For Comment Only Ballots (Included in the Version 3 Section of This Document)

For Comment Only Ballots (Included in the Version 3 Section of This Document)


July 12, 2004

Health Level Seven will be balloting the following candidate standards/documents before the September 2004 working group meeting. Comments received in response to these ballots will be discussed at the next HL7 working group meeting, which convenes September 26 – October 1, 2004 in Atlanta, GA.

  • GELLO
  • Arden Syntax
  • Template and Archetype Architecture
  • Version 2.6
  • CDA, Release 2
  • Version 3

For Comment Only Ballots (Included in the Version 3 section of this document)

  • HL7 Version 3 Standard: Patient Administration, Release 2
  • HL7 Version 3 Standard: Therapeutic Devices, Release 1 - Implanted Cardiac Devices
  • HL7 Version 3 Standard: Care Provision, Release 1 (previously balloted under the title Patient Care)

A section is devoted to each below.

NOTE: At the request of some of our members, each ballot document now has a unique ballot Id that can be found in the text for each ballot document below. We are also updating the ballot spreadsheets. These will be made available on the balloting web site when they are ready for use, prior to a ballot opening.
The membership is also reminded that ANSI rules dictate that all individuals who were in a membership ballot pool MUST be included in the initial ballot pool when the same document goes out for a subsequent membership ballot. Thus, if a document is going out for a 2nd membership level ballot, all individuals who were in the ballot pool for the 1st membership ballot are automatically subscribed as members of the ballot pool for the 2nd membership ballot. If you do not wish to continue being in that ballot pool, removal options are available on the web site or you can send me an e-mail asking to be removed.

Finally, please note that when a ballot document is going into a ballot cycle subsequent to its first that participants will be voting only on what has changed from the previous version.

GELLO

Scheduled ballot open date: August 16, 2004

Scheduled ballot close date: September 18, 2004

Unique Ballot ID: GELLO_C2_AUG2004

The Clinical Decision Support Technical Committee announces the formation of a ballot pool for the following document:

  • GELLO: An Object-Oriented Query and Expression Language for Clinical Decision Support (2nd Committee Level, previously balloted under the name Common Expression Language Standard (code name GELLO)) - GELLO is a formalism for denoting logical and query expressions as part of the knowledge representation in a clinical decision support system. The following changes have been made since the last ballot: Changes in this release cover the removal of OCL specifications; removal of specification of GELLO as a replacement for Arden Syntax; removal of any specification of the virtual medical record, the addition of illustrative examples and conformance to typical HL7 format with an HL7 copyright.

Arden Syntax

Scheduled ballot open date: August 16, 2004

Scheduled ballot close date: September 18, 2004

Unique Ballot ID: ARDEN_V25_C1_AUG2004

The Clinical Decision Support Technical Committee and Arden Syntax Special Interest Group announces the formation of a ballot pool for the following document:

  • Arden Syntax for Medical Logic Systems, V2.5 (1st Committee Level) – Arden Syntax is a formalism for procedural knowledge representation in clinical decision support systems. Arden Syntax V2.5 is a backwards-compatible successor to Arden Syntax V2.1. This version of the Arden Syntax includes the addition of new operators and constructs to support an object-oriented data model and further structuring of the links and citations slot. An optional XML format for medical logic models is also included.

Template and Archetype Architecture

Scheduled ballot open date: August 16, 2004

Scheduled ballot close date: September 18, 2004

Unique Ballot ID: TEMPLATEARCH_C2_AUG2004

The Modeling and Methodology Technical Committee and Templates Special Interest Group announce the formation of a ballot group for the following document:

