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Original document : https://docs.google.com/document/d/17mr6V_d3dALvrF0hKr1KJJ5vIJCpBM38TmxZtjdpm28/edit?usp=sharing


Introduction

All HL7 Working Groups have been asked to adopt a common Decision Making Process (DMP) document, to which we may supply an addendum. Imaging Integration’s Decision Making Process document has deviated from the default document in a number of ways;

  • In most cases, the process is the same but the wording is different

  • In some cases, the process is different and it makes sense to adopt the default process

  • Still in other cases, the process is different and it makes sense to keep the current process

The following document outlines the differences between the standard document and the II-specific document, and then provides a new DMP document based on the specific recommendations.


Imaging Integration’s current document is described here: http://www.hl7.org/documentcenter/public/wg/imagemgt/IIWG_DMP_v2%200.docx

HL7’s default Decision Making Process is detailed here: http://www.hl7.org/documentcenter/public/procedures/Default_HL7_WG_DMP_2018.pdf


The intent is to keep the change to an absolute minimum; it shouldn’t be akin to re-writing the constitution, but more just bring the process in-line to have a standard approach across all HL7 workgroups.



Introduction 1

Side by side compare 3

1. Introduction 3

2. Open Meetings 4

2.1. Working Group Meetings (WGM) 5

2.2. Scheduled Conference Calls 5

3. Meeting Notifications 6

3.1. Meeting Agenda Notification Timing 6

3.1.1. WGM Agendas 6

3.1.2. Scheduled Conference Call Agendas 7

3.2. Out of cycle Face-to-face meetings 7

4. Decision Publication 7

4.1. Meeting Minutes 7

4.2. Electronically Recording Meetings 8

5. Quorum Requirements 8

5.1. Preponderance of Interest 8

5.2. Presiding Chair Vote 8

6. Decision Making Requirements 9

6.1. Work Group Decisions 9

6.2. Revisiting Decisions 10

7. Electronic Voting 10

8. Participation 10

8.1. General Participation 11

8.2. Statement of Position 11

8.3. Proxy Allowed – within a closed membership committee 11

8.3.1. Time-limited Proxy 11

8.3.2. Issue-limited Proxy 11

8.3.3. Proxy constraints 11

8.3.4. Proxy Notification 11

9. Roberts Rules of Order 11

Memorandum of Understanding between HL7 and DICOM 11

Proposed Newly Formulated Document 12

1       Introduction 12

2       Open Meetings 12

2.1   Working Group Meetings (WGM) 13

2.2   Scheduled Conference Calls 13

3       Meeting Notifications 13

3.1   Meeting Agenda Notification Timing 14

3.1.1  WGM Agendas 14

3.1.2  Scheduled Conference Call Agendas 14

3.2   Out of Cycle Face-to-Face Meetings 15

4       Decision Publication 15

4.1   Meeting Minutes 15

4.2   Electronically Recording Meetings 15

5       Quorum Requirements 16

5.1   Preponderance of Interest 16

5.2      Presiding Chair Vote 16

6       Decision Making Requirements 17

6.1   Work Group Decisions 17

6.2   Revisiting Decisions 17

7       Electronic Voting 17

8       Participation 18

8.1   General Participation 18

8.2   Statement of Position 18

9       Roberts Rules of Order 18

Appendix A: Imaging Integration-specific Decision Making Processes 19

A.1 Introduction 19

A.2 Meetings 19

A.3 Decisions 19

A.4 Consultation With DICOM Standards Committee 20

A.5 Memorandum of Agreement 20

Document Revision History 20

Changes to Discuss 24

Timeframe to Post Minutes 24

Defer Decisions Process 24

Specific Preponderance of Interest Rule 24

Recording change of presiding chair 25

Vested Interest 25

Definition of a consensus decision 25


Side by side compare

1. Introduction

II: a)         The Imaging Integration Work Group (IIWG, or Work Group) operates in accordance with the Memorandum of Agreement between HL7 International and the DICOM Standards Committee (MOA - see Appendix).

b)         In accordance with the MOA, the IIWG usually meets jointly with DICOM WG-20 Imaging Integration.  The two WGs have substantial overlap in membership, but are formally separate bodies.

Recommendation: Add to II-specific Appendix

II: This document is the decision-making practices of the IIWG.

Default: This document defines the decision-making practices (DMP) used by Health Level Seven (HL7) Work Groups (WG) and Committees.

Recommendation: Adopt the default language.

II: The IIWG adheres to a set of decision-making practices that ensure consensus, openness, and balance of interest.

Default: They were developed to ensure consensus, openness, and balance of interest.

Recommendation: Adopt the default language.

II: Balance of interest is related to ballot procedures; refer to the Governance and Operations Manual, or GOM (Section 14.03.03) for additional information on ballots and balance of interest.

Default: Balance of interest is related to Normative ballot procedures. (Refer to HL7 Essential Requirements: Due process requirements for HL7 American National Standards (HL7 ER) for additional information on Normative ballots and balance of interest.  §01.03 presents the ANSI position; while §02.03.03 presents the HL7 process for seeking balance in normative ballot consensus groups).

Recommendation: Adopt the default language.

II: The decision-making practices are intended to govern the standard operating procedures of the IIWG and shall not conflict with rules governing ballot procedure as defined by ANSI and the HL7 Governance and Operations Manual (GOM).

Default: The decision-making practices are intended to govern the standard operating procedures of the HL7 WGs and Committees and  not intended to conflict with rules governing ballot procedure as defined by the American National Standards Institute (ANSI), the HL7 Governance and Operations Manual (GOM), and the HL7 Essential Requirements (HL7 ER).

Recommendation: Adopt the default language.

