SAEAFOrganizationStruct

Organization Structure Return to SAEAF Table of Contents

The following is extracted from the HL7 Strategic Initiatives and Implementation Proposal (07/26/06) presented at the BoD Retreat with revisions/comments consistent with input from the Advisory Committee, the BoD, and the Transition Team.

New Business Model and Organizational Structure=

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.

Even though the CEO, and conceivably the CTO, will be a contracted position the subsequent hiring of staff is expected to occur under the existing model, at least through the period of the current contract between HL7 and AMG. While the CEO and/or CTO may participate in the interview and selection process, ultimately the individual selected for a staff position will be employed and paid by AMG. Given this scenario, it is inappropriate to suggest that “staff will report” to the CEO or CTO. More appropriately, the CEO and/or CTO should be involved in establishing performance management objectives (PMO) for staff and contribute to staff evaluations. There is also the consideration that it would be inappropriate for line staff (technical editors, project managers, etc.) to report directly to executive management. Such direct reports would require significant time commitments by the executive involved and might prove detrimental to their own job performance. Even if staff are employed under the contract model envisioned for the CEO, they should still be under the control of AMG versus the CEO. The working relationship existent between HL7, represented by the Board of Directors (BoD), and AMG should shift to the CEO. This would literally make the CEO the boss without the need of direct staff reports. Such a change is appropriate as we shift the focus of the BoD to a strategic body setting direction for the organization. It also clarifies the relationship between AMG and the CEO, which is not one of AMG reporting to the CEO in the traditional sense.

It is sufficient to state that AMG executive management will serve as the COO. There is no reason to stipulate a “part time” position given that the COO is actually responsible for day-to-day operations. If a specific person is to be named it should probably be the Associate Executive Director since their time is dedicated to HL7.

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.

Although we are planning to restructure the Technical Steering Committee (TSC) using the ORC developed model, as yet we have not actually addressed “project-focused committees.” The proposed structure of the Technical Directorate (TD) envisions the volunteer leadership as consisting of the chairs of the three functional areas of the restructured TSC, given that the proposed structure eliminates the Technical Chair and Vice Chair in favor of a CTO. To suggest the inclusion of the co-chairs of “project-focused committees” will eventually lead to a top heavy and bloated TD reminiscent of the current TSC. Let’s stick to the original vision for the TD and keep it lean and responsive.

To say “the work of standards development will remain volunteer driven” sends the wrong message in that it implies business as usual. In fact we are attempting to take “the work of standards development” off our volunteers’ shoulders so they may focus their domain expertise on the content of the standard. The work of standards development (editing, publishing, etc) becomes the purview of the TD.

The new Organizational Chart is found 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 is 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 oversees 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

The CEO is not and should not be responsible for day-to-day operations. He or she could not hope to accomplish the list above if bogged down by daily operations. Daily operations are now and should remain the purview of AMG staff under the supervision of the Chief Operating Officer.

Chief Technical Officer

• Reports to the CEO: The reporting structure needs to be clarified in the context of both being contractual employees.
• Chairs the Technical Directorate: “Chairs” may convey the perception of the Technical Directorate as the next iteration of TSC evolution versus an organization responsible for standards development, publication, and distribution. The Technical Directorate was not conceived as a consensus oriented organization. Its members will have assigned tasks/responsibilities and will be held accountable for meeting objectives. “Leads” the Technical Directorate seems to more appropriately express the responsibilities of the CTO.
• Develops, coordinates, and harmonizes an HL7 Technical Architecture
• Coordinates resource allocation for priority projects: The CTO must first develop a protocol for the prioritization of projects and the subsequent allocation of resources.
• 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

There is no clear statement of what appointments will be made to the TD. The only volunteer members of the Technical Directorate are the TSC group chairs elected by the TSC. If appointed positions are to be defined for the Technical Directorate, they should not be at the discretion of or require the approval of the BoD. Such action would serve only to perpetuate the BoD as an operational committee versus the strategic body it is intended to become. If certain appointed positions within the Technical Directorate are subsequently identified, they should be at the discretion of the CTO and ratified by the CEO and COO.

• 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

What does the term “technical” contribute to this phrase? Is there the suggestion that someone else would manage non-technical collaboration? Simply “Manages collaboration with other SDO” should suffice.

