strategic initiative thoughts

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Strategic InitiativeThoughts

SITF members

Hans Buitendijk, Liora Alschuler, Ken McCaslin, Klaus Veil, Dan Russler

14 September 2006

Transformation - Transparency - TeamworkTransformation - Transparency - Teamwork

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Where did we come from?

• Drivers:– Recognized need to improve/accelerate standards development– A burgeoning organizational structure– Responsiveness to volunteers/stakeholder/PIC concerns– Request to the Board to “do something”

• Initially leading to formation of the Organizational Review Committee (ORC)

– Established January 2004– Broad representation– Identified key issues and recommendations

• Robert Wood Johnson Foundation expressed interest to explore ways to accelerate the standards development process

– Discussions started early 2005– Yielded a unique opportunity to gain new perspective on organization and

process with dedicated focus

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Strategic Initiative TaskForce

• Strategic Initiative Taskforce– Kickoff – August 2005– Multi-national, multi-faceted group of HL7 members,

staff, and consulting team

• Objectives– Create a strategy/plan to restructure the organization

to:• Establish and meet long term strategic objectives• Support role as global/international SDO while

addressing concerns of national affiliates• Develop standards more efficiently and

expeditiously– Deliverable by May 2006 WGM

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A Very Basic Premise

• Optimize the effectiveness of our core resource: the volunteers– Maintain culture of volunteerism– Global participation– Document institutional process– Identify new sources of volunteers

– Support: Comprehensive toolkit– Support: Professional/HQ staff– Support: e-Working– Support: Organization/Governance

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Problems & Solutions

Product LineConfusion over role of V2, V3; messages, documents; functional spec, interoperability

Define product line in conformance with product & services strategy

Confusion over role of HL7 relative to other SDO, professional and clinical organizations

Products & Services strategy must articulate relationship with external groups

Lack of quality in ballot material

Introduce and enforce quality measures; hire technical editor

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Priorities / Project ManagementCumbersome, hard to maintain tooling

Investing in tooling enhancements and web site/collaboration tools

Lack of a well-conceived, well-executed business plan

Develop and adopt a products & services strategy that can guide the organization

No coordination between projects, groups

Reorganize TCs & SIGs by functional area; clearly articulate harmonization processes and ownership; increase communication through TSC.

Individual work products fail to support organizational goals

Develop a Technical Directorate to lead development of HL7 Technical Architecture, set priorities among projects

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Marketing and CommunicationLack of clarity on role of HL7 in key user communities (both traditional enterprise users and new exchange communities)

Develop and promote a brand hierarchy that conforms to products & services strategy (white papers, web, etc.); hire in-house marketing expertise

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Organization/GovernanceLeadership cadre is narrow, does not reflect all constituencies. Need to ensure balance, full spectrum of users as well as developers and to recruit new talent.

Revise P&P, Bylaws: open nomination process; Revise Board of Directors drawing from different constituencies

Insufficient professional management addressing strategic, product management

Hire CEO, CTO, ½ time marketing professional; integrate w/existing operations staff (AMG)

Tension between requirements of the organization as a whole, the affiliates and the US constituency

Promote a US Affiliate and adopt an international structure for HL7 as a whole

Too driven by technology, theory; lost connection to market, users

Define market, user requirements; initiate user conferences

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Transition Planning

• Board of Directors met August 2006– Developed transition strategy– Start to identify transition team(s)– Assigned major task areas:

• Structure/Organization/Governance• Product Life Cycle/Project Management• Product & Services Strategy• Communication/Branding• Funding/Revenue Sources• Volunteer Resources

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Foundation & TechnologiesFoundation & Technologies

Structure & Semantic DesignStructure & Semantic Design

ConformanceConformanceCCOWCCOW

Infrastructure & MessagingInfrastructure & Messaging

Electronic ServicesElectronic Services

JavaJava

Modeling & MethodologyModeling & Methodology

SecuritySecurity

PublishingPublishing

ImplementationImplementation

Early AdoptersEarly Adopters

ToolsTools

Services Oriented ArchitectureServices Oriented Architecture

Domain ExpertsDomain ExpertsGovernment ProjectsGovernment Projects

Clinical Decision SupportClinical Decision Support

Arden SyntaxArden Syntax

LabLab

TemplatesTemplates

TermInfoTermInfo

Healthcare DevicesHealthcare DevicesImage IntegrationImage Integration

XMLXML VocabularyVocabulary

Structured DocumentsStructured Documents Orders and ObservationsOrders and Observations