II: f)          In accordance with the MOA, joint meetings of IIWG and DICOM WG-20 shall, at all times, be conducted within the rules of both organizations.  If, during the course of a joint meeting, a vote is taken relative to either organization’s standards, or to conduct other business specific to either HL7 or DICOM, then the relevant procedures of the respective organization shall be enforced.

Recommendation: Add to II-specific Appendix

2. Open Meetings

Default: Meetings and conference calls are open to all interested parties unless specifically restricted to members in their Mission and Charter statement.

II: Work Group meetings and conference calls are open to all interested parties.

Recommendation: Adopt the default language

Default: Unless stipulated as above, meetings of the WG or Committee are open to everyone to ensure that viewpoints of all affected parties have an opportunity to be shared and considered. Everyone will be given an opportunity to speak; however, the chair may limit discussion on topics deemed to be non-constructive.  Guests (non-members) are welcome to participate in the WG or may be invited to a Committee and are recognized as guests of HL7.

II: Meetings of the Work Group are open to everyone to ensure that viewpoints of all affected parties have an opportunity to be shared and considered.  Everyone will be given an opportunity to speak; however, the chair may limit discussion on topics deemed to be non-constructive.

Recommendation: Adopt the default language

II: Particular HL7 or DICOM members may be asked to attend to provide specific input regarding a particular issue.

Recommendation: Add to II-specific Appendix

II: In accordance with the MOA, HL7 recognizes formally appointed members of DICOM WG-20 as members of IIWG for the express purpose of participating in IIWG meetings.

Recommendation: Add to II-specific Appendix

Default: In keeping with the ANSI policy on openness, guests may participate on all matters related to the development of HL7 specifications; although they will typically only address specific questions in the course of a Committee meeting.

II: In keeping with the ANSI policy on openness, Guests may participate on all matters related to the development of HL7 specifications.

Recommendation: Adopt the default language

Default: HL7 Staff members who participate and are members of the WG or Committee Name shall have voting privileges.

Recommendation: Adopt the default language

2.1. Working Group Meetings (WGM)

Default: WGMs are held in person and may be attended by any registered WGM attendee who wishes to participate, unless the group is a closed group, per their Mission & Charter.  

Participants should introduce themselves and identify the nature of their affiliation with HL7.

II: Meetings during Working Group Meetings (WGM) may be attended by any WGM registered attendee who wishes to participate. Participants should introduce themselves and identify the nature of their affiliation with HL7.

Recommendation: Adopt the default language


2.2. Scheduled Conference Calls

Default: Scheduled or periodic conference call meetings of any open Committee or WG may be attended by anyone, consistent with HL7’s Open Meeting Policy (See Section 2).  This does not apply to closed Committees or WG, which will have closed list servers.

All meeting announcements, minutes, and other notices will be sent to the list and posted to the WG or Committee’s web page or wiki (see Section 3).  Therefore anyone expecting to participate is encouraged to join the public list so that the WG or Committee can communicate with them.

II: a) Scheduled or periodic conference call meetings may be attended by persons registered on the Work Group list server.  

b) Persons not subscribed to the Work Group list may still attend, however, all meeting announcements, minutes, and other notices will be sent to the list and posted to the Work Group’s web page or wiki (see Section 3).  Therefore anyone expecting to participate is encouraged to join the list so that the Work Group can communicate with them.

Recommendation: Adopt the default language

3. Meeting Notifications

Default: NOTE:  For consistency across WGs and Committees, Process Improvement recommends that minutes, agendas, and action items use the HL7 Work Group Meeting Minutes templates at http://www.hl7.org/permalink/?MinutesTemplate, or http://www.hl7.org/permalink/?WikiMinutesTemplate.  

Approved minutes shall be posted under the “Agenda & Minutes” section of the WG or Committee’s web page, or other HL7 hosted site hyperlinked from the “Agenda & Minutes” tab.

Recommendation: Adopt the default language

3.1. Meeting Agenda Notification Timing

NOTE: II’s 3.1 section is called “3.1 Unscheduled Meetings”, which is called out in default document’s 3.2 section. It is assumed we follow the default document’s structure.

NOTE: II’s “Meeting Agenda Notification Timing” is listed as section 3.2, it is assumed that these are the sections to be compared and become section 3.1.

Default: a) Meeting notification and the proposed agenda are provided prior to the meeting. See Sections 3.2.1and 3.2.2 below for advance notification requirements for WGM agendas vs. scheduled conference call agendas.

b) Binding decisions can be made only at quorate meetings or via electronic voting with the required advance notification: A binding decision refers to any decision made by the WG or committee that establishes a practice, formal recommendation, or formal action (e.g., creating a new program, rendering guidance, etc.).

II: a) Meeting notification and the proposed agenda are provided prior to the meeting.   

b) Binding decisions can be made only at meetings with the required advance notification where quorum is met;

i. A binding decision refers to any decision made by the committee that establishes a practice, formal recommendation, or formal action by the committee (e.g., creating a new program, rendering guidance, etc.).  

Recommendation: Adopt the default language

3.1.1. WGM Agendas

NOTE: II doesn’t have a 3.1.1 section; it instead maps onto section 3.2.1. It is assumed we follow the default document’s structure.

Default: b) Once a WG has decided to meet at a WGM, and requested rooms, any change to the plan must be communicated with ample notice, at least 30 days in advance of the meeting.  

c) The preliminary agenda is finalized and posted as required by HL7 Headquarters.  It must be hyperlinked from the WGM Information wiki page.

II: b) A preliminary agenda is developed by the end of the prior WGM and posted with the minutes following the WGM (posting deadlines are established by HL7 Headquarters; typically 5-6 weeks after the WGM).  

c) The preliminary agenda is finalized at least two weeks prior to the WGM and posted within 2 business days or as required by HL7 Headquarters.