Chief Operating Officer/Associate Executive Director

• Reports to the CEO in the context of the relationship between the CEO and AMG
• 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
• Responsible for the day-to-day operations of the organization

Board of Directors

Composition-Proposed: 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 term with 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

It is the consensus of the Advisory Committee, selected Affiliate Chairs and the current BoD that such a drastic change to the governance model is unnecessary and could prove disruptive. The following alternative is proposed:

Composition-Alternate: 10 voting members, 3 ex officio members

• Chair
  • Nominated from among the members of HL7
  • Elected by the members of HL7 and the Affiliates, each to be considered the equivalent of an HL7 organizational member casting the number of votes allowed by their Affiliate Charter
  • A four year commitment equivalent to a single term; the first and fourth year seated as the Vice Chair
  • Member of the Executive Committee
• Vice Chair
  • Otherwise known as the “chair elect” or “immediate past chair”; the first and fourth years of the commitment to the Chair
  • If seated as the immediate past chair, may be designated Chair Pro Tem pending new elections should the Chair resign of be otherwise unable to fulfill the office
  • If seated as the immediate past chair, may be nominated for Chair as this would not represent consecutive terms.
  • If seated as the chair elect, may assume the Chair should the Chair resign or be otherwise unable to fulfill the office
  • Member of the Executive Committee
• Secretary
  • Nominated from among the members of HL7
  • Elected by the members of HL7 and the Affiliates, each to be considered the equivalent of an HL7 organizational member casting the number of votes allowed by their Affiliate Charter
  • To serve a three year term with no more than two consecutive terms
  • Member of the Executive Committee
  • Chair of the Bylaws/Policy and Procedure Review (BPR) Committee
• Treasurer
  • Nominated from among the members of HL7
  • Elected by the members of HL7 and the Affiliates, each to be considered the equivalent of an HL7 organizational member casting the number of votes allowed by their Affiliate Charter
  • To serve a three year term with no more than two consecutive terms
  • Member of the Executive Committee
  • Chair of the Finance Committee
• 4 Directors at Large
  • Nominated from among and elected by the members of HL7
  • Two to be elected in even numbered years and two to be elected in odd numbered years
  • To serve two year terms with no more than three consecutive terms
• 2 Directors at Large
  • Nominated from among and elected by the Affiliates, each to be considered the equivalent of an HL7 organizational member casting the number of votes allowed by their Affiliate Charter
  • One to be elected in even numbered years and one to be elected in odd numbered years
  • To serve two year terms with no more than three consecutive terms
• Chief Executive Officer
  • Ex officio member
  • Chair of the Executive Committee
  • Member of the Finance Committee
  • Chair of the Advisory Committee
• Chief Technology Officer
  • Ex officio member
  • Member of the Finance Committee
  • Interim to selection of the CTO, the co-chairs of the TSC shall appoint one of their fellows to fill the seat
• Chief Operating Officer/Associate Executive Director
  • Ex officio member
  • Recording Secretary of Executive Committee
  • Member of the Finance Committee

Roles and Responsibilities:

• Meet three times annually in conjunction with HL7 Working Group Meetings to conduct business as designated by the Chair
• Respond to call from Chair for special business meeting, which may be conducted telephonically
• Conduct an Annual Retreat, to be scheduled by the Chair, to
  • Establish organizational focus through mission, vision, and strategic priorities
  • Review the product and services strategy and revise as necessary
  • Ratify the marketing and communication plans proposed by the CEO
• Ratify the annual budget as developed by the CEO and Finance Committee
• Advise the CEO on external relations (new sponsors, new relationships, affiliations)
• The Executive Committee and Finance Committee will work closely with the CEO to implement the strategic direction established by the BoD

Criteria for Board membership:

• The transition plan shall cause a defined set of qualifications for nomination to the Board to be developed which will include
  • The exclusion of staff members, consultants or others under contract to HL7
  • Stipulation of member in good standing
  • Some reference to a required period of membership
  • Some reference to experience in HL7 TC or SIG leadership
• Strive for a balance between business, technical and clinical perspectives (This criteria should be eliminated as it puts an undue burden on the nominations committee and may lead to the exclusion of otherwise qualified candidates)
• 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

• 2 members elected by the Advisory Committee
• 2 members elected by the TSC
• 4 members elected at-large from a pool of candidates meeting the same criteria as required to be nominated for a committee co-chair; primarily being a member in good standing and an active member of any given committee

This is an unworkable proposal. It requires an election to form what is normally an ad hoc committee and does not address committee chairmanship. It also sets unrealistic requirements on the composition of the committee; stipulating a mix of developers, implementers, and users – a rather nebulous category in itself. Further, it requires the committee to “ensure that an adequate number of candidates representing a balance of constituencies” be put forward. Is the committee to wait for some indication of who is being nominated then seek out opposing candidates for the other constituencies? The actual focus of this proposal is expressed by the phrase “with all appearing on the ballot.” If we are to place all individuals who meet the criteria for nomination on the slate, what is the purpose of the nominations committee? Staff could simply validate candidates against the criteria and add their name to the slate. The current process should be retained with the addition of two members to be sought from among the members of the TSC and one member to be sought from among the members of the Advisory Committee.

