HL7 STRATEGIC INITITIVES AND IMPLEMENTATION PROPOSAL
July 26, 2006
HL7 STRATEGIC INITIATIVES
AND
IMPLEMENTATION PROPOSAL
July 26, 2006
TABLE OF CONTENTS
Executive Summary 4
Methodology 7
Strategic Initiatives and Proposed Implementation 8
New Business Model and Organizational Structure 8
Task 8
Rationale 8
Implementation Actions 9
Organization Structure 9
Executive Staff 9
Board of Directors 10
Technical Directorate 11
Technical Steering Committee 13
Internationalization 13
Membership 14
Voting on Standards 15
Meetings 15
Voting for HL7 Elected Positions 15
New Business Model 15
Financial Plan 16
Product and Services Strategy 17
Task 17
Rationale 17
Implementation Actions 17
HL7’s Products 18
Optimize Volunteers and Resources 19
Task 19
Rationale 19
Implementation Actions 19
Brand Hierarchy and Communications Strategy 21
Task 21
Rationale 21
Implementation Actions 22
Staffing 22
HL7 Brand 22
Website 23
Outreach 23
Education 26
Product-oriented Project Management Approach 27
Task 27
Rationale 27
Product-Project Lifecycle and Criteria for Proposing, Approving and Executing Projects 28
New Project Management Approach 39
Product-Project Lifecycle Task Force 40
Tooling Support of Project Activities 41
Quality Testing 42
Task 42
Rationale 42
Elements of Quality Testing 42
Quality Testing Measures 43
Evaluation Against Success Criteria 43
QC Process to Leverage Best Practices 43
Appendix 1: 45
Strategic Initiative Task Force 45
Implementation Actions Subgroups 45
New Business Model and Organizational Structure 45
Product and Services Strategy 45
Communications and Branding 46
Productivity Management and QC 46
Methodology 46
Appendix 2: New HL7 Global Organizational Chart 48
Appendix 3: Organizational Changes: New Functions 49
Appendix 4: Revenue Model and Business Plan 51
Appendix 5: Proposed Increase in Membership Fees 53
Appendix 6: Initial Thinking on Product and Services Strategy 57
Initial Product and Services Strategy 57
Product Vision 58
Elements of Product Strategy 58
Elements of Services Strategy 59
Strategic Issues to Address 59
Appendix 7: Branding and Communication Implementation Activities 60
Appendix 8: Project Lifecycle on HL7 Products 62
Product Sunset 64
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:
Ø More efficiently and expeditiously develop standards,
Ø More effectively address long-term strategic objectives, and
Ø 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
Ø 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.
Ø 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.
Ø 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.
Ø Brand Hierarchy
AND
Ø 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 must identify 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.
Ø Product-oriented Project Management Approach
AND
Ø 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 timeframe in 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, established the 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:
Ø 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,
Ø Establish new processes and procedures to implement HL7’s product and services strategy to deliver high quality standards in a timely fashion,
Ø Create a new organizational structure that focuses on developing/implementing HL7 products,
Ø Upgrade infrastructure and administrative support systems, and
Ø 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 hiring sufficient 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:
Ø Providing adequate staffing to support the volunteer functions
Ø Defining position descriptions and staff qualification requirements
Ø Defining management and staff accountability for revenue, cost, and quality
Ø 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
Ø Reports to the Board of Directors
Ø Presents the public face of HL7 global (assisted by the Board Chair and Affiliate Council leadership)
Ø Serves as the point person for policy relationships, e.g., Office of National Coordinator (ONC), NHS, etc.
Ø Is responsible for membership development and relations
Ø Manages external relations and marketing
Ø Develops annual fundraising and revenue plan and oversee implementation