Recommendation: Adopt the default language

3.1.2. Scheduled Conference Call Agendas

Adopt the default language (essentially the exact same)

3.2. Out of cycle Face-to-face meetings

NOTE: II’s 3.2 section is called “3.2 Meeting Agenda Notification Timing”, as noted above. II has this content in section 3.1 called “3.1 Unscheduled Meetings”. It is assumed that these are the sections to be compared and become section 3.1.

Sections are essentially word-for-word the same; recommend adopting the default language.

4. Decision Publication

4.1. Meeting Minutes

II: vi. For joint meetings of IIWG and DICOM WG-20, identification of votes on HL7 business taken under HL7 rules only, and votes on DICOM business taken under DICOM rules only.

Recommendation: Add to appendix

II: e) For joint meetings of IIWG and DICOM WG-20, the presiding co-chair may determine that minutes recorded by the DICOM Secretariat will serve as the minutes for the IIWG.

Recommendation: Add to appendix

Default: f) Minutes from a WGM session shall be posted within 2 weeks after the WGM; minutes from a conference call shall be posted within one week following the call.

II: g) Minutes from each meeting shall be posted within 30 days after the meeting, consistent with the requirements of the GOM

Recommendation: Discuss.

4.2. Electronically Recording Meetings

Sections are essentially word-for-word the same; recommend adopting the default language.

5. Quorum Requirements

Default: Quorum for an open membership WG or Committee requires that a co-chair and at least two other Work Group or Committee members be present, where no single organization or party represents more than a simple majority of the voting WG or Committee members present. Quorum for closed membership groups requires that a presiding chair (or designate) and at least half of the voting members be present.

In all cases, the presiding chair may be counted as the co-chair representing his/her constituents in the event no other co-chairs of that constituent are present.

II: A quorum for committee meetings require that a co-chair and at least two other HL7 Work Group members be present, where no single organization or party represents more than a simple majority of the voting Work Group membership for that meeting.  NOTE: The minimum number of attendees required for a quorum varies based on Work Group size, but is be no less than two in addition to the co-chair.

Recommendation: Adopt default language

Default: A motion may be made, by any member, to defer major decisions even if quorum is met, particularly if key stakeholders are not present.

II: A motion may be made, by any member, to table (defer) major decisions even if quorum is met, particularly if key stakeholders are not present.   In accordance with Robert’s Rules of Order, such a motion to table requires a second, is not subject to debate, and shall be voted upon immediately.

Recommendation: Discuss.

5.1. Preponderance of Interest

II: c) This rule shall be stringently enforced by the presiding co-chair.  A Work Group member may invoke this “Preponderance of Influence Clause” as a question of privilege under Robert’s Rules of Order, requiring the co-chair to bring the voting membership into compliance with this 50% rule. This invocation is non-debatable.

Recommendation: Discuss

5.2. Presiding Chair Vote

Default : For example: Six members are present, one of whom is the presiding co-chair.  Three others are with the same organization; the co-chair’s vote removes the majority vote of the over-represented organization and thus brings the committee into balance.

II: For example: 5 members are present, one of whom is the presiding co-chair.  Two others are with the same organization; the co-chair’s vote removes the majority vote of the over-represented organization and thus brings the committee into balance.

Recommendation: Accept default example.

Default: Note that the presiding chair can change within the course of a given session so long as a public statement recognizing the change is made and recorded in the minutes.

II: Note that the presiding co-chair can change within the course of a given session so long as a public statement recognizing the change is made.

Recommendation: Discuss

Default: d) No co-chair should preside over discussions or a vote for which they could reasonably be perceived to have a vested interest.

Recommendation: Discuss

6. Decision Making Requirements

II’s section is titled, “”Decision Threshold Requirements”. Recommend adopting default title.

6.1. Work Group Decisions

II’s document has a problem with the bulleted list; recommend correcting it (editorial).

II’s document does not have a “section 6.1”, instead, it is part of the base section 6. Recommend adopting default structure.

Default: The WGs and Committees will strive for consensus in decision-making; however, decisions of the WG or Committee are affirmed by simple majority.

II: The Work Group will strive for consensus in decision-making. To be called a consensus decision, a proposal must receive two-thirds (66%) majority support.  A variety of informal techniques may be used to determine if consensus has been reached including, but not limited to, straw poll, seeking response to a hypothetical opposing view, and polling each participant to voice their position on the issue.  

Recommendation: Discuss

II: e) Where a consensus decision is not reached the Work Group shall agree on a course of action to be followed in order that sufficient information to achieve consensus may be gathered.

f) In joint meetings of IIWG and DICOM WG-20, unless explicitly stated otherwise by the presiding co-chair, all motions shall be considered as joint motions and shall be affirmed only if affirmed according to procedures of both IIWG and DICOM WG-20.  

g) The presiding co-chair may declare that a specific decision is a matter only for HL7, or only for DICOM.   This declaration may be challenged by any member in an appeal from the decision of the chair, in accordance with Robert’s Rules of Order.  Such a motion to appeal requires a second, is not subject to debate, and shall be voted upon immediately as a joint motion, i.e., it must pass according to the procedures of both IIWG and DICOM WG-20.

h) Decisions of IIWG are affirmed by simple majority of those present and voting.

NOTE:  Decisions of DICOM WG-20 are affirmed by simple majority of those members present and voting, but with only one vote per member organization or formally appointed individual member.

i) When a formal vote is taken, the co-chair will explain the eligibility for voting, and in a joint meeting the joint decision making process.  

Recommendation: Discuss - generally include language, but note clarify the percentages.

II: k) All proposals shall be seconded by a member of an organization different from that of the proposer of the motion.

Recommendation: Add to appendix.

