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1 Purpose
1.1 Canada Health Infoway (Infoway) operating under the business name of HL7 Canada is a formally recognized Affiliate of Health Level Seven (HL7) International. Infoway holds legal and financial responsibility for the domestic and international activities of HL7 Canada. As the Affiliate, it is entitled to an assigned number of votes on HL7 technical and administrative ballots and Board positions, as defined by the HL7 Canada Affiliate Agreement.
1.2 HL7 Canada endorses HL7 International Standards to address the standardization of electronic health information exchange and supports HL7’s mission
"To provide a comprehensive framework and protocol specifications for the exchange, integration, storage, and retrieval of health information that support clinical practices and the management, delivery, and evaluation of healthcare services. Specifically, to create flexible, cost effective approaches, standards, guidelines, methodologies, and related services for interoperability between healthcare information systems and management of electronic health records."
1.3 HL7 Canada is a semi-formally organized Constituency within the InfoCentral Communities hosted by Infoway and supports the execution of the Affiliate’s obligations, as defined in the HL7 Canada Affiliate Agreement.
2 Responsibilities
The HL7 Canada Council has responsibilities related to domestic HL7 activities as well as international HL7 activities.
2.1 Domestic
2.1.1 Review and advise Infoway as necessary regarding terms and conditions of the HL7 Canada Affiliate Agreement to ensure the ongoing value, validity and currency of the Agreement to support the HL7 related needs of the HL7 Canada Community.
2.1.2 Attend domestic HL7 Community teleconferences and HL7 Canadian Constituency meetings (if held).
2.1.3 Advise the InfoCentral Communities on the harmonization of processes, policies, standards and other HL7 International matters where opportunities to harmonize are identified.
2.1.4 Represent HL7 Canada positions within Canada as generated through the collection of feedback from the HL7 Canadian Constituency.
2.1.5 Participate in conference calls to discuss Canadian HL7 matters.
2.1.6 Consult with InfoCentral Communities, Working Groups, providing advice and taking direction as appropriate.
2.2 International
2.2.1 Make recommendations to the HL7 Canadian Constituency regarding HL7 matters of interest in Canada.
2.2.2 Review and comment on HL7 International ballots
2.2.3 Lead and sustain Canadian consensus positions on HL7 work items in collaboration with InfoCentral Communities, Working Groups, etc., and vote on HL7 International technical and administrative ballots
2.2.3.1 Canadian positions are based directly on feedback generated through consultation with the InfoCentral Communities and the HL7 Canadian Constituency
2.2.4 Review and advise on HL7 International documents (e.g. the HL7 Governance and Operations Manual (GOM)) based on feedback from the InfoCentral Communities and HL7 Canada Constituency to ensure validity and applicability to the HL7 Canada Community.
2.2.5 On behalf of the InfoCentral Communities, maintain awareness of HL7 International matters through participation in HL7 governance / work group conference calls and / or HL7 Working Group Meetings (WGMs) and liaise with the HL7 Canadian Constituency.
2.2.6 Represent HL7 Canadian interests at HL7 International meetings and / or conference calls based on feedback from the InfoCentral Communities and HL7 Canadian Constituency.
2.2.7 Review and advise on voting direction for HL7 International Council elections and other voting where only the Affiliate Chair votes on behalf of HL7 Canada.
2.2.8 Voting
2.2.8.1 The HL7 Canada Council will exercise the voting obligations of the Affiliate on behalf of HL7 Canada including, but not limited to, HL7 International Ballots and HL7 International Board elections
2.2.8.2 The total number of allocated Canadian votes is determined based on the paid HL7 access to InfoCentral in accordance with the HL7 Canada Affiliate Agreement (i.e. as of 2016, representing 10% of total paid premium access seats).
2.3 General
The Council has the following additional roles and responsibilities:
2.3.1 Promote and support the use of HL7 related pan-Canadian health information standards.
2.3.2 Promote and support domestic and international HL7 harmonization to the benefit of health information standards in Canada.
