HL7 STRATEGIC INITITIVES AND IMPLEMENTATION PROPOSAL
July 26, 2006
HL7 STRATEGIC INITIATIVES
AND
IMPLEMENTATION PROPOSAL
July 26, 2006
TABLE OF CONTENTS
Executive Summary......
Methodology......
Strategic Initiatives and Proposed Implementation......
New Business Model and Organizational Structure......
Task......
Rationale......
Implementation Actions......
Organization Structure......
Executive Staff......
Board of Directors......
Technical Directorate......
Technical Steering Committee......
Internationalization......
Membership......
Voting on Standards......
Meetings......
Voting for HL7 Elected Positions......
New Business Model......
Financial Plan......
Product and Services Strategy......
Task......
Rationale......
Implementation Actions......
HL7’s Products......
Optimize Volunteers and Resources......
Task
Rationale
Implementation Actions......
Brand Hierarchy and Communications Strategy......
Task......
Rationale......
Implementation Actions......
Staffing......
HL7 Brand......
Website......
Outreach......
Education......
Product-oriented Project Management Approach......
Task......
Rationale......
Product-Project Lifecycle and Criteria for Proposing, Approving and Executing Projects
New Project Management Approach......
Product-Project Lifecycle Task Force......
Tooling Support of Project Activities......
Quality Testing
Task
Rationale
Elements of Quality Testing......
Quality Testing Measures
Evaluation Against Success Criteria
QC Process to Leverage Best Practices
Appendix 1:......
Strategic Initiative Task Force......
Implementation Actions Subgroups......
New Business Model and Organizational Structure......
Product and Services Strategy......
Communications and Branding......
Productivity Management and QC......
Methodology......
Appendix 2: New HL7 Global Organizational Chart......
Appendix 3: Organizational Changes: New Functions......
Appendix 4: Revenue Model and Business Plan......
Appendix 5: Proposed Increase in Membership Fees......
Appendix 6: Initial Thinking on Product and Services Strategy......
Initial Product and Services Strategy......
Product Vision......
Elements of Product Strategy......
Elements of Services Strategy......
Strategic Issues to Address......
Appendix 7: Branding and Communication Implementation Activities......
Appendix 8: Project Lifecycle on HL7 Products......
Product Sunset......
Executive Summary
In 2005 HL7 was approached by the Robert Wood Johnson Foundation (RWJ) with a proposal to fund a project with the objective of improving the efficiency of the standards development process in our organization. The HL7 Board of Directors (BoD) quickly recognized that the RWJ proposal represented an opportunity to get a new perspective on the HL7 organization and process. A Request for Proposal (RFP) was released and HL7 leadership selected a team of consultants, headed by Cherri McGrew, to lead the project.
The team met with the BoD at their annual retreat in August 2005 to set the objectives for the project. Termed the Strategic Initiatives Project, its purpose and focus was established through discussion with the BoD and the external Advisory Committee. It was determined that to position HL7 for success in the future it would be necessary to restructure the organization to:
More efficiently and expeditiously develop standards,
More effectively address long-term strategic objectives, and
Support its role at the international and affiliate level in an increasingly crowded standards/interoperability space
while maintaining the organization’s essential characteristics: open membership, consensus-based standards development, democratic election of leadership, and not-for-profit status.
The BoD approved the formation of a Strategic Initiatives Task Force (SITF) to work with the consulting team to develop a viable strategic plan including provisions for its announcement and implementation. The SITF was drawn from a broad spectrum of membership domains and functional areas. Task Force members are identified in Appendix 1.
Over the past eleven months the SITF, supported by the McGrew team, has completed significant outreach to the healthcare community; interviewed members and non-members, and collected data via an online questionnaire. From the information gathered the SITF formulated a set of strategic issues that, through a series of meetings and teleconferences, were eventually honed into seven strategic recommendations with key areas for consideration. These initiatives were presented to the BoD in March 2006 and subsequently adopted as the basis for the following proposal.