II has this section:

6.1 Consultation With DICOM Standards Committee

a) Prior to approval of any imaging-related HL7 standard (including foundational standards, FHIR resources, and implementation guides), or substantive change thereto, IIWG shall refer the proposed standard or change to the DICOM Standards Committee WG-06 Base Standard.  WG-06 may elect to submit the proposed standard to a formal Public Comment review by the members of the DICOM Standards Committee. The referral shall provide sufficient time for DICOM Public Comment to complete prior to the conclusion of any related HL7 Ballot.

NOTE:  The DICOM Public Comment period is 45 days.

Recommendation: Add to Appendix

6.2. Revisiting Decisions

Sections are essentially word-for-word the same; recommend adopting the default language.

7. Electronic Voting

Default: Electronic voting will be announced by one of the co-chairs on the WG or Committee list server. Co-chairs may conduct the eVote using the list server or any other tool available to them.

II: Work Group electronic votes will be announced on the Work Group list server.

Recommendation: Adopt default language

Default: The results of electronic votes are Determined as per section 6.1.

II: Electronic votes are decided by simple majority of the affirmatives and negatives.

Recommendation: Adopt default language

8. Participation

Note: II’s section 8 is called “Proxy Participation”. Given section 8 also has non-proxy participation, recommend using default structure.

8.1. General Participation

Note: II’s 8.1 section is called “Proxy Not Allowed”. It makes more sense to use the default structure. Propose moving II’s notes on proxy participation into appendix.

Default: a) Where possible, the co-chairs should accommodate schedules to ensure such representation can be present in the appropriate venue.

Recommendation: Accept default language.

8.2. Statement of Position

Note: II has essentially the exact same content in it’s 8.1.1. Recommend adopting default language and structure.

8.3. Proxy Allowed – within a closed membership committee

Note: This does not apply, as noted in the document. Recommend noting II’s position on proxy within the appendix.

8.3.1. Time-limited Proxy

Note: This does not apply, as noted in the document. Recommend noting II’s position on proxy within the appendix.

8.3.2. Issue-limited Proxy

Note: This does not apply, as noted in the document. Recommend noting II’s position on proxy within the appendix.

8.3.3. Proxy constraints

Note: This does not apply, as noted in the document. Recommend noting II’s position on proxy within the appendix.

8.3.4. Proxy Notification

Note: This does not apply, as noted in the document. Recommend noting II’s position on proxy within the appendix.

9. Roberts Rules of Order

Sections are essentially word-for-word the same; recommend adopting the default language.

Memorandum of Understanding between HL7 and DICOM

Should be added to Appendix

Proposed Newly Formulated Document


1       Introduction

This document defines the decision-making practices (DMP) used by Health Level Seven (HL7) Work Groups (WG) and Committees.  They were developed to ensure consensus, openness, and balance of interest. Balance of interest is related to Normative ballot procedures. (Refer to HL7 Essential Requirements: Due process requirements for HL7 American National Standards (HL7 ER) for additional information on Normative ballots and balance of interest.  §01.03 presents the ANSI position; while §02.03.03 presents the HL7 process for seeking balance in normative ballot consensus groups).

The practices as outlined in this document are designed to enable timely decision-making balanced with an earnest attempt to ensure that input from all affected parties is considered.  The decision-making practices are intended to govern the standard operating procedures of the HL7 WGs and Committees and not intended to conflict with rules governing ballot procedure as defined by the American National Standards Institute (ANSI), the HL7 Governance and Operations Manual (GOM), and the HL7 Essential Requirements (HL7 ER).

In the event of joint meetings, the DMP of the host WG shall be the governing document.

2       Open Meetings

All Work Groups must include this section

Groups that may hold closed meetings, where this section does not apply, are the HL7 Board of directors, the Technical Steering Committee (TSC), and committees appointed by the Board or TSC.

  1. Meetings and conference calls are open to all interested parties unless specifically restricted to members in their Mission and Charter statement.

  2. The purpose of these meetings and calls is to transact business including the resolution of design and implementation issues related to the WG’s area of responsibility or area of interest and to make decisions relevant to the their business.

  3. Unless stipulated as above, meetings of the WG or Committee are open to everyone to ensure that viewpoints of all affected parties have an opportunity to be shared and considered. Everyone will be given an opportunity to speak; however, the chair may limit discussion on topics deemed to be non-constructive.  Guests (non-members) are welcome to participate in the WG or may be invited to a Committee and are recognized as guests of HL7.

  4. Individuals may be expected to attend a particular meeting if they are key participants for an item on the agenda.

  5. Other HL7 members may be asked to attend to provide input regarding a particular issue.

  6. In keeping with the ANSI policy on openness, guests may participate on all matters related to the development of HL7 specifications; although they will typically only address specific questions in the course of a Committee meeting.

  7. HL7 Staff members who participate and are members of the WG or Committee Name shall have voting privileges.

2.1   Working Group Meetings (WGM)

WGMs are held in person and may be attended by any registered WGM attendee who wishes to participate, unless the group is a closed group, per their Mission & Charter.

Participants should introduce themselves and identify the nature of their affiliation with HL7.

2.2   Scheduled Conference Calls

Scheduled or periodic conference call meetings of any open Committee or WG may be attended by anyone, consistent with HL7’s Open Meeting Policy (See Section 2).  This does not apply to closed Committees or WG, which will have closed list servers.

All meeting announcements, minutes, and other notices will be sent to the list and posted to the WG or Committee’s web page or wiki (see Section 3).  Therefore anyone expecting to participate is encouraged to join the public list so that the WG or Committee can communicate with them.

