Governance Framework Overview

1. Governance Framework Overview

2. Coherent Standards – HL7’s Overarching Goal Standards Architecture – a specification of all the component parts, their relationship to each other and any precepts needed to support those relationships. Coherence – A coherent architecture is one where the definition of all components and their relationships is clear, complete, concise, correct and consistent. A goal of HL7 is to produce a coherent family of standards, each fit for an intended use, without conflict or ambiguity if implemented together. The governance section of HL7’s SAIF Implementation Guide is intended to help the organization achieve this goal.

3. Core Definitions: Precept • A precept is an authoritative rule of action. Precepts are the essence of governance because they determine who has authority to make decisions, they establish constraints for those decisions, and they prescribe consequences for non-compliance. • Precepts codify decision-making rules using: • objectives - broadly define a precept and establish its overarching responsibility, authority, and goals • policies - define specific aspects of a precept and establish decision-making constraints and consequences defined in terms of permissions, prohibitions, obligations or authorizations • standards - specify the mandatory formats, technologies, processes, actions, and metrics that people are required to use and carry out in order to implement one or more policies • guidelines - are non-mandatory recommendations and best practices

4. Core Definitions: Process A process is a collection of steps taking place in a prescribed manner and leading to an objective. A step may be associated with multiple roles. Every step shall have one or more actors.

5. Core Definitions: Roles People (and groups of people) play different roles in different circumstances. A role is a named set of responsibilities. Responsibilities are explicit behaviors or actions associated with a role. Responsibility for acting is stated as a permission, an obligation or sometimes as a prohibition to perform an act; and the conditions under which each action is valid. People must understand the intents and purposes of the precepts and they must understand and accept the responsibilities and authorities established by the precepts

6. Core Definitions: Metrics Metrics provide information that can be used to measure and verify compliance with precepts. Metrics are often measures about a process that can be derived from the observing the actions taken Metrics can also be observations of the anticipated outcome of a process to determine whether the actions were effective in achieving an objective Analyzing metrics can result in changing the precepts, the processes or some other constraining factors to improve the achievement of a goal

7. RACI Chart • RACI is an acronym made up of 4 key terms • Responsible – who performs the actions • Accountable – who approves the results of the actions • Consulted – who needs to be involved in the actions • Informed – who needs to be informed about the actions • A RACI chart is a matrix that lists people or groups (or their roles) involved in a process on one axis, the steps in a process on the other axis, and an indication of which type of participation in the process step is expected of each party (or named role) • The HL7 SAIF IG will need to use RACI charts to clarify responsibilities of Work Groups as Precepts are articulated

8. Defining Precepts • Shared understanding and agreement on: • How will decisions be made and executed? • Which decisions can be taken autonomously and which need to be made in concert? • What benefits are expected? • How will benefits be measured? • What information will need to be shared? Why? • What artifacts will be required? • What new roles and responsibilities will be needed? • What changes in processes and policies are required?

9. HL7 is a community of members representingInterdependent interests Scope of control Scope of influence Scope of interest

10. Understanding governance from an individual’s perspective • Each perspective defined by a Scope and set of Actions • Scope: Control  Actions: Manage • Scope: Influence  Actions: Participate • Scope: Interest  Actions: Monitor • As the scope becomes more “generalized”, actions become less “direct” and require more collaboration and cooperation

11. HL7 already has Precepts • Has Bylaws that must be followed • Has Governance and Operations Manual (GOM) • defines how specifications are to be developed • members follow these rules • to produce and approve specifications • Is accountable to ANSI • required to demonstrate effective governance • Has international affiliates • similar jurisdiction within their own countries

12. Precepts Partition Responsibility • Governance tasks partitioned to groups within organization • Members participate in the development of standards • representatives of varying interests in the healthcare community • specifications produced via a consensus-building process • SAIF IG will need to make governance precepts explicit • some fine-tuning of responsibilities of some groups • no radical change in the essential collaborative nature of producing consensus-based specifications • Within HL7 • Alignment and harmonization processes are part of HL7’s existing governance framework • Will need to be articulated further going forward

13. More explicit responsiblities • Work Groups serve as forums for domain experts • articulate the expectations for interoperability of their domain • Layered conformance via ECCF • Requirements artifacts  Conceptual layer • Design artifacts (e.g. RMIMs)  Logical layer • Implementable artifacts (e.g. Implementation Guides)  Implementable layer

14. Governance Processes • Definition Processes • Processes to make precepts explicit • Processes to adjust precepts as needed • Communication • Processes that use various communication channels to • inform • gain feedback • gain acceptance • Appeal • Processes to gain permission to vary from established precepts • Revitalization • Process to periodically examine effectiveness and recommend adjustments

15. SAIF Value Proposition -- Topology