STRATEGIC INITIATIVES
- HL7 will implement a new business model and organizational structure.
- HL7 will formally approve a product and services strategy that is reviewed annually by the Board of Directors.
- HL7 will optimize the effectiveness of its volunteers and other resources.
- HL7 will develop a brand hierarchy that helps the marketplace understand the relationship of its products to each other and to the overall organization.
- HL7 will develop consistent organizational messages and a communications strategy to disseminate those messages.
- HL7 will implement a product-oriented project management approach to ensure development of high-quality standards and associated products in a committed timeframe.
- HL7 will ensure that all standards undergo quality testing at key stages of the development process.
Implementation of these initiatives will begin in August of 2006. Key activities have been identified for each strategic initiative and are presented in this report.
IMPLEMENTATION PROPOSAL
Business Model and Organization Structure
For too long HL7 existed without a well-conceived or well-communicated business plan and relied on its volunteers to promote its viability and existence. HL7 must clearly position itself as an international standards development organization; yet continue to address the various national initiatives of importance to its affiliates including the United States. HL7 will create a global HL7 and a US affiliate. To further accomplish organizational positioning and provide support for the other strategic initiatives, HL7 must institute a more effective organizational structure including a CEO, CTO, and Technical Directorate with project management capabilities, an enhanced Web presence, and greatly enhanced tooling. With operational control at the executive level, the BoD must assume responsibility for HL7’s strategic direction.
All of this will demand significantly more funding than is currently generated in support of the organization. The new business model includes a strategy for increasing membership fees to provide additional revenue. A comprehensive financial plan will be developed during transition.
Product and Services Strategy
HL7 must have a product and services strategy that both provides coherence and accommodates the stated requirements of HL7 members and industry leaders. This strategy is essential for product positioning and branding and for organizational positioning with various stakeholders. This strategy must support HL7’s commitment to have all global standards adopted internationally through ISO. It must facilitate timely delivery of standards by refining the focus of HL7’s standards work. The product and services strategy will embrace what’s become recognized as HL7’s role as the health information architecture group; supporting messaging, document exchange, and services. It will define HL7’s relationship with other Standards Development Organizations (SDOs) and certification groups. The Board is charged with completing the interim product and services strategy during the August retreat. A recommendation to re-assess V3 and its future viability will occur immediately upon approval of the strategic initiatives.
Optimize Volunteers and Other Resources
Our volunteer culture is fundamental to the organization. However, our extraordinary growth, international reach, and expanded domain coverage has taxed the limits of volunteerism as we know it. Plans to enhance the contributions of our volunteers must focus on three major issues: institutional knowledge, tools, and infrastructure support. Volunteer empowerment comes through greater leadership. HL7 must develop and implement a comprehensive approach to documenting institutional process and procedure and its dissemination through orientation, education, and mentoring of its volunteers, be they committee members or leaders. This process must facilitate the recruiting and retention of new volunteers from yet untapped sectors. Tooling must be developed or purchased to allow the volunteers to focus their efforts on contributing to the standards versus handling the mundane tasks of assembling and bringing the outcome to ballot. Tooling support necessary to achieve these objectives is addressed in the productivity section. Increased staffing support is addressed in the Organization Structure to provide for technical editing, project management, balloting and publishing.
Brand Hierarchy
AND
Consistent Organizational Messages and Communications Strategy
In the past, HL7 the organization was synonymous with HL7 the standard. The change from a single standard to multiple standards began with CCOW and Arden Syntax. What HL7 is/does was further diffused by the introduction of the Reference Information Model (RIM), Version 3, and Clinical Document Architecture (CDA). HL7 has done little to alleviate this situation. HL7 mustidentify its core products and develop a brand hierarchy that helps the marketplace differentiate the products and better relate to the organization. Having established a branding strategy, communicating it to the industry is imperative. However, HL7 must first identify its target audiences then prepare a comprehensive communications plan, using consistent communication tools, to disseminate its message to its diverse stakeholders. The three key activities identified for immediate action are: re-design of the website to enhance web presence, branding of HL7, and outreach to key constituents.