3       Meeting Notifications

All activities shall be conducted in a public light with efforts made to ensure ample notification of those interested.  The WG or Committee shall utilize the following key mechanisms to notify interested parties of its activities

  1. WG or Committee’s listserv

  2. WG or Committee web pages under http://www.hl7.org/permalink/?WorkGroups

  3. WG or Committee wiki pages under http://www.hl7.org/permalink/?HL7Wiki.

Minimal notification requirements dictate that announcements and supporting materials shall be posted to both the listserv and the web or wiki page.  (The web page must contain a link to the wiki if agendas are posted on the wiki.)

Any use of the terms post, posted, or posting refers to notification, subject to the above constraints.

NOTE:  For consistency across WGs and Committees, Process Improvement recommends that minutes, agendas, and action items use the HL7 Work Group Meeting Minutes templates at http://www.hl7.org/permalink/?MinutesTemplate, or http://www.hl7.org/permalink/?WikiMinutesTemplate.  

Approved minutes shall be posted under the “Agenda & Minutes” section of the WG or Committee’s web page, or other HL7 hosted site hyperlinked from the “Agenda & Minutes” tab.

3.1   Meeting Agenda Notification Timing

  1. Meeting notification and the proposed agenda are provided prior to the meeting. See Sections 3.2.1and 3.2.2 below for advance notification requirements for WGM agendas vs. scheduled conference call agendas.

  2. Binding decisions can be made only at quorate meetings or via electronic voting with the required advance notification: A binding decision refers to any decision made by the WG or committee that establishes a practice, formal recommendation, or formal action (e.g., creating a new program, rendering guidance, etc.).

  3. The co-chairs of the WG or Committee shall make every attempt to ensure that all parties with an interest in agenda topics are made aware of the meeting time and location subject to the documented notification requirements and the stated openness of the Committee.  As appropriate, WG or Committee activities will be cross-posted to other HL7 lists, depending upon the topic and type of meeting as indicated in the following list. The GOM stipulates that all face-to-face meetings require at least 30 days’ notice.

3.1.1 WGM Agendas

  1. WGM schedules are posted in the meeting brochure; WG or Committee agendas are posted under WGM information at the HL7 wiki (wiki.hl7.org/index.php?title=WGM_information)

  2. Once a WG has decided to meet at a WGM, and requested rooms, any change to the plan must be communicated with ample notice, at least 30 days in advance of the meeting.  

  3. The preliminary agenda is finalized and posted as required by HL7 Headquarters.  It must be hyperlinked from the WGM Information wiki page.

  4. Recognizing the dynamic nature of the WGM, the agenda may require updates during the WGM.  Notification will be satisfied so long as at least two of the following are used:

    1. E-mail notification to the WG listserv by 6:00 pm local time the evening before the event

    2. Notification posted on the bulletin board (near the HL7 registration desk) at least 2 quarters (there are four 90-minute quarters per WGM day) prior to the event

    3. Announcement during the general session or lunch session prior to the event

    4. Announcement via the EventMobi app at the WGM at least 2 quarters prior to the event

3.1.2 Scheduled Conference Call Agendas

Scheduled conference call agendas shall be posted by close-of-business of the first business day prior to a call.

Preliminary agendas for the next conference call are to be determined at the close of each teleconference.

3.2   Out of Cycle Face-to-Face Meetings

WGs or Committees requiring face-to-face meetings between scheduled WGM sessions or conference calls have two options:

  1. An 'Out of Cycle Meeting' can be convened as defined in GOM §11.04, which requires 30 days’ notice.

  2. The issues may be discussed in an informal group, bringing forward recommendations to the list or as a discussion topic for the next regularly scheduled WGM session or conference call.   Recommendations brought forward by the informal group are not binding decisions until acted upon by the WG or Committee in regular session conforming to the notification requirements defined in Section 3.

4       Decision Publication

4.1   Meeting Minutes

  1. Minutes will be produced and published for all WGM sessions and conference calls achieving quorum (see section 5).

  2. The presiding co-chair of the meeting is responsible for ensuring that minutes are taken and posted.

  3. When quorum is not achieved, the production of minutes is at the discretion of the presiding co-chair.

  4. Minutes shall include, at a minimum, the following information:

    1. Date, time and location of the session/call

    2. List of attendees including names and organizations

    3. Identification of presiding chair (if the presiding chair changes during meeting this must be noted in the minutes.)

    4. Assertion of quorum (met or not met)

    5. A summary of discussion topics and the outcome of proposals or motions made (including vote tallies if votes were taken)

  5. Minutes shall be published on the WG or Committee’s webpage or the wiki as well as the WG or Committee’s listserv.

  6. Minutes from a WGM session shall be posted within 2 weeks after the WGM; minutes from a conference call shall be posted within one week following the call.

4.2   Electronically Recording Meetings

  1. WGs and/or Committees may decide that they wish to electronically record a session, conference call, or event through audio or video recordings.

  2. Electronic recordings will not replace the minutes or the requirements for minutes as defined in Section 4.1.

  3. Prior to starting any electronic recording, the presiding chair will seek approval from all attendees for the recording to occur and will note the acceptance by all attendees in the meeting minutes.

  4. With the approval of the WG or Committee to proceed with any electronic recording, the presiding chair will explain the method and purpose of the recording and how the recording will be used and made available.

5       Quorum Requirements

Quorum requirements differ for open and closed membership groups. Most WG and Committees are open membership. Others, like the TSC and Steering Divisions, have a defined membership.

Quorum for an open membership WG or Committee requires that a co-chair and at least two other Work Group or Committee members be present, where no single organization or party represents more than a simple majority of the voting WG or Committee members present. Quorum for closed membership groups requires that a presiding chair (or designate) and at least half of the voting members be present.

In all cases, the presiding chair may be counted as the co-chair representing his/her constituents in the event no other co-chairs of that constituent are present.

A motion may be made, by any member, to defer major decisions even if quorum is met, particularly if key stakeholders are not present.

