Hello IC members.

In the last two HL7 WGM's it has become increasingly clear to me that there is a lack of clarity or consistent understanding on what it means to be developing standards intended for international adoption.  Given the HL7 is positioned as an International SDO, many of us can be forgiven for presuming that all work done within the SDO should be developed in a way that allows the specifications to be transferable to, and usable by, other countries.  However, practically speaking, it is also clear that the nature of the work being done is driven by the compelling need of participant communities to achieve strategic objectives in terms of their operational context.  Given the preponderance of member representation from the United States, combined with the incentives, directives and accompanying (welcome) funding arising from ONC, and proposed rule making by HHS, this often means the business problems to be solved have a distinctly national, rather than international, perspective to them.

While International Affiliate members play very key and supportive roles in the work being done, and while International Affiliates are able to vote on resulting work, these alone are not enough to ensure that specifications are readily "transferable" to other national realms.  There seems to be a lack of organizational guidance and "mindfulness", in some cases, about what the characteristics of a truly international standards specification should be (including both what is and is not desirable).

As a returning participant to the HL7 Architecture Review Board I have proposed a work item for the ARB notionally called "Characteristics of Realm-Transferable Standards".   This is probably not the appropriate title, perhaps it should be "Characteristics of Candidate International Standards".

Here is my ask of the IC: ARB would like to know if the International Council would like to be a co-sponsor of this PSS, and of course have the opportunity to shape and participate in the resulting project, should it be approved.

I realize this deserves more discussion by the IC, but it would be very helpful if we could have some Q&A here by our IC members on the nature of the project, its value, and how it should proceed.  I am also proposing that this be an agenda item for our WGM in Montreal in May.

Your thoughts? Ron G. Parker

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  1. Dear Ron,

    Thanks for informing us of this important initiative. HL7 Netherlands has long ago contributed to a document on localization of International Standards, which in reverse puts forward some of the key characteristics of such International or Realm-Tranferable Standards. In addition, we have created an HL7 FHIR NL Board and Validation Team to make sure NL profiles/localizations of HL7 FHIR core resources are truly compatible with the International Standard.

    Finally, on a more personal note, I have engaged in discussions on the status of the HL7 International Patient Summary as a universal realm specification and its relationship to the HL7 FHIR US core specifications adopted by, for instance, the Argonaut Project. We will have a discussion on this topic in Montreal, so make sure you are able to participate to see whether we can resolve the issue you are addressing with respect to a specific and very real topic.

    To me it seems obvious that the IC would co-sponsor such a PSS, but I'll see that it is discussed by the HL7 Netherlands Board and Core Team at our April WGM.

    Kind regards,


    1. Ron G. Parker AUTHOR

      Thanks for this comment Robert.  I am aware of a document crafted some time ago by the HL7 Affiliates on realm localisation of HL7 v3, which provides insight into those elements of a standards specification that need to be designed to be localized.  This may be what you are referring to?  

      I think your experience with adoption and localization of International standards would be incredibly valuable to the proposed work.  My proposal is to create guidance to the community, regardless of the specification "product family", that allows the HL7 community to be mindful of how specifications can be architected / engineered to support necessary localization, and also how to avoid specifications that will only work in a realm-specific workflow.

      In my opinion, the IC members will have the very best insight into how to achieve this.

      Thanks for your response.


      1. Yes, the Version 3 document was the one I was referring to. I also saw it published on the IC Confluence home page. There is also a wiki page on FHIR localization: http://wiki.hl7.org/index.php?title=Affiliate_Governance_of_Localised_FHIR_Artefacts

  2. Hi Ron, I agree that this is a good topic for discussion in Montreal and that IC should be a co-sponsor of this PSS. Robert's comments are also insightful and the indicative relationship between the IPS and Argonaut is one that many of us would like to follow closely. Do we know which Working Group will be hosting that discussion in Montreal, Robert Stegwee ?

    1. I suppose the EHR WG is hosting the IPS discussion. Robert Hausam can you confirm?

      1. Yes.  We had a discussion yesterday with Gary Dickinson and EHR WG is again offering to host IPS on Wed. Q2.  Patient Care may also be interested in hosting us (I'll check back to see if we have a quarter planned for that, as I know it was discussed).  And we will discuss it further on the IPS call today (11:00 AM EDT, 16:00 CET).

    2. Ron G. Parker AUTHOR

      On a related note, I am working actively right now to encourage a couple of Canadian initiatives to participate in demonstrations of the IPS at the May FHIR Connectathon in Montreal.  Rob and Giorgio recently presented on IPS to the HL7 Canada community and their presentation was VERY well received. It seems that this demonstration of collaboration between HL7 International and CEN 251 has real credibility.  Canada has long been challenged with achieving a consistent approach to rendering and exchanging Patient Summary information.  When those who have been trying to solve for this problem see a truly international standard that seems to be working why not just embrace that?  This sentiment is long overdue, but adopters need to have confidence that such an approach brings real value.

      1. Great to hear this reaction to the IPS presentation.

  3. David Hay  - you may be interested in this discussion and the upcoming session in Montreal.

  4. Indeed. I shall try to attend...