Clinical GuidelinesClinical Guidelines

Anatomic PathologyAnatomic Pathology Emergency CareEmergency Care

AnesthesiologyAnesthesiologyCardiologyCardiology

Community Based HealthCommunity Based Health

Pediatrics Data StandardsPediatrics Data StandardsPharmacyPharmacy

Patient SafetyPatient Safety

Public Health/Emergency ResponsePublic Health/Emergency Response

Establish Harmonization ProcessesClarify Governance

Provide Project Support

AttachmentsAttachments

Clinical GenomicsClinical Genomics

Patient CarePatient Care

RCRIMRCRIM

RIMRIM

EHREHR

Personnel ManagementPersonnel Management

Financial ManagementFinancial Management

Scheduling & LogisticsScheduling & Logistics Patient AdministrationPatient Administration

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Structure/Organization/Governance

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Role of TSC

• What you will see in the SIIP Draft:– The co-chairs of the Committees and SIG’s represent the primary labor

pool and will remain the core source of technical expertise and development within HL7. The Technical Steering Committee (TSC) is the primary voice and organization belonging to this core cadre of volunteers.

– It will be re-invigorated by providing self-elected leadership and a voice on the TD and the Board.

– ... In addition to these new powers, the TSC will adopt a new routine for meetings to facilitate communication and lessen the need for joint meetings.

• Summary:• Elects own co-chairs who sit on Board of Directors• Elects 3 reps to TD• Input to slate of nominations for open election to TD• Elects 2 representatives to the Board nomination committee• Introduce more flexible meeting schedule

• How is the Board responding to these recommendations?

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Transitional Technical Task Force

• The Transitional Technical Task Force (T3F) is a forerunner of the Technical Directorate which will be brought in under the changes initiated within the 2005-2006 Strategic Initiative.

• The T3F will develop an approach that will be ratified by the Technical Directorate and endorsed by the Board of Directors.

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T3F Tasks

• Define parameters of an HL7 technical architecture including:– Relationship among HL7 technical work products

including specifications, implementation guides and tools.

– Relationship of those products to external products/standards

• Define the relationship of these products to the HL7 Products & Services strategy.

• Establish an approach to meeting new product requirements identified by the Products & Services Task Force.

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What can we expect?

• When fully defined, the Technical Directorate will ratify this approach, with the endorsement of the Board. At that time, they will address issues/questions such as, for example:– When to create a new specification and when to

constrain an existing specification?– When to use messaging and when to use a service

oriented architecture?– When to use a message and when to use a document?

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How will the T3F be formed?

• The T3F will be created at the September Plenary:– 2 members elected by the International

Affiliates (Sunday)– 3 members elected by the Technical Steering

Committee (Monday)– 1 member appointed by the Board (Tuesday)

• The Transition Team will recommend to the Board, and the Board will approve, a method and schedule to convene the T3F, latest January, 2007

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Board

• What you will see in the SIIP draft:– Nominations: 2 options – from membership or member-elected nominating committee– Composition

• 3 elected from TSC (co-chairs)• 1 from Advisory Council• 1 Emeritus (5-year term, elected)• 1 each from 3 geo groups of Affiliates• 1 from US Affiliate• 4 directors at large

– Officers: Chair, Secretary, elected by the Board

• Alternate from Governance Transition Team:– Nominations: no change– Composition: “Streamlined” Board of Directors

• 4 fewer Directors at large• 2 from Affiliates• Vice-chair replaces chair-elect• No HL7 Technical or vice-chair positions

• How will these issues be resolved?– With recommendations by the Transition Team– By the Board– In conjunction with the CEO– Ultimately reflected in changes to Bylaws and Policies & Procedures

• Member votes to adopt Bylaws• P&P is set by the Board

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Transition to US Affiliate/HL7

• What you’ll read in the SIIP Draft:– Affiliate or HL7 or joint membership– Financial obligations tbd– “The change will take place over a 3-year period ...”