Product-oriented Project Management Approach
AND
Quality Testing
HL7 must improve its ability to produce high-quality standards and associated products necessary for supporting successful end user implementation in a shorter timeframein order to maintain its worldwide leadership position in health care information exchange. A project-focus with a well-defined project management approach will improve the predictability of timely delivery of standards that meet end user needs. These strategic initiatives address the developmental process specific to meeting the project-focused objective. Given that quality control is an inherent component of product life-cycle management, a single work group has developed a comprehensive implementation process addressing these two initiatives.
Methodology
The SITF, appointed by the BoD, worked diligently with the McGrew team from August 2005 through July 2006 to develop a set of strategic recommendations and associated implementation strategies for HL7’s future. With the support of the BoD and the involvement of various HL7 members, the SITF set up a framework, establishedthe necessary committees, and completed the strategic initiatives and proposed implementation plans. A summary of the developmental process, a list of the Strategic Initiative Task Force members, and the subgroups established to develop implementation actions appears in Appendix 1.
Strategic Initiatives and Proposed Implementation
Details of the proposed implementation plan for each strategic initiative follow. The members of the subgroups involved in developing the plans are listed in Appendix 1.
Strategic Initiative: HL7 will implement a new business model and organizational structure.
New Business Model and Organizational Structure
Task:
The new organizational structure and associated business model will:
Institute full-time executive leadership (CEO and CTO) to direct HL7 as an ongoing entity focused on standards products and services, and to serve as HL7’s point of contact for external positioning in the health care industry,
Establish new processes and procedures to implement HL7’s product and services strategy to deliver high quality standards in a timely fashion,
Create a new organizational structure that focuses on developing/implementing HL7 products,
Upgrade infrastructure and administrative support systems, and
Develop revenue sources and a funding model to support an expanded infrastructure.
Rationale:
HL7 will continue to focus its energies and resources on what it does best—the development of high-quality standards, however HL7 needs to perform its tasks with greater efficiency and a more defined user-focus. Critical components of this effort include a well-crafted vision/mission statement, strategic priorities set at the board level, resources and committees assigned to support these priorities, and an infrastructure that has the capacity and ease-of-use to support a product focus. End user input (early adopters, etc.) will be solicited for ongoing product design and improvement. As always, HL7 will continue to provide a forum and structure for domains that wish to develop healthcare standards to meet specific needs.
Implementation Actions:
Organization Structure
The keystone to the new organization is to hire full-time, executive-level staff. The CEO will be hired on a consultant arrangement immediately and the CTO position will be phased in when funds are available. The CEO, CTO, staff, and consultants will collaborate with the BoD and volunteer leaders in implementing HL7’s strategic priorities, including tasks such as managing infrastructure, publishing, project management, tooling, web presence, etc. Staff will report to the CEO or CTO depending upon the nature of the work they are hired to perform. HL7’s current Executive Director will serve as a part-time COO, and AMG staff will handle operations during the transition phase. The COO and AMG staff will report to the CEO. The CEO will re-evaluate the arrangements prior to the conclusion of the current AMG contract.
A Technical Directorate includes the volunteer leadership of key project-focused committees, the CTO, and technical staff. The Directorate will oversee project management, tooling, web presence, etc. The work of standards development will remain volunteer-driven with HL7 hiringsufficient staff to support the work of the organization as fiscal resources become available.
The new Organizational Chart is contained in Appendix 2. The objective of the overall management structure is to clarify responsibilities and streamline HL7’s ability to support business processes and functions. Part of the rationale of the new organizational structure is to improve accountability by:
Providing adequate staffing to support the volunteer functions
Defining position descriptions and staff qualification requirements
Defining management and staff accountability for revenue, cost, and quality
Clarifying reporting relationships for both staff and volunteers
A description of the new organizational functions are included in Appendix 3.