5.1   Preponderance of Interest

  1. To ensure balanced decision-making, no single organizational interest may wield a “Preponderance of Influence” within a WG.

  2. Preponderance of Influence is defined as having one organization representing more than 50 percent of the voting WG members in session.   .

5.2      Presiding Chair Vote

  1. The presiding chair may cast a vote in only two circumstances:

    1. The presiding chair may cast a tie-breaking vote.

    2. The presiding chair may vote when that vote corrects potential preponderance of influence concerns within the WG.  For example: Six members are present, one of whom is the presiding co-chair. Three others are with the same organization; the co-chair’s vote removes the majority vote of the over-represented organization and thus brings the committee into balance.

  2. In all circumstances, the WG or Committee can have only one presiding chair, with any other co-chairs participating as regular members when not presiding.  Note that the presiding chair can change within the course of a given session so long as a public statement recognizing the change is made and recorded in the minutes.

  3. Although any issue may be discussed at any time, binding actions cannot be taken without sufficient notification (see Section 3.2) and quorum (see Section 5).  Absence of either of these conditions allows the WG or Committee to issue recommendations that must subsequently be ratified by the WG or Committee subject to satisfying constraints placed upon binding decisions.

  4. No co-chair should preside over discussions or a vote for which they could reasonably be perceived to have a vested interest.

6       Decision Making Requirements

6.1   Work Group Decisions

  1. The WGs and Committees will strive for consensus in decision-making; however, decisions of the WG or Committee are affirmed by simple majority.

  2. Any participant concerned that a given organization has undue representation or influence within a session of the WG may invoke the “Preponderance of Influence” clause (see Section 5.2).  This invocation is non-debatable.

6.2   Revisiting Decisions

  1. It is recognized that revisiting previously made decisions inhibits progress and should be discouraged.  That said, circumstances might exist that warrant re-opening discussion on a previously resolved issue.

  2. To dissuade this practice, such re-opening requires a formal motion, second, and two-thirds (66%) majority affirmative vote subject to the quorum rules in this document.

  3. For the decision to revisit a previous decision to be considered binding, advance notification as specified in Meeting Notifications (section 3) is required.

  4. The Meeting Notifications (section 3) can be waived to expedite ballot reconciliation items if the WG determines that the new discussion represents the same range of views as addressed in the original decision.

7       Electronic Voting

  1. At the discretion of the Work Group Chair or Work Group members, decisions considered outside of the WGM may be resolved electronically.

  2. Electronic voting will be announced by one of the co-chairs on the WG or Committee list server. Co-chairs may conduct the eVote using the list server or any other tool available to them.

  3. If the motion was NOT made, seconded and discussed during a quorum meeting then, the Co-chair will circulate the motion and request a second via the list service.  Once seconded there will be a period of not less than 3 days of discussion via the list server prior to the opening of the e-vote.

  4. Electronic votes will be held open for a minimum period of 1 week.  The voting period will be defined in the announcement of opening the e-vote.

  5. Quorum for electronic voting will be set at 90% of the number of attendees at the last WGM session or conference call at which quorum was achieved. Refer to Section 5 for WGM quorum requirements.  

  6. If quorum has not been achieved at the end of the announced voting period, the vote will be closed as unsuccessful due to lack of quorum.

  7. The results of electronic votes are Determined as per section 6.1.

8       Participation

8.1   General Participation

  1. Where possible, the co-chairs should accommodate schedules to ensure such representation can be present in the appropriate venue.

8.2   Statement of Position

  1. Those wishing to establish a position in writing may do so subject to the notification requirements outlined in Section 3

  2. Statements of Position received prior to or during the meeting will be shared by the presiding chair as part of the discussion on the related topic.

  3. The presiding chair has the responsibility to present these positions during relevant discussion, though they are not under any obligation to support or defend them.

  4. These statements do not carry the weight of a vote and are included as informational only for consideration by the WG.

  5. All Statements of Position received in electronic form will be included as attachments to the minutes.

9       Roberts Rules of Order

The WG or Committee shall rely upon Roberts Rules of Order in the event that formal guidance of parliamentary procedure is needed or requested.  

In the interest of ensuring the effective and active engagement of all participants, the WG or Committee shall follow its documented decision-making practices, referring to Roberts Rules of Order in the event of a question or concern.  Since Robert’s Rules of Order provides formalism for addressing almost all matters of process, this provides a “backup mechanism” of formality in the event that it is required.

It is the responsibility of the presiding chair to guide the WG or Committee to an efficient and effective outcome.  The WG or Committee shall follow, in this order of precedence, these Decision-making Practices (which cannot conflict with the HL7 Bylaws, GOM, or ER), the HL7 GOM, the HL7 ER, the HL7 Bylaws, and Roberts Rules of Order.  The established decision-making practices can refine certain policies and procedures so long as they remain in accordance with the HL7 GOM, HL7 ER, and Bylaws.

In the event that an issue arises where formality is required and no other guidance exists, Robert’s Rules of Order shall take precedence.  This provides a “common denominator” to keep in-check the power of the presiding chair and to confirm the rights of all participants and members.


Appendix A: Imaging Integration-specific Decision Making Processes

A.1 Introduction

The Imaging Integration Work Group (IIWG, or Work Group) operates in accordance with the Memorandum of Agreement between HL7 International and the DICOM Standards Committee (see A.5).

A.2 Meetings

In accordance with the MOA, the IIWG usually meets jointly with DICOM WG-20 Imaging Integration.  The two WGs have substantial overlap in membership, but are formally separate bodies.


In accordance with the MOA, joint meetings of IIWG and DICOM WG-20 shall, at all times, be conducted within the rules of both organizations.  If, during the course of a joint meeting, a vote is taken relative to either organization’s standards, or to conduct other business specific to either HL7 or DICOM, then the relevant procedures of the respective organization shall be enforced.