• How is the Board addressing these points:– Under discussion:

• Affiliate or HL7 or joint membership• Financial obligations: developed in collaboration

with Affiliates• Transition timing recommended by Transition Team,

approved and adopted by Board in consultation with CEO

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Conclusion

• Change is happening

• Many aspects in play

• What is known:– Board is committed to the HL7 Mission– Objective is more rapid, effective standards

development

• What is unknown:– Exact form, timing of transition

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Process & Productivity

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Objectives

• HL7 will implement a product-oriented project management approach to ensure development of high-quality standards and associated products in a committed timeframe.

• All standards will undergo quality testing at key stages of the development process.

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Product-oriented Project Management Approach

Complete

HL7Product Lines (1)

Request forNew Product

Project InitiationFind resourcesFind Funding

Develop Project Plan(4)

Appropriate Approvals (2)

RequirementsDefinition(7)

Logical designMethodology

Refinement(8)

Draft Specification (9)

Prepare Final Specification,

Implementation Guidance and

Training Materials (18) Product

Sunset (3)

Request forEnhancement

QVSD

QVSD

QualityVerification /

Step Decision (QVSD)(5)

QV

SD

DSTU Ballot (10)

repeat if ballot does not pass

DSTU Validation (11)

Accelerated Revisions (12)

Produce Final Specifications

(16)

repeat DSTU process if changes warrant another verification

QV

SD

Normative Ballot (17)

repeat if ballot

does not pass

QVSD

Wider industry use of DSTU needed? (13)

Industry Use of DSTU (15)

Revised DSTU

Specifications and training

(14)

QVSD

yes

QVSD

no

AppropriateApprovalto move

Forward (6)

yes

no

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Product-oriented Project Management Product Sunset

Project InitiationFind resources

Find Funding (3a)

AppropriateApprovesto move

Forward (3b)

ReviewDocumentation

(3c)

Announceand set sunset

Date (3d)

ProductSunset (3e)

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Next Steps

• Seek your comments on Product Oriented Project Management Approach

– Peer Review and source document will be posted on the HL7 Website under Strategic Initiatives

– Email responses to [email protected] by 11/01/2006

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Volunteers

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Volunteers

• The HL7 work is done by volunteers ...– ... but many are "volun-tolds" (eg. their contribution is

driven by their organisation's goals) – HL7 recognises that its "workers" cannot be managed

the same way as a corporation or army ...

• How to "push a piece of rope"?

• HL7 is listening!!!

• Proposed approach:– Support, support, support ...– Motivation ...– Work management

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Volunteers: Support

• HL7 has and will continue to increase the professional support to its volunteer workers:– Project Management Office √– Technical Editor (in progress)– Better web-site tools for balloting √– Better web-site tools for tele-conferences √– Better web-site for collaboration (Wiki)– Better V3 tooling (Manager & Collaborative √)

• Also:– Free WiFi, First-timer Education, Co-chair Training, e-

Learning, nice locations, …

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Volunteers: Motivation

• Volunteer Recognition:– "Volunteer of the Year" √– Co-Chair recognition– Recognition of other functions: Facilitators, Editors,

TC/SIG "Secretaries", etc.

• Volunteer Recruitment:– Outline professional benefits of participation– Outline different “jobs” within HL7– Outline skills-enhancement of working in HL7

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Volunteers: Work Management

• Project Management:– Overview/information, NOT control/pressure– Project Management Office √– Project Reporting System (in progress)

• New Projects:– ... Require sufficient resources– ... Require commitment– … Have sunset mechanisms

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Wrap-Up

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Execution: Current

• Hiring Technical Editor

• Investing in Tooling

• Contracting for Web-site

• Contracting for e-learning

• Contracting project tooling

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Execution: Next Step

• Convene Transitional Technical Task Force

• Enhance TSC Org Structure

• Refine design of Technical Directorate

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Management & Coordination

• Hire CEO

• Create Product line management

• Improve Marketing Message

• Prioritize

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Strategic InitiativesA renewed HL7 on the horizon

Thank you for your attention.

QUESTIONS?