Health Level Seven's CEO says government pressure related to Meaningful Use had nothing to do with the decision.
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Health Level Seven (HL7), a nonprofit organization whose messaging standards are widely used to share information among disparate health IT systems, plans to make much of its intellectual property available for free to non-HL7 members, probably in the first quarter of next year. But HL7 will retain control of the underlying copyrights.
Besides the standards themselves, the intellectual property that will become free under licensing terms includes domain analysis models, data profiles, and implementation guides and tools that are used to apply the standards. HL7 educational programs, certifications, the ability to participate in workgroups, and voting rights will remain the perquisites of HL7 members.
At a press webinar, HL7 CEO Charles Jaffe, MD, called the decision to make HL7 intellectual property free worldwide a "true milestone for HL7. We think the step we're about to take will enable greater use of [health IT] and will improve interoperability worldwide… HL7's goal of achieving interoperability will now have an easier path for many of the stakeholders and the countries for which the access to our intellectual property has been limited."
HL7 has a number of international affiliates, and Jaffe said the use of its standards has been expanding abroad. He cited a European program called epSOS, in which the European Commission has "empowered" 27 countries to use HL7's clinical data architecture (CDA) in clinical summaries and electronic prescribing data.
Portions of the U.S. government's Meaningful Use Stage 2 rules also require the use of HL7 standards. But Jaffe emphasized that HL7's decision to make its standards freely available was not directly related to Meaningful Use. In fact, he said, the Office of the National Coordinator of Health IT (ONC) never asked HL7 to eliminate the charge for its intellectual content.
"We made this decision unilaterally to reduce any barriers, either real or perceived, to accessing our intellectual property," he said. "We thought it was an important step outside of the U.S. as well as for Meaningful Use."
The only example Jaffe could offer of content fees obstructing anyone's access to HL7 intellectual content was in developing countries. But an HL7 fact sheet states, "There is increasing government demand for standards that do not require a licensing fee. This is particularly true of the U.S. Health Information Technology Standards Committee, which does not want to adopt standards when the cost could be a barrier to implementation."
The Health IT Standards Committee, a governmental advisory body, makes recommendations on the standards for certifying electronic health records for Meaningful Use.
John Halamka, MD, co-chair of the Health IT Standards Committee and CIO of Beth Israel Deaconess Medical Center in Boston, commented in the HL7 press release, "This announcement [from HL7] is the most significant standards development in the past decade. It ensures that every stakeholder will have ready access to the content standards they need for Meaningful Use."
Many healthcare providers and software vendors are HL7 members and entitled to use the intellectual property as part of their membership, but many other software developers are not, Jaffe told InformationWeek Healthcare. "We've had an outreach program to persuade other vendors to participate in the program," he noted.
HL7's leaders took more than a year to reach their decision because "some people were concerned that it would curtail membership and reduce revenues," Jaffe said. But the HL7 board finally moved because "it was the right thing to do."
The organization is currently developing a "mitigation plan to offset the loss of revenues," he noted. Among other things, he said, HL7 will try to persuade some big healthcare providers that are not now HL7 members to support the organization. Jaffe also predicted that U.S. government agencies, which now pay a trifling $1,000 a year to be members, will have to pay substantially more.
HL7 permeates the public healthcare sector, just as it is does private hospitals, labs, and other providers. Besides the inclusion of CDA document types in Meaningful Use, for example, the Centers for Disease Control and Prevention (CDC) just announced it would have providers use the Direct Project messaging protocol to send clinical document architecture (CDA)-formatted reports to the CDC's National Healthcare Safety Network. Altogether, Jaffe said, 54 government agencies use HL7 standards.
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