Strategy Challenges for HL7 Tooling

1. Strategy Challenges forHL7 Tooling John Quinn January 10, 2009

2. The Requirements • We (HL7) and its users use tooling as it relates to V3 family products for: • Balloting and Publishing the V3 Normative Version that is published each Spring. • Create CDA Implementation Guides through a templating process (e.g., CCD); • Creating V3 messaging Implementation Guides/Specifications for “programming” the interface;

3. The Users • V3 products are now much more widely used around the world than even two years ago. • Users include governments and government funded entities (e.g., NHS, CHI, Turkey, US (HITSP (CCD), US VA, US MHS). • The exact forms of use (i.e., messaging, electronic documents or services) varies as well as their approach and methodology.

4. The Users • We now have four major stakeholder-users: • NHS CfH • CDA Community • Canada Health Infoway • HITSP / US Federal Health Architecture • HL7 V3 is not being applied to any two stakeholders in the same way. No two of the stakeholders have the same problem-set or the same approach and use of HL7.

5. The Methodology • Methodologies across users vary significantly. • HL7 has an HDF Methodology that: • Is rich in describing the processes for WG project initiation and processes going forward to balloting • Is wanting in describing the process needed for users to take the Standard and produce IGs. Any growth in this area requires new user tooling that does not presently exist. • As a user, the NHS has adopted the publishing/balloting tools and methodology as the basis for producing their IGs. They have further invested significantly in enhancing the core tool (R-MIM modeler) that they now want to make available to all users via OHT.

6. HL7 Has Three Camps • The “Camps” described here are not necessarily competing. However, HL7 has limited resources (time and money) and all three “camps” combined create an oversubscription of these resources. • Also, the three “camps” are not aligned and doing all three as currently proposed would create duplicative/competitive methodologies

7. Camp 1 • The current Tooling WG’s plan: • Prioritize the balloting/publishing requirements • Focus on creating a sharable database of artifacts and ballotable pieces for shared ballot development • Make use of the NHS Static R-MIM modeling tools but maintain the use of the HL7 MIF2 Model Interchange Format • Make templating tools a next “high priority” • Eventually Move to UML-based “COTS” tools (i.e., RUP) but only after questions are resolved about: • Completeness and HL7 Developer familiarity of UML graphics vs. current Visio graphics • The HDF is upgraded to reflect the current tools (it supports neither now) • The Tooling WG is convinced that UML/XMI will communicate methodology, rules and context • Proponents are the HL7 Tooling WG with thought leadership from Woody Beeler.

8. HL7 Tactical Tooling Steps

9. Camp 2 • Closely aligned with Camp 1 except: • Templating tools must be priority 1 • Largely driven by a real need for tools and methodologies for creating CDA implementation guides. The largest world-wide real growth in the use of V3 appears to be coming from CDA implementations • Bob Dolan is the chief proponent.

10. Camp 3 • Make a “bold” move and give priority to moving the HDF and HL7 tooling rapidly to COTS UML based tooling and the methodologies that these tools can support. • Use the introduction of an HL7 Architecture (i.e., the SAEAF Services Aware Enterprise Architecture Framework) as the event to launch the development of a well documented user methodology and tools to support that methodology that could be used by “average?” HL7 users. • IBM has assisted the VA in demonstrating that the IBM Rational Unified Process (i.e., RUP) can import the current MIF2 representation of the RIM. • IBM has offered to provide restricted free access to RUP for HL7 Developers. • Chief proponent is Ioana Singureanu and has been proposed to the VA.

11. Complications • The publishing of V3 Normative Edition is fragile and out-right failed in 2007 because of this fragility. • HL7 publishing of V3 Normative Editions is at risk until new tools and methodologies are finished. • NHS, CHI, VA and others all appear to have different approaches, tool requirements and methodologies in their use of HL7 V3.

12. Tooling Tactical Plan Plan forward for current tooling addressed problem set

13. Current Publication Process July 31, 2008

15. Future Publication Process July 31, 2008

17. Current Tooling Tactical Plan

18. Still to determine • G: Vocabulary Maintenance • Gathering Requirements • Monitor OHT IHTSDO Terminology Services Project • Determine investment/development strategy • H: Standard Artifact Repository/Registry • Identify investment/collaboration opportunities • Requirements

19. Capabilities for Template Design & Registry

20. CDA Template Constraint Capabilities

21. Continuing Collaboration • Tooling Work Group to coordinate with Publishing, Electronic Services and Education Work Groups • Providing opportunity to examine tooling developed by other volunteers, Open Source projects • Continuing to collaborate with OHT