Particular HL7 or DICOM members may be asked to attend to provide specific input regarding a particular issue.


In accordance with the MOA, HL7 recognizes formally appointed members of DICOM WG-20 as members of IIWG for the express purpose of participating in IIWG meetings.

A.3 Decisions

For joint meetings of IIWG and DICOM WG-20, identification of votes on HL7 business taken under HL7 rules only, and votes on DICOM business taken under DICOM rules only.


For joint meetings of IIWG and DICOM WG-20, the presiding co-chair may determine that minutes recorded by the DICOM Secretariat will serve as the minutes for the IIWG.


Where a consensus decision is not reached the Work Group shall agree on a course of action to be followed in order that sufficient information to achieve consensus may be gathered.


In joint meetings of IIWG and DICOM WG-20, unless explicitly stated otherwise by the presiding co-chair, all motions shall be considered as joint motions and shall be affirmed only if affirmed according to procedures of both IIWG and DICOM WG-20.  


The presiding co-chair may declare that a specific decision is a matter only for HL7, or only for DICOM.   This declaration may be challenged by any member in an appeal from the decision of the chair, in accordance with Robert’s Rules of Order.  Such a motion to appeal requires a second, is not subject to debate, and shall be voted upon immediately as a joint motion, i.e., it must pass according to the procedures of both IIWG and DICOM WG-20.


Decisions of IIWG are affirmed by simple majority of those present and voting.
NOTE:  Decisions of DICOM WG-20 are affirmed by simple majority of those members present and voting, but with only one vote per member organization or formally appointed individual member.

When a formal vote is taken, the co-chair will explain the eligibility for voting, and in a joint meeting the joint decision making process.  


All proposals shall be seconded by a member of an organization different from that of the proposer of the motion.

A.4 Consultation With DICOM Standards Committee

Prior to approval of any imaging-related HL7 standard (including foundational standards, FHIR resources, and implementation guides), or substantive change thereto, IIWG shall refer the proposed standard or change to the DICOM Standards Committee WG-06 Base Standard.  WG-06 may elect to submit the proposed standard to a formal Public Comment review by the members of the DICOM Standards Committee. The referral shall provide sufficient time for DICOM Public Comment to complete prior to the conclusion of any related HL7 Ballot.
NOTE:  The DICOM Public Comment period is 45 days.

A.5 Memorandum of Agreement

Document Revision History


Version Number

Adoption Date

1

October 6, 2010

2

May 10, 2016


MEMORANDUM OF AGREEMENT
Regarding
Joint Meetings
of
DICOM WG-20 & HL7 IISIG


This Memorandum of Agreement shall become effective on the date written below and is between:


Health Level Seven, Inc. (“HL7”)
3300 Washtenaw Avenue, Suite 227
Ann Arbor, Michigan 48104-4261
and the


DICOM Standards Committee (“DICOM”)
c/o National Electrical Manufacturers Association
Suite 1847
1300 North 17th Street
Rosslyn, Virginia 22209

Effective Date: April 1, 2002

Statement of Purpose
HL7 has as its mission the goal of providing reliable standards for the exchange, management and integration of data that support clinical patient care and the management, delivery and evaluation of healthcare services.  HL7 encourages the creation of flexible, cost-effective approaches, standards, guidelines, methodologies, and related services for the interoperability of healthcare information systems. HL7 provides a forum for the effective and efficient communication between the constituents of the healthcare community as represented by its membership: an international community of healthcare organizations, vendors and developers of healthcare information systems, consultants and systems integrators, and related public and private healthcare service agencies.  Recognizing that complementary efforts are underway to create and extend comprehensive standards in the healthcare community, HL7 enters into agreements with other, independent, non-profit entities whose mission is to advance, nationally or internationally, the acceptance and usage of standards within healthcare. Such entities include, but are not limited to, other standards development organizations (SDO), industry associations or consortiums and other groups that share the vision of improved healthcare through standards.

The DICOM Standards Committee (DICOM) exists for the purpose of creating standards for the communication of bio-medical diagnostic and therapeutic images.  Biomedical images are created by a wide range of biomedical specialties. DICOM consists of its members and secretariat – the National Electrical Manufacturers Association (NEMA).  Membership in DICOM consists of biomedical professional organizations, manufacturing companies, trade associations, other standards developer organizations, and government agencies, worldwide that have a direct and material interest in the activities of DICOM.  Proposed standards developed by DICOM are approved by its members. Standards are published by the secretariat, but they are international in scope. DICOM is proactive in having its standards adopted by standards developing and coordinating bodies including, but not limited to, CEN, JIRA and ISO.  

To promote the coordination of their standards development activities, HL7 and DICOM agree that:
1.0 Introduction
1.1 Each party shall establish its own meeting schedules and may establish meetings with other organizations when convenient and desirable.  Each party is encouraged to work with other standards-writing organizations (such as CEN, JIRA and ISO) toward harmonization of healthcare standards.
1.2 Joint meetings between DICOM and HL7 may be scheduled where such meetings serve a common purpose and are convenient to the respective organization’s meeting schedules.
1.3 Each party to this agreement shall appoint a liaison to represent it to the other.  It is expected, although not required, that these liaisons will not only be members of HL7 but also will be formally appointed representatives (or alternates) of companies, organizations or agencies that are members of DICOM or one of its working groups.
1.4 Any projects that HL7 and DICOM propose to undertake jointly shall be clearly defined and delineated by a joint project proposal.  Such proposals must include:

  • A succinct description of the proposed project,

  • An estimate of time required and

  • A statement regarding the resources that each party is expected to contribute.

No such projects may begin until approved by both parties to this agreement.

