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Electronic Health Record System Approved as Draft Standard for Trial Use (DSTU)

HL7 Board of Directors Unanimously Approves EHR for Draft Standard Status

New EHR Ballot Numbers Released as Reconciliation Continues

Ann Arbor, Michigan, USA. July 27, 2004.

The Health Level Seven (HL7) Board of Directors has unanimously approved the Electronic Health Record System Functional Model (EHR-S) to move forward as a Draft Standard for Trial Use (DSTU). The EHR Draft Standard can now be registered with ANSI, beginning the draft standard's trial period of up to 24 months.

The announcement was made shortly after National Coordinator for Health Information Technology, U.S. Department of Health and Human Services (HHS) David J. Brailer, M.D., Ph.D. at a healthcare IT summit in Washington unveiled the government's plan to establish a national health information infrastructure (NHII) with a goal of having an electronic health record for every patient within 10 years. An EHR standard is seen as one of the keys to supporting the exchange of information for clinical decisions and treatments, and can help lay the groundwork for nationwide interoperability by providing common language parameters that can be used in developing systems that support electronic records.

"We hope that the HL7 EHR DSTU will assist the industry's response to the challenges set forth by Dr. Brailer," said Mark Shafarman, HL7's Chair. Shafarman noted that the development of the EHR DSTU was made possible through the efforts of hundreds of dedicated individuals spanning the healthcare industry and crossing international lines. He pointed out also that the organization reached out to the provider community through the EHR Collaborative, a group of seven organizations representing key stakeholders in healthcare. "HL7 looks forward to continuing to meet the needs for standards that support the interoperability of healthcare information," Shafarman said.

Negative Comments Resolved

At the end of April 2004 the EHR-S DSTU won approval in an industry-wide HL7 ballot that featured a record number of votes from stakeholders. A reconciliation period immediately ensued during which time the HL7 EHR Technical Committee was able to resolve many of the issues with voters who placed negative votes, causing them to withdraw their negative ballots and, in many cases, change their vote to affirmative.

The EHR-S DSTU consists of four distinct sections, which were each balloted independently.

Here are the official ballot results as of July 23, 2004:

Section                   Affirmtive Negative No Return Pool Total Affirmative Percentage
EHR-S Functional Overview    200       22       63       294   90.09%
Direct Care                  191       39       63       297   83.04%
Supportive                   189       38       65       297   83.25%
Information Infrastructure   173       50       66       294   77.57%

The quorum for each section above ranged from 77.6% to 78.8%, well exceeding the 60% quorum required for a ballot. Each section was then required to meet a two-thirds affirmative ballot in order to pass. Some reconciliation continues and negative votes may still be retracted or changed to affirmative. For more information on the EHR-S DSTU, visit


Jonathan Himlin
Director of Communications
Health Level Seven, Inc.
3300 Washtenaw Ave., Ste. 227
Ann Arbor, MI 48104
Tel: +1 (734) 677-7777 x 165

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Prepared by Robin Cover for The XML Cover Pages archive.

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