Technical Directorate

The Technical Directorate (TD) is responsible for product project approval and management oversight. It will rely on both staff and volunteers with increasing levels of professional staffing as the financial model allows. Note: Volunteer representatives to the TD should have sufficient support from their employers to ensure an average of 3-4 hours/week participation.

Composition:

The proposed composition is too large to be effective and calls for the membership, which may not have sufficient interest in or knowledge of the requirements for membership, to elect members. Not only does this implement a significant administrative burden on the staff and membership, it does not allow the TD to easily adapt its membership to changing circumstances. It is recommended that the following composition be implemented.

• [CTO is chair of the TD] CTO leads the Technical Directorate. While the CTO may seek consensus among the members of the TD, as the responsible party he or she holds the final decision making authority.
• [3 representatives being the] The three co-chairs of the Technical Steering Committee, one each from Foundation & Technologies (F&T), Structure & Semantic Design (S&SD), and Domain Expertise (DE) shall be members. These are volunteer-filled positions which focus on the technical content of standards development, ensuring that they meet end-user needs, and make recommendations to the Board on project priorities.
• [3 representatives appointed by the] The Affiliates Council shall seat two members to be [and] reconfirmed annually [with one being a member of the US Affiliate]
• The US Affiliate shall seat one member to be reconfirmed annually
• [2 representatives appointed by the Board on the recommendation of the CTO and re-confirmed by Board vote annually,] The CTO, with the concurrence of the CEO and COO, may choose to fill up to three seats in order to eliminate gaps in skill sets, provide balance and ensure capacity to track and manage joint projects with other SDO; the need for such participation to be reassessed against current membership annually
• [2 representatives elected at-large for two-year terms from a slate of candidates prepared by the CTO in collaboration with the TSC co-chairs] Deleted
• [Board appoint one additional member] Deleted
• [One member elected at large] Deleted
• Technical staff and consultants (non-voting)

Responsibilities:

• Supports CTO in development and implementation of HL7 Technical Architecture and standards development
• Provides input to CTO for protocol to prioritize projects and allocate resources
• Approves, monitors, and may intervene in product project development
• Oversees standards development
• Responsible for methods and process for quality assurance
• Sets milestones, monitors and ensures that quality assurance [has been done] is accomplished
• Explains requirements for quality assurance to project-sponsoring committee and monitors committee performance against QA objectives [Revised]
• Approves new work groups based on priority projects
• Resolves cross-domain content issues
• Oversees continuous quality process
• Defines international harmonization mechanism and manages process
• Identifies gaps and overlaps in the standard and recommends resolution
• Refers [questions] issues to Technical Steering Committee for discussion
• Reviews and approves requests from Technical Committees to initiate a ballot
• Reviews requests for new projects. Upon acceptance of the proposal, solicits input from the TSC for appropriate committee placement
• Manages progress and productivity, resolves committee charters against the product and services strategy [set] established by the Board
• [Recommends] Implements project probation or dissolution [to the Board] following collaboration with the TSC (The BoD should not be involved in operational issues.)

Operation of the TD:

• Meets bi-weekly between Working Group Meetings (WGM) via teleconference or other electronic means
• Meets on the opening and closing day of each WGM
• Meetings are open to the public, unless called into executive session by CTO; non-members may ask to be recognized

Technical Steering Committee

For the foreseeable future, HL7 specifications will continue to be developed primarily through volunteer contributions. The co-chairs of the Committees and SIG’s represent the primary labor pool and will remain the core source of technical expertise and development within HL7. The Technical Steering Committee (TSC) is the primary voice and organization belonging to this core cadre of volunteers. It will be re-invigorated by providing self-elected leadership and a voice in the TD [Delete and the Board]. The TSC is the primary vehicle for communication among the committees and SIG’s. In addition to these new powers, the TSC will adopt a new routine for its meetings to facilitate communication and lessen the need for joint meetings to effect coordination.