2.0 Rights Granted
2.1 To facilitate mutual interaction, HL7 will recognize formally appointed representatives (or alternates) of companies, organizations or agencies that are members of the DICOM’s WG-20 as members of the Imaging Integration Special Interest Group (IISIG) for the express purpose of participating in IISIG meetings.  In turn, DICOM will appoint the elected officers of the IISIG as members of WG-20 and extend such privileges as that entails.
2.2 Joint meetings of IISIG and WG 20 shall be planned and managed through the cooperation of their respective officers.
2.3 Joint meetings shall, at all times, be conducted within the rules of both organizations.  If, during the course of a joint meeting, a vote is taken relative to either organization’s standards, or to conduct other business specific to either HL7 or DICOM, then, the relevant procedures of the respective organization shall be enforced.
2.4 Except for straw votes taken at joint committee meetings, DICOM members may not participate in HL7 chapter or general membership ballots unless they also hold HL7 membership.  Similarly, HL7 members may not vote on DICOM ballots unless they are also members of DICOM.
2.5 While DICOM members are encouraged to participate in HL7 technical committees or special interest groups, they may not seek leadership positions within HL7 unless they also hold HL7 membership.  Likewise, while HL7 members are encouraged to participate in DICOM working groups, they may not seek leadership positions within DICOM unless they also hold membership in DICOM.
2.6 DICOM membership does not convey free access to or the right to distribute the HL7 standard.  Likewise, membership in HL7 does not convey free access to or the right to distribute the DICOM standard.

3.0 Objectives
Through participation in joint meetings, the members of HL7 and DICOM may:

  • Contribute to the development of the HL7 Reference Information Model (RIM),

  • Propose extensions to the DICOM and HL7 standards where appropriate and

  • Develop mappings between the DICOM and HL7 standards.


4.0 Fees and Payments
4.1 Members of DICOM are encouraged to attend any HL7 sponsored events.  Fees will be assessed at the HL7 membership rate.
4.2 HL7 members may, in turn, attend any DICOM sponsored events.  DICOM membership fees shall apply to HL7 members who register through HL7 headquarters.
4.3 No monies shall be exchanged between DICOM and HL7.

5.0 Warranties
The parties hereto make no expressed or implied warranties other than those contained in this agreement.

6.0 Term and Termination
This agreement shall remain in effect until such time as either party terminates the agreement.  Either party may terminate this agreement upon 30-days written notice.

7.0 Modifications
HL7 reserves the right to propose alterations to this agreement at any time by an action of the HL7 Board of Directors.  Similarly, DICOM reserves the right to propose alterations to this agreement at any time by an action of the DICOM Standards Committee.  The other party will acknowledge within sixty (60) days the acceptance or rejection of such changes and/or amendments. In the event any such changes are unacceptable, either party may take advantage of the Termination provisions afforded above.

8.0 Miscellaneous
8.1 Nothing in this agreement shall grant ownership rights to – or any license under – the other’s Standard or Trademarks.
8.2 There will be no exchange of mailing lists or general membership information.
8.3 Each party shall comply with all relevant provisions of this agreement.
8.4 This agreement constitutes the entire agreement and complete understanding of the parties hereto.
8.5 This agreement may only be modified by a signed amendment, duly executed by both parties.

Authorized Signatures:

HEALTH LEVEL SEVEN, INC.

Sign:  __________________________

Stanley Huff, MD
Chair, HL7 Board of Directors

Sign:  __________________________

Mark McDougall
Executive Director, HL7

DICOM Standards Committee

Sign:   _________________________
David Clunie, MD
Co-Chair, DICOM Standards Cmte.


Sign:  __________________________
Lloyd Hildebrand,
Co-Chair, DICOM Standards Cmte.


Changes to Discuss

Timeframe to Post Minutes

Existing: Minutes from each meeting shall be posted within 30 days after the meeting, consistent with the requirements of the GOM

Proposed: Minutes from a WGM session shall be posted within 2 weeks after the WGM; minutes from a conference call shall be posted within one week following the call.

Is the change in timeline acceptable?

Defer Decisions Process

Existing: A motion may be made, by any member, to table (defer) major decisions even if quorum is met, particularly if key stakeholders are not present.   In accordance with Robert’s Rules of Order, such a motion to table requires a second, is not subject to debate, and shall be voted upon immediately.

Proposed: A motion may be made, by any member, to defer major decisions even if quorum is met, particularly if key stakeholders are not present.

Is the simplification acceptable?

Specific Preponderance of Interest Rule

Existing process stipulates this addition to section 5.1:

This rule shall be stringently enforced by the presiding co-chair.  A Work Group member may invoke this “Preponderance of Influence Clause” as a question of privilege under Robert’s Rules of Order, requiring the co-chair to bring the voting membership into compliance with this 50% rule. This invocation is non-debatable.

Does this need to be stipulated?

Recording change of presiding chair

Existing: Note that the presiding co-chair can change within the course of a given session so long as a public statement recognizing the change is made.

Proposed: Note that the presiding chair can change within the course of a given session so long as a public statement recognizing the change is made and recorded in the minutes.

Is it okay to require this stipulated in the minutes?

Vested Interest

Proposed: No co-chair should preside over discussions or a vote for which they could reasonably be perceived to have a vested interest.

Is it okay to require this statement?

Definition of a consensus decision


Existing: The Work Group will strive for consensus in decision-making. To be called a consensus decision, a proposal must receive two-thirds (66%) majority support.  A variety of informal techniques may be used to determine if consensus has been reached including, but not limited to, straw poll, seeking response to a hypothetical opposing view, and polling each participant to voice their position on the issue.  


Proposed: The WGs and Committees will strive for consensus in decision-making; however, decisions of the WG or Committee are affirmed by simple majority.

Is this simplification acceptable?




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