HL7 International Mentoring CommitteeHL7 Working Group Meeting, Atlanta, GA, USA

2013-05-05(Atlanta 2 room)

Sunday Q4

Listserv: internationalmentors@lists.HL7.org

Attending: John RITTER; IMC co-chair; scribe; johnritter1@verizon.net Diego KAMINKER; IMC co-chair; diego.kaminker@kern-it.com.ar ;

kaminker.diego@gmail.com John GACHAGO; john.gachago@gmail.com Mwenda GITONGA; mgitonga@futuresgroup.com; Futures Group (Juma) Ali KARISA; jkarisa@futuresgroup.com; Futures Group Donna MEDEIROS; donna_d_medeiros@yahoo.com ; Futures Group Stacey BERLOW; sberlow@projectbalance.com ; Futures Group Fernando CAMPOS; Fernando.campos@gmail.com ; Chair, HL7 Argentina Marivan ABRAHAO; chair@HL7.org.br ; Chair, HL7 Brazil Julio CAHIGAS; Julio@medirecpr.com ; Chair, HL7 Puerto Rico Gora DATTA; gora@cal2cal.com Ticia GERBER; tgerber@HL7.org ; HL7, Director of Global Partnership and Policy

Invited: Dr. Jorge Sanchez-Conon; President of the Board of Governance of the University of Puerto

Rico;

MOTIONS: (None)

Materials: "IMC minutes 20120909.doc" "IMC minutes 20130113.doc"

Minutes:1. The minutes of the previous two meetings (2012-09-09 and 2013-01-13) were reviewed and

accepted.

2. The IMC recently presented an update to the Board of Directors and to the International Council as follows:

AFRICA Various HL7 members have made inroads to Africa over the years, but creation of stable HL7 Affiliate organizations in Africa remains elusive. The International Mentoring Committee launched a “Healthcare IT Standards in Africa initiative” at the January 2012 HL7 Working Group Meeting to help develop awareness – and promote the adoption and use – of standards in Low and Middle Income Countries (LMICs), specifically in Africa. The IMC is currently packaging the findings of that Initiative into business-related PowerPoints and Templates for use in Africa.

KENYA New governmental mandate to use HL7 standards nationally. How best to deliver HL7 education in Kenya (since there is no HL7 Affiliate in Africa)? Considering targeting Universities to train-the-trainers (via the HL7 eLearning courses). The IMC is meeting with two invitees from Kenya at the May 2013 Working Group Meeting.

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CHILE Interest in forming an HL7 Affiliate is currently being expressed (even though the previous Affiliate was terminated a year beforehand). Requests for Standards education is being expressed in Chile.

PARAGUAY Interest in Standards education is beginning to arise in Paraguay.

HL7 Intellectual Property available at No Cost The IMC needs to codify compelling business reasons for the creation of an HL7 Affiliate (when the IP is freely available). E.g., "Create your own localizations", "Create your own education:

HL7 Plenary September 2013 The IMC is promoting a focus on Low-and-Middle-Income-Countries, Usability, and Mobile Health at the September 2013 HL7 Plenary. Such a focus would help promote the creation of HL7 Affiliates in LMICs.

3. International Council (IC) report:During the International Council on Sunday, 05 May 2013, the IMC offered a report and asked the IC to recommend IMC activities for 2013.

Figure 1 IMC Report to the International Council

Travel-related issues: Problem:

o Difficult for HL7 experts to fund their own travel in response to requests for assistance in regions where no HL7 Affiliate exists.

o Difficult for candidates to acquire sponsorship for travel to HL7 WGMs. Request:

o At the January 2013 WGM, the IMC asked International Council’s permission to research methods of identifying travel support, specifically: Unused Air Miles and Expiring "Cancelled" Flights.

