We have had a role in the development of many of the primary standards for health information interoperability over the past 15 years.

Core Clinical Information Standards:

• HL7’s Clinical Document Architecture (CDA)
• ASTM/HL7 Continuity of Care Document (CCD)
• HL7/Health Story specifications for “common document types”:

• History & Physical
• Consult
• Operative Note
• Discharge Summary
• Diagnostic Imaging Reports
• Procedure Note
• Unstructured Documents
• Progress Note
• HITSP C32/C83, etc.

Public Health and Quality Reporting:

• CDC’s National Healthcare Safety Network Healthcare Associated Infection Reporting
• HL7’s Quality Reporting Document Architecture (QRDA)
• HL7’s Healthcare Quality Measure Format (HQMF or “eMeasure”)
• CDC’s Public Health Case Reports
• AHRQ Common Format, CDA Implementation Guide
• CMS’s Minimum Data Set, CDA Implementation Guide
• FDA’s Structured Product Labeling (SPL)

Terminology

• Value sets for each of the standards listed
• SNOMED Editorial Board

Through our volunteer work with HL7 and other Standards Development Organizations, we have developed a good sense of the process for developing and expressing consensus on a HIT standard.

Eighteen of the specifications where we have led development through HL7 over the past several years have been published after a single round of balloting. We attribute this track record of success to our respect for both the consensus-driven ballot process and the underlying business requirements reflected in the standards.