive from a marketing perspective even though attendees effectively end up paying the exact same overall costs (attendee fees + hotel costs).
Klaus Veil, an active HL7 member from Australia, and former board member of HL7 International, comments on some of the internationalization issues in the video below:
The board meeting held during the WGM discussed some of the internationalization aspects as well. Amongst other things, the board has decided to refer to the global organization as “HL7 international” (instead of HL7 Inc.), and to rename the “Affiliates Council” to “International Council”. A mechanism will be established whereby a US representative will be elected to participate in this meeting. I expect the role of the International Council is likely to change. Whereas the board of HL7 International has a global focus the country organizations of the International Council will have to ensure that the actions of the board are sufficiently aligned with the requirements at the local level. The International Council has a role to play in balancing the requirement for global standards with the requirement to support local implementations.
The internationalization of HL7 impacts all sorts of things (e.g. organizational and financial) which will need much more work – the above issues show that progress is being made. The HL7 community does seem to realize that internationalization is a necessity – but not at the cost of not being able to deal with local issues. This duality is a balancing act which will take time.
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Index of columns:
- FHIR DevDays and the year in review (Dec 27, 2018)
- Creation and Curation of FHIR Profiles - process and governance (Dec 14, 2017)
- De Algemene Verordening Gegevensbescherming (AVG) in de zorg (Dutch, Sep 19, 2017)
- Impact of the GDPR on the use of interoperability standards (Jun 27, 2017)
- News from the FHIR DevDays in Amsterdam (Dec 15, 2016)
- Next XDS Release (Oct 27, 2016)
- Five years of FHIR (Aug 11, 2016)
- Interoperability projects in Ireland - FHIReland (Mar 14, 2016)
- 2016 FHIR Jedi Calendar (Jan 06, 2016)
- Top 10 HL7 videos watched in 2015 (Dec 24, 2015)
- Update from the trenches on CDA R2.1/R3 and HL7v2. (Oct 15, 2015)
- FHIR DevDays - UK GP System APIs (Sep 16, 2015)
- IHE XDS - testing and implementation tools (Aug 25, 2015)
- Most often implemented IHE Profiles (Jun 08, 2015)
- Why we sponsor the HL7 WGM (May 10, 2015)
- FHIR in Paris (Apr 21, 2015)
- Mapping HL7v2 messages to FHIR. (Apr 13, 2015)
- Analysis of CDA R2 testing tools - most requirements are neither tested nor respected. (Feb 13, 2015)
- HL7 and IHE in Sweden (Feb 08, 2015)
- 2015 FHIR Chiefs Calendar (Jan 07, 2015)
- The Merry FHIR Choir caroling the 12 Days of Christmas (Dec 09, 2014)
- Chicago FHIR Update (Oct 13, 2014)
- Internationalization of HL7 (Sep 25, 2014)
- New XDS Advanced training course on offer by IHE Services and IHE Academy (Jul 14, 2014)
- Recent and Future developments of the DICOM standard (Mar 06, 2014)
- Top 10 HL7 videos watched in 2013 (Jan 02, 2014)
- Report from the HL7 WGM in Cambridge (Oct 16, 2013)
- Documenting the history of HL7 (Sep 03, 2013)
- Histology Lab Device Automation using HL7 version 2 (Jul 23, 2013)
- HL7 FHIR Elevator Pitch (Jul 15, 2013)
- Interoperability Standards - the no-sales pitch (Jul 09, 2013)
- HL7 UK - new landscape, new opportunities (Jun 26, 2013)
- Validation and error correction at the IHE Connectathon (Apr 25, 2013)
- CDA Implementation Guides - (not) invented here (Apr 17, 2013)
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- CDA implementation experiences in the UK (Dec 04, 2012)
- Musings on free HL7 IP (Oct 01, 2012)
- HL7 Connectathons (Sep 09, 2012)
- Renovate HL7 version 3 (Aug 03, 2012)
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- Lighting the FHIR, HL7s new major interoperability standard (Jun 15, 2012)
- Reflections on the HL7 membership model - the affiliate life cycle (Dec 28, 2011)
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- RFH (Resources for Health): HL7 version 3 taken to the next step (Aug 18, 2011)
- What's so great about the HL7 organization? (Aug 04, 2011)
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- A HL7 RIMBAA update (Apr 21, 2011)
- Timezone Hotel (Mar 29, 2011)
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- Increasing demand for IHE training courses (Dec 18, 2010)
- Context issues with the IHE QED profile (Dec 15, 2010)
- The changing role of HL7 country organizations (Jul 16, 2010)
- Implementing HL7 version 3 - the book (May 06, 2010)
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- How to lower the hurdle for HL7 v3 implementers (Jan 21, 2010)
- HL7 v3 deployment statistics (Dec 17, 2009)
- There's Trouble in Paradigm (Sep 25, 2009)
- Internationalization of HL7 (Sep 24, 2009)
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- The Next Web Conference in Amsterdam (Apr 17, 2009)
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- The HL7 Wiki reaches 2000 pages (Mar 02, 2009)
- The HL7 roadmap for CDA R3 and the CCD (Jan 17, 2009)
- HL7 Affiliates Meeting in Orlando (Jan 11, 2009)
- Swiss and Dutch HL7 News (Dec 31, 2008)
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- HL7 in Norway: a situation report (Sep 02, 2008)
- Russian whitepaper (Jul 09, 2008)
- The HL7 Interoperability Conference - IHIC 2008 (May 30, 2008)
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Ringholm bv is a group of European experts in the field of messaging standards and systems integration in healthcare IT.
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