Findings: Management of a "travel-support bucket" will require overhead. What would be the return-on-investment? Pros and Cons need to be defined. Oversight and governance of the travel-support bucket would need to be established that IC can live with. For example:

o Candidates must pay for their own room and meals.o A country/realm can only receive support one time.o (Other rules…)

Alternative approaches:o Identify an organization that already performs a travel-support service and ask to

be added to their list of recipients.o Promote the creation of Standards Collaborative Organizations (where HL7

participates). Travel-related resources could be collected by the SCO and shared with HL7 candidates.

o Target existing HL7 benefactors (whose organizations routinely have Cancelled-Flights-that-are-about-to-expire).

o Target travel agencies (who manage the travel of large organizations) and ask them for advice.

4. Africa and Low-and-Middle-Income-Countries (LMIC) approaches: Rather than attempt to launch an HL7 Affiliate in a certain country, it might be better to

target benefactors and collaborate with them to introduce the need for standards. That is,

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since HL7 standards are one part of the collection of standards required for a successful HIT system, a collaboration of SDOs is needed. This approach is likely to require coordinated educational offerings in order to build the capacity of the local implementers.

5. Discussion: Gora mentioned his role as co-chair of the newly-formed Mobile Health Work Group –

and its outreach in LMIC settings in Nigeria (through the creation of a framework – a set of templated approaches to Health Information Technology – that can be adapted in multiple LMIC settings). Integrating the Healthcare Enterprise (IHE) recently held an international conference in Turkey, where 21 countries attended; the focus was on LMICs.

Fernando (HL7 Argentina, Chair) mentioned that he is willing to provide educational assistance to African-related efforts through the HL7 eLearning program. (See Appendix 3, below.)

Marivan (HL7 Brazil, Chair) mentioned that it is a good, rewarding, but difficult effort to launch and sustain an HL7 Affiliate – especially using volunteer efforts. He recently had the HL7 eLearning program translated into Portuguese.

Julio mentioned the need to interact with the government, universities, and vendors in order to establish and sustain an HL7 Affiliate. Diligence is necessary to mitigate the regularly scheduled changes in governmental personnel and programs. Vendor often focus on revenue generation; universities tendency to focus on the academic and theoretic aspects of HIT, rather than the implementation and use of HIT systems. It is critically important to establish the local HL7 Affiliate's bylaws in order to provide clear and dispassionate guidance regarding the operation and interaction of the stakeholder groups.

John Gachago mentioned the critical need to introduce and implement HIT standards in Africa as a means of combating easily addressed diseases such as malaria and tuberculosis.

Ali mentioned that interoperability of EHR systems in Kenya needs to increase. He and Mwenda offered a formal presentation ("HL7 WGM - Kenya Introduction 20130505.pptx") that described the current HIT landscape and corresponding goals and activities in Kenya. Challenges include:

o Disparate information systemso Capacity buildingo Mentorshipo Community of HL7 Implementerso Developing localized Implementation Guides (of the HL7 standards).

Figure 2 Backgrounder on HIT in Kenya

Question: How many people (estimated) would comprise a successfully-generated (localized) capacity of HIT expert human resources? How many laboratory systems, pharmacy systems, etc., exist in Kenya? Is there a master patient list, a master "service" list, etc.? [These questions portray the need to (a priori) establish a clear understanding of the current state – and the scope of the effort that will be required. An HL7 educational plan can be generated accordingly that can support the effort.]

Ticia (HL7 Staff) helps develop HIT-related policies in various international realms. One of her goals at HL7 is to brainstorm out-of-the-box methods of garnering resources that might support capacity-building.

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6. Ongoing/Future Activities: The IMC traditionally schedules a Joint meeting at the WGMs with the Marketing

Committee and the Education Committee to request that those committees consider creating strategies and collateral that the IMC can use to perform outreach to LMICs.

7. Next Meeting The IMC will meet Sunday Q4 at the September 2013 Working Group Meeting.

8. Adjournment The meeting adjourned at 1700.

Actions Required: John Ritter: [DONE: 20130513] Send Ticia the latest "Healthcare IT Standards in Africa

initiative 20130426 draft.docx" (so that she can be updated on the IMC's Africa-related activities).

Fernando: [DONE: See Appendix 3, below] Support the creation of an eLearning program in Kenya.