  • HL7 Template andArchetype Architecture (2nd Committee, previously balloted under the name HL7 Archetype and Template Architecture) – The Template SIG has recognized the need, as a common industry standard, to provide an integrated group of formalisms, methodology, and a repository mechanism for constraints on HL7 artifacts in general, and for clinical data specifically, in order to permit syntactic and semantic representation of complex clinical data, computer processing of the clinical data, interoperability in multiple languages, and international digital communication among information systems and human users.
    Template and Archetype Architecture will provide a common understanding of these constraints, to inform industry stakeholders (patients, providers, practitioners, payers, etc.) of Archetype and Template functions, and to provide a standard representation to describe these functions. A broad constituency including intensive outreach to industry, care providers and healthcare organizations has worked to refine the initial HL7 Archetype and Template specification as well as progress the work through initial formal representation, comparison of implementation methods and tools, registry, and evaluation of interoperability.
    Changes since the previous draft include a substantive revision and of the proposal, with (1) normative representation of HL7 RIM-based Templates in UML, (2) canonical representation of template and archetype constituents as HL7 balloted rMIM fragments with associated OCL constraints, (3) description of standard methodology within the HL7 Model Interchange Format, and (4) informative discussions of implementation (utilizing isomorphic transformations in XML, OWL, and ADL), based on input from both internal HL7 activities and external HL7 participants.
Version 2.6

Scheduled ballot open date: August 16, 2004

Scheduled ballot close date: September 18, 2004

The Control/Query, Patient Administration, Financial Management, Orders and Observations, Medical Records, Patient Care, Scheduling and Logistics, and Personnel Management Technical Committees and the Laboratory Automation, Point-of-Care Testing Special Interest Group announce the formation of ballot groups for the following v2.6 chapters (all at 1stCommittee ballot).

Global changes in v2.6 affecting all chapters include the following:

  1. A new segment - UAC - User Authentication Credential is being balloted. Like the SFT segment introduced in v2.5, this will be a change to ALL messages.
  2. The TS - Timestamp data type is being replaced by the DTM - Date/Time data type.
  3. The CE - Coded Element data type is being replaced by either the CNE - Coded with No Exceptions or the CWE - Coded with Exceptions data types.
  4. "External" tables that reference a set of coded values defined and published by another standards organization will no longer be designated as HL7 tables, although an HL7 number will be assigned. An external table may be imported into the HL7 standard subject to specific license or copyright requirements of the supplier/author. The Table Type will be "External" if HL7 does not list the values. The Table Type will be "Imported" if the code values appear in the HL7 Standard.

The CNN, NDL, LA1 and LA2 data types have been deprecated. This affects chapters 4 and 7.