Composition:

• Members shall be the co-chairs of all SIG and TC, excluding Board-appointed committees and those classified as "Production" (Tooling, Education, etc.)
• Each SIG and TC shall have one vote
• The TSC membership shall be divided into the three functional areas identified by the ORC and SITF: Foundation & Technologies (F&T), Structure & Semantic Design (S&SD), and Domain Experts (DE)
• Each functional area shall elect a TSC co-chair for a two-year term from among its representative co-chairs by paper ballot during the first working group meeting of each odd numbered year. (This assumes that an election will occur at the January 2007 WGM.)

Roles and Responsibilities:

• Identify areas of potential gaps and overlaps as “early warning”, and forward to TD for action
• Identify areas requiring harmonization or definition; referring such to the Committees and/or TD
• Review individual WGM agendas, ensuring time for joint projects

Meeting Structure:

• Meets for half hour every morning during WGM (This could only happen as a gathering in the general session room at 7:15 or 7:30 provided no setup was required. It would have to be ended by 8 AM or risk being cut off in favor of the General Session. It seems questionable whether 120+ people would show up every morning.)
• May convene functional area sub-groups to foster common approach and communication among these groups
• May meet in special session for a full quarter or in the evening

Internationalization

A significant organizational change for HL7 will be the creation of the US Affiliate, and recognizing HL7 [global] as the host organization. HL7 [global] would continue to schedule, coordinate, and host working group meetings and support global standards development. HL7 Affiliates will deal with realm localization, education, and realm-specific political and regulatory issues. HL7 [global] will develop a new business and [global] membership structure. This will strengthen the position of HL7 as an international SDO. The change will take place over a 3-year period and will have an impact on many facets of current policies and procedures. These are outlined below and need to be addressed in more depth during the transition phase. (Revised) Note that use of the term Global or International in conjunction with HL7 is to be discouraged. HL7 is and will continue to be the source for international/global standards. The HL7 Affiliates will always be referred to as Affiliates or, in the national sense, individually as HL7 US, UK, Germany, etc. Membership

“Members” refers to both individual and organizational membership. There will be three levels of membership available: I. [National] Affiliate Membership II. HL7 [Global] Membership III. Joint Membership

Affiliate Membership and HL7 Membership reflect the current structure of national and regional Affiliate organizations and, for the most part, US based members. Joint Membership, by definition, would involve membership in both HL7 and one or more Affiliates; allowing direct participation at both a national and international level. Joint membership may carry a higher cost. (Revised)

I. Affiliate Membership other than the US Affiliate

Individuals and organizations may join an Affiliate under the membership rules and requirements of that Affiliate. Based on the Affiliate Charter, a legal agreement between the Affiliate and HL7, a portion of the Affiliate’s membership fees are allocated to HL7. Voting on HL7 standards and for HL7 elected positions occurs at the Affiliate level. An Affiliate is allocated a fixed number of voting members based on the terms of the Affiliate Charter. Submission of votes by an Affiliate is the equivalent of an HL7 organizational member voting. Depending on the Affiliate’s membership fees, this may be a relatively low-cost option for accessing HL7 standards and participating in standards development through the Affiliate. Members of an Affiliate have access to that Affiliate’s data base, but are not granted member’s access to HL7 resources. (Revised) [Q: Do Affiliate chairs and/or voting members have member access to HL7?]

II. HL7 Membership and the US Affiliate

Individuals and organizations may join HL7. Members are subject to the fees established by HL7 and vote directly on standards and for elected positions. Unless otherwise stipulated, HL7 leadership positions require membership in HL7. HL7 members have access to all HL7 resources. HL7 members located in the United States will provide the base for members of the US Affiliate. (Revised) [Q: Given that joint membership requires additional fees from Affiliates for HL7 membership, should membership in HL7 US require a surcharge which would be used to support the US Affiliate? Having no associated fee could perpetuate the argument that HL7 is a “US standard” in that US members are granted special “Joint” status. Those individuals and organizations who qualify by virtue of location would pay the surcharge to become HL7 US members. US based Benefactors, by virtue of their special commitment to HL7, would not be subject to the surcharge and could simply be designated members of HL7 US.]