Summary responsibilities for the new executive positions, committees, and changes related to the BoD are outlined below:
Executive Staff
Responsibilities of the Executive staff will be as follows:
Chief Executive Officer
Reports to the Board of Directors
Presents the public face of HL7 global (assisted by the Board Chair and Affiliate Council leadership)
Serves as the point person for policy relationships, e.g., Office of National Coordinator (ONC), NHS, etc.
Is responsible for membership development and relations
Manages external relations and marketing
Develops annual fundraising and revenue plan and oversee implementation
Ensures the development of a communications/marketing strategy
Implements the product and services strategy in conjunction with the CTO
Develops an annual business plan based on the product and services strategy
Is responsible for the day-to-day operations of the organization
Chief Technical Officer
Reports to the CEO
Chairs the Technical Directorate
Develops, coordinates, and harmonizes a Technical Architecture
Coordinates resource allocation for priority projects
Has overall responsibility for the technical viability of HL7 specifications
- Acts on recommendations of TD, regarding gaps and overlaps
- Ensures the quality of ballots and specifications
Recommends appointments to the Technical Directorate, subject to review and approval by the BoD and the CEO
Implements the product and services strategy in conjunction with CEO
Oversees the work of staff project managers, ensuring reports on the progress of key projects and specifications
Manages other technical staff and consultants
Manages technical collaboration with other SDOs
Chief Operating Officer/Executive Director
Reports to the CEO
Manages the operational aspects of the standards development process
Implements the operations support required to implement the product and services strategy in conjunction with the CEO
Oversees the work of revenue-producing activities, public relations, internal and external communications, and marketing
Manages the annual operations budget and priorities
Board of Directors
Composition:13 members total
3 Directors being the Technical Steering Committee (TSC) co-chairs: 1 each from Foundation & Technologies, Structure and Semantic Design, and Domain Expertise, whose terms shall be concurrent with their positions
1 Director being the Advisory Committee chair, whose term shall be concurrent with his/her position
1 Director Emeritus for 5-year termwith life-time tenure (filled by majority vote of the membership when vacant)
1 Director elected to a two-year term by members of the US affiliate
1 Director elected to a two-year term by members of the North/Central/South American affiliates excluding the US
1 Director elected to a two-year term by members of the EU/African/Middle Eastern affiliates
1 Director elected to a two-year term by members of the Asia/Pacific affiliates
4 Directors-at-large to provide a balance of clinical/non-clinical, government, and top-tier member organizations elected to three-year terms by the general membership
The members of the Board shall annually designate a Chair and a Recording Secretary, who may serve no more than three consecutive terms
Roles and Responsibilities:
Set strategic direction through mission, vision, strategic priorities
Review the product and services strategy annually and revise as necessary
Review and approve the annual budget as developed by the CEO and Finance Committee
Review and approve the marketing and communication plans proposed by the CEO
Advise the CEO on external relations (new sponsors, new relationships, affiliations)
The responsibilities of the Executive Committee and Finance Committee will be subsumed by the CEO and subcommittees of the BoD.
Criteria for Board membership:
As part of the transition plan, a defined set of qualifications will be developed for Board membership
Cannot be a staff member, consultant to HL7 or anyone under contract to HL7
Strive for a balance between business, technical and clinical perspectives
Criteria will be shared with the members before call for nominees
Nominations for Director-at-large:
Any member in good standing can be nominated through a petition process to be defined by amendment to Policies & Procedures. Criteria will be a certain number of supporters representing a certain number of organizations (for example, 20 members, 10 organizations) with all appearing on the ballot. A nominating committee, will be convened to ensure that an adequate number of candidates representing a balance of constituencies are put forward for ballot. The Nominating Committee will be composed of eight members representing developers, implementers and users of HL7 products