  • Chapter 2 – Control – This chapter defines the generic rules that apply to all HL7 messages. This version contains updated Conformance Message Profiles to allow for annotations and table constraints. (Unique Ballot ID: V26_CH02_CONTROL_C1_AUG2004)
  • Chapter 3 – Patient Administration --The Patient Administration transaction set provides for the transmission of new or updated demographic and visit information about patients. Since virtually any system attached to the network requires information about patients, the Patient Administration transaction set is one of the most commonly used. (Unique Ballot ID: V26_CH03_PA_C1_AUG2004)
  • Chapter 4 –Order Entry – This chapter defines the Order Entry transaction set which provides for the transmission of orders or information about orders between applications that capture the order, by those that fulfill the order, and other applications as needed. An order is a request for material or services, usually for a specific patient. These services include medications from the pharmacy, clinical observations (e.g., vitals, I&Os) from the nursing service, tests in the laboratory, food from dietary, films from radiology, linens from housekeeping, supplies from central supply, an order to give a medication (as opposed to delivering it to the ward), etc. Proposed changes include data type synchronization, incorporating useful segments into existing messages, definition cleanup, order control code clarifications, introduced queries for immunizations, support for referral and shared care, and a new message type to support the national animal health laboratory network (NAHLN). (Unique Ballot ID: V26_CH04_ORDERS_C1_AUG2004)
  • Chapter 5 – Query – This chapter defines the rules that apply to queries and to their responses. It also defines the unsolicited display messages because their message syntax is query-like in nature. This version contains updated HL7 message profiles. (Unique Ballot ID: V26_CH05_QUERY_C1_AUG2004)
  • Chapter 6– Financial Management – The Financial Management chapter describes patient account transactions. The chapter contains changes to the Diagnosis and Procedure segments, including the addition of many new fields. (Unique Ballot ID: V26_CH06_FM_C1_AUG2004)
  • Chapter 7 –Observation Reporting – This chapter describes the transaction set required for sending structured patient-oriented clinical data from one computer system to another. A common use of these transaction sets will be to transmit observations and results of diagnostic studies from the producing system (e.g., clinical laboratory system, EKG system) (the filler), to the ordering system (e.g., HIS order entry, physician’s office system) (the placer). Observations can be sent from producing systems to clinical information systems (not necessarily the order placer) and from such systems to other systems that were not part of the ordering loop, e.g., an office practice system of the referring physician for inpatient test results ordered by an inpatient surgeon. This chapter also provides mechanisms for registering clinical trials and methods for linking orders and results to clinical trials and for reporting experiences with drugs and devices. Proposed changes include additions to table 0074, definition cleanup, introduction of PID-related OBX segment, message structure corrections, and support for referral and shared care. (Unique Ballot ID: V26_CH07_OBSREPORT_C1_AUG2004)
  • Chapter 8– Master Files - This chapter defines messages for synchronizing master files, those common reference files in an open-architecture healthcare environment that are used by one or more application systems. This version adds a DRG Master File message (M16). (Unique Ballot ID: V26_CH08_MF_C1_AUG2004)
  • Chapter 9 – Medical Records / Information Management -- This chapter currently supports document management. In the future, it is intended also to support the data exchange needs of applications supporting other medical record functions, including chart location and tracking, deficiency analysis, consents, and release of information. The main purpose of the medical record is to produce an accurate, legal, and legible document that serves as a comprehensive account of healthcare services provided to a patient. (Unique Ballot ID: V26_CH09_MR_C1_AUG2004)
  • Chapter 10– Scheduling – This chapter defines messages for the purpose of communicating various events related to the scheduling of appointments for services or for the use of resources. This version includes updated data types and the resolutions to the issues that were listed in the Outstanding Issues section of this chapter as provided in Version 2.5. (Unique Ballot ID: V26_CH10_SC_C1_AUG2004)
  • Chapter 11– Patient Referral - This chapter defines the messages used in patient referral communications between mutually exclusive healthcare entities. (Unique Ballot ID: V26_CH11_REFERRAL_C1_AUG2004)
  • Chapter 12 – Patient Care – This chapter defines messages to support the communication of problem-oriented records, including clinical problems, goals and pathway information between computer systems. (Unique Ballot ID: V26_CH12_PC_C1_AUG2004)
  • Chapter 13 – Clinical Laboratory Automation – This chapter specifies HL7 triggers, messages and segments required fro implementation of clinical laboratory automation communication interfaces. (Unique Ballot ID: V26_CH13_LABAUTO_C1_AUG2004)
  • Chapter 14 – Application Management – This chapter specifies messages that provide a means to manage HL7 supporting applications over a network. (Unique Ballot ID: V26_CH14_APPMGMT_C1_AUG2004)
  • Chapter 15– Personnel Management – This chapter defines a set of messages that provides for the transmission of new or updated healthcare administration information about individual healthcare practitioners and supporting staff members. This version contains new attributes to the STF and ROL segments. (Unique Ballot ID: V26_CH15_PM_C1_AUG2004)
  • Chapter 16 – Claims and Reimbursement. --This chapter contains the HL7 messaging specifications to support Claims and Reimbursement (CR) for the electronic exchange of health invoice (claim) data. The document is intended for use by benefit group vendors, Third Party Administrators (TPA) and Payers who wish to develop software that is compliant with an international standard for the electronic exchange of claim data. This is a new chapter. Previously balloted “For Comments only” as Appendix F. (Unique Ballot ID: V26_CH16_CR_C1_AUG2004)
  • Chapter 17 – Materials Management - This new chapter defines abstract messages for the purpose of communicating various events related to the transactions derived from supply chain management within a healthcare facility. This version of the ballot chapter includes inventory and sterilization messaging. This is a new chapter to the HL7 standard. (Unique Ballot ID: V26_CH17_MM_C1_AUG2004)

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Clinical Document Architecture

Scheduled ballot open date: August 16, 2004

Scheduled ballot close date: September 18, 2004

UNIQUE BALLOT ID: CDA_R2_C3_AUG2004

The Structured DocumentsTechnical Committee announces the formation of a ballot group for the following document:

  • Clinical Document Architecture, Release 2 (3rd Committee Level) – The HL7 Clinical Document Architecture is in a transition period. CDA, Release One became an ANSI-approved HL7 Standard in November 2000, representing the first specification derived from the HL7 Reference Information Model (RIM). Since then, the RIM has matured, as has the methodology used to derive RIM-based specifications. In addition, early adopters are posing new use cases for incorporation.
    The basic model of CDA, Release Two is essentially unchanged. A CDAdocument has a header and a body. The body contains nested structures (such as sections). These structures can be coded using standard vocabularies, and can contain "entries". CDA, Release One entries included such things as character data, hyperlinks, and multimedia.
    The main evolutionary steps in CDA, Release Two are that both header and body are fully RIM-derived, and there is a much richer assortment of entries to use within CDA structures. CDA, Release Two enables clinical content to be formally expressed to the extent that is it modeled in the RIM.
    CDA, Release Two takes advantage of HL7's growing expertise in creating model-based XML standards. Given the evolution of the RIM and the HL7 development methodology since November 2000, there are a number of backward compatibility issues between the new and the old CDA.

Version 3

Scheduled ballot open date: August 16, 2004

Scheduled ballot close date: September 18, 2004

The Version 3 ballot is scheduled to open no sooner than August 16 2004. The documents included in this ballot are listed below:

The Control/Query Technical Committee announces the formation of ballot groups for the following documents:

  • HL7 Version 3 Standard; Infrastructure Management, Release 1(5th Membership ballot) -- This document focuses on the development and management of the infrastructure of the V3 standard. It includes information from the Transmission Infrastructure, Control Act Infrastructure, Master File Infrastructure and the Query Infrastructure domains. Changes to this version include technical corrections and minor editorial changes based on ballot responses from membership level ballot. (Unique Ballot ID: V3_INFRA_MGMT_R1_M5_AUG2004)
  • HL7 Version 3 Standard: Shared Messages, Release 2 (1stMembershipballot) – This document provides data on common messages such as acknowledgements shared across multiple domains. (Unique Ballot ID: V3_MT_R2_M1_AUG2004)

The Financial Management Technical Committee announces the formation of ballot groups for the following documents:

  • HL7 Version 3 Standard: Claims and Reimbursement, Release 3– (1stCommittee ballot). This documents provides support for Generic, Pharmacy, Preferred Accommodation, Physician Oral Health, Vision Care and Hospital claims for eligibility, authorization, coverage extension, pre-determination, invoice adjudication, payment advice and Statement of Financial Activity (SOFA). Release 3 of this document adds claims messaging support for Physician, Oral Health, Vision Care and Hospital claims as well as changes from early adopters.(Unique Ballot ID: V3_CR_R3_C1_AUG2004)
  • HL7 Version 3 Standard: Accounting and Billing, Release 1 -- (7th Committee ballot) – Release 1 of the FIAB (Accounting & Billing) messaging includes support for account management and posting of financial transactions. This version of the document incorporates the refinements requested by commenters to the last ballot and as agreed to in the ballot reconciliation. Changes include updates to the State transition for all trigger events that are state transition based; change the A_AccountPayor (universal) and addition of a new A_AccountPayor(identified) CMET; addition of the subject Participation in the PatientAccountEvent RMIM; use of FIAB specific interaction; resolution of the Trigger Event Control Act issue with CQ; Change trigger event type from Interaction Based to State Transition Based for FIAB_TE20001; and several enhancements to the ballot narratives, state transition models and definitions. (Unique Ballot ID: V3_AB_R1_C7_AUG2004).

The Medical Records Technical Committee announces the formation of a ballot group for the following document:

  • HL7 Version 3 Standard: Medical Records, Release 1(1stUpdate) – This ballot represents an update to the current Medical Records DSTU. New functionality (including a Clinical Document Directory application role and a new Document Repudiation Trigger) have been added to the DSTU.
    If approved, this new material is incorporated into the DSTU, without extending the period for which the DSTU is viable. At the end of the DSTU period, this draft standard, revised as necessary, will undergo formal normative balloting.
    Specific changes since the last ballot include: addition of a Clinical Document Directory application role; addition of a Document Repudiation Trigger; Changes to the Document Replacement Notification Trigger, to include a status field for the superceded document; and Changes to the model to re-synchronize with evolutions in the CDA model that have occurred since this DSTU came to closure. (Unique Ballot ID: V3_MR_R1_U1_AUG2004)

The Modeling & Methodology Technical Committee announces the formation of a ballot group for the following document:

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