Ticia: Follow up with the folks who attended the May 2013 IMC meeting regarding Kenya. Mwenda and Ali: Develop a high-level, step-by-step plan that can be used to demonstrate

iterative progress in Kenya. Diego: Lead the development of an educational plan that includes an eLearning course;

lead the dissemination of materials that may help in the creation of an HL7 Affiliate in Kenya.

Donna: Propose the creation of a Healthcare Information Technology forum (event). Marivan: Inform Beatriz Leao that it might be good to collaborate (e.g., Mozambique) on

the creation of a Healthcare Information Technology forum (event). John [DONE on 2013-05-06] Request for a room for the IMC on Sunday Q4 at the

September 2013 WGM.

< End of Meeting >

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Appendix 1IMC’s Geo-Template and Selected Efforts

Europe1) Northern Europe

a) N/A2) Western Europe3) Eastern Europe4) Southern Europe

a) Greece (Affiliated)i) Catherine Chronaki’s efforts

Africa1) Eastern Africa

a) Kenya (non-Affiliated)i) Donna Mediero’s efforts

2) Southern Africa3) Western Africa

Americas1) North America

a) Puerto Rico (Affiliated)i) Julio Cajiga’s efforts

2) Central America3) South America

Asia1) Southern Asia

a) Indonesia(non-Affiliated)i) Gora Datta’s efforts

a) India (Affiliated)i) Supten Sarbadhikari’s efforts

2) Western Asia3) Eastern Asia

Australia

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Appendix 2IMC Parking Lot

1. A new tutorial (“How to Maximize the Value of Your HL7 Involvement”) should be developed. We should collect input to the tutorial over the next six months and plan to offer the tutorial at an upcoming Working Group Meeting.

2. The IMC could showcase (say, at the registration area during each WGM) a selected Health Information Technology (HIT) topic that touches all realms. The IMC could encourage the creation of a poster area whereby the IMC, Education

Committee, and the Marketing Committee jointly target a topic. For example,o Personal Health Records –related activities that are occurring in every realm that

is currently represented by the International Councilo Patient Identificationo Use of V3 in ambulance-to-EHR communicationso ePrescribingo Patient Safetyo Decision Supporto A realm-specific topic (e.g., Africa: Challenges and Opportunities)o HL7.TV (youtube-like video) segments

The IMC could invite the attendees of the WGM to create a poster according to their own interests (with HL7 offering an HL7-store prize to the winner). Depictions of the posters could be displayed on the HL7 wiki after the HL7 WGM.

Consider targeting the first poster session for the next WGM.

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Appendix 3

From: Fernando Campos [mailto:fernando.campos@gmail.com] Sent: Thursday, May 09, 2013 6:14 PMTo: Gitonga, Mwenda; Stacey Berlow; diego kaminker; dmedeiros@futuresgroup.com; John Ritter; Melva Peters; jkarisa@futuresgroup.comSubject: HL7 Kenya Online Course

As a part of the HL7 International Mentoring Committee Efforts towards dissemination of HL7 standards in Africa, HL7 Argentina will provide an online course based on the HL7 Fundamentals course with the following subjects:

Introduction to interoperability Introduction to vocabulary Introduction to xml Introduction to V3 RIM Datatypes From the model to the message Intro to CDA CDA R2 Header body CDA implementation guides

25 scholarships for representatives from at least 4 members of these following sectors: Vendors, Consultants, Insurances Companies, University, Health care providers, and Ministry Of Health.

We will provide three slots for tutors from Kenya. All of them will be able to participate free of charge in this first edition. HL7 Argentina will provide the website and a senior tutor and a technical leader to assist with the course.

http://hl7elc.org/campus

Additionally, Kenya should begin the process to create a local HL7 Affiliate in order to be able to further expand education and HL7 standards adoption and localization.

The application form can be found here: http://www.hl7.org/documentcenter/public/wg/intl/Application%20to%20Form%20an%20HL7%20International%20Affiliate%20-%202010-01-19.doc(Applicants should be representative from 6 sectors - see above-, at least 5 organizations representing 4 of the sectors)

Kind regards,

Fernando CamposHL7 Argentina, Chair

< End of document >

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