III. Joint Membership

Joint membership is a previously undefined category, even though there are a number of joint memberships currently in place. As the name implies, it involves membership in both HL7 and one or more Affiliates. Joint members participate in standards development at the Affiliate and International level, vote directly on standards and for elected positions, and may seek leadership positions within HL7. Multinational corporations may choose to establish positions within various Affiliates as well as HL7. A super membership level, perhaps termed Global, is being contemplated for those organizations who desire recognition as truly International members. This membership level would conceivably grant the holder access to all HL7 and Affiliate resources. Members at this level would be demonstrably supporting global standards development and implementation. (Revised and consolidated)

Global membership would be a level above HL7 Benefactor and only open to organizations. Its fee structure would be perhaps 50% higher than Benefactor. Changes would be incorporated into the Affiliate Charters for 2008 granting Global members an organizational membership in those Affiliates in which they wish to participate. Consideration should be given to including some token payment from the Global membership fee, perhaps $100 or the equivalent organizational member fee for that Affiliate whichever is less, to each Affiliate chosen.

HL7 US Affiliate

An Affiliate Charter will be drafted specific to the US Affiliate and presented to the BoD for consideration under the current Bylaws. Membership will be construed as Joint, in that one must be an HL7 member in order to become a member of the US Affiliate. The current Bylaws and Policy and Procedure Manual may serve as the basis for like documents defining HL7 US process. It is recommended that other ANSI accredited SDO be extended membership in the US Affiliate and that the US Affiliate, under the name HL7 US, seek membership in appropriate national consortia such as the HITSP.

Voting on Standards

The HL7 standards will continue to be balloted as informative or normative documents. Normative standards will be submitted to ANSI for accreditation and may be submitted, concurrently or subsequently, to ISO for consideration as international standards. HL7 members shall vote directly on the standards, while Affiliates will cast the number of votes allocated by the terms of their Associate Charter; the equivalent of an HL7 organizational member vote.

Each Affiliate will follow its established process for developing and adopting localizations/extensions of HL7 specifications for Affiliate/realm-specific standards. (Revised)

Meetings (Revised)

The structure, number, and location of HL7 Working Group Meeting may evolve through the course of the transition period, but for the foreseeable future:

• HL7 will continue to hold three WGM annually; two within the contiguous 48 states and one outside.
• An Affiliate Council meeting shall convene each Sunday preceding a WGM.
• Each Affiliate will set its own meeting policy and may choose to hold separate Affiliate-only meetings in addition to meeting in conjunction with HL7.

Voting for HL7 Elected Positions

Membership is a prerequisite for voting (see categories of membership). Voting for HL7 Committee/SIG co-chairs will be reserved for members who meet the criteria defined by Policy and Procedure. Voting for at-large positions on the Board and for any other organization-wide position will be conducted in the same manner as voting on HL7 standards.

New Business Model

HL7 will develop and create new revenue sources and a new financial plan to implement the strategic recommendations. HL7 will develop a licensing structure, maximize the revenue from its products and services, expand the current membership fee structure and establish new revenue streams to include government programs, both national and international, as well as grants and monies from non-governmental organizations (NGOs) and foundations. HL7 will restructure its existing membership fee structure and introduce new levels of membership with additional benefits and fees. It is recommended that certain priority activities receive kick-start funding from HL7 reserves with the proviso that the reserves not be depleted to a level representing less than six months of operation funds. As part of the transition plan, a detailed budget of transition costs must be established.

Proposed opportunities for increasing HL7 revenue are included in Appendix 4. To create new revenue, HL7 must be perceived as an international standards development organization, project-driven, and accountable for producing high quality, timely standards. It is clear that the future in healthcare standards development requires collaboration among the many stakeholders. HL7 must position itself to be a leader in these efforts. HL7 must improve its external positioning around the globe and focus on consistent messages to all of its constituents, including additional outreach to its markets (users, potential users of its standards, and other relevant parties). The Communications and Branding recommendation contains more details about the approach.

Financial Plan

HL7 must shift its thinking to be focus driven rather than resource driven. In the past, HL7 has let the existing revenue dictate what can be accomplished and supported. Instead the organization needs to ask the question, “What standards do we want to have developed in five years?” and then create a revenue stream to support the defined goals.

Initial modeling on the membership fees and other opportunities to increase revenue are included in Appendix 5. Further analysis of the impact of increasing membership fees and modeling will occur during the transition phase.

Tony 20:04, 14 August 2008 (UTC)

Tony 18:32, 6 August 2008 (UTC)