2.3.3 Ensure that consensus positions, advice and decisions are reached with appropriate consultation and in an open, transparent and accountable manner that avoids preponderance of influence of any one stakeholder group.
3 Accountability
3.1 Canada Health Infoway is accountable to HL7 International through the HL7 Canada Affiliate Agreement.
3.2 Canada Health Infoway is responsible for the domestic and international activities of the HL7 Canada mandate via the HL7 Community.
3.3 The HL7 Canada Council is accountable to the HL7 Community through the HL7 Canada Chair.
4 HL7 Canada Council Composition
4.1 The membership of the HL7 Canada Council will be as follows:
4.1.1 HL7 Canada Affiliate Chair (Seats: 1): Ex-officio, elected by the InfoCentral Communities as the HL7 Canadian Constituency Affiliate Chair.
4.1.2 Canada Health Infoway Representative (Seats: 1): Appointed by Canada Health Infoway.
4.1.2.1 The appointed representative from Canada Health Infoway shall designate a proxy to vote on their behalf in case he or she is unable to do so.
4.1.3 HL7 Canada Members-At-Large (Seats: 4): Members and stakeholders from the communities who wish to observe, speak freely and voice opinions that are reflected in the voting directions to the designated council voting members. There are 2 Member-at-Large seats for public sector representatives and 2 Member-at-Large seats for private sector representatives.
4.2 HL7 Canada Voting Members:
4.2.1 The number of voters is determined by HL7 international International based on the number of number of paid HL7 Canada members, as defined in the HL7 Affiliate Agreement.
4.2.2 The voting positions are determined in the following manner:
4.2.2.1 HL7 Affiliate Chair holds one vote
4.2.2.2 The Infoway representative holds one vote
4.2.2.3 The remaining voters are elected annually by the HL7 Canada Council and ideally include a newly elected HL7 Canada Council member, as well as a member who is partway through their two-year term.
4.3 Preponderance of Influence:
4.3.1 No single constituency (providers, consultants, payers, vendors, government and academia) or organization, where consultants are of an organization if it contributes more than 50% of their direct billing; may have direct or indirect personnel holding more than one-third of the seats on the HL7 Canada Council.
4.3.2 No single jurisdiction may have direct or indirect personnel holding more than one-third of the seats on the HL7 Canada Council.
4.4 Term Limits
4.4.1 Each elected member of the Council serves a term of 2 years, after which an election shall be held. See section 6.1.2 for the frequency and method for nominating and electing Council members.
4.4.2 An elected member can be re-elected for an unlimited number of terms.
5 Roles
5.1 Chair
5.1.1 The HL7 Affiliate Chair is the Chair of the Council.
5.2 Alternates
5.2.1 Alternates on the HL7 Canada Council are not permitted.
6 Members
6.1 Council members (Chair and Voting Members) are elected by the HL7 Community.
6.1.1 The Chair will be elected for a two-year term and the seat will come open for nomination every other January.
6.1.2 Two elected member positions (non-Chair and non-Infoway) will come open for nomination every January. One position will be for a public sector representative and one position will be for a private sector representative. This is done to ensure knowledge transfer of voting processes and history, as well as to provide continuity in terms of community issues and impacts over time.
6.1.3 At the close of the nomination, a voting period of not less than 2 weeks shall open.
6.1.4 The results of the election will be posted no later than 3 business days after the close of the election period.
6.2 Council members shall meet the following qualifications:
6.2.1 Shall be a registered member of HL7 Canada (fee paid and in good standing).
6.2.2 Should have active and current participation on an HL7 International Committee or Work Group via teleconferences within the past year (In person attendance preferred).
6.2.2.1 A list of the working groups should be provided to the community and it is expected that updates be provided to the community at each HL7 Canada Community meeting.
6.2.3 Demonstrate knowledge of HL7 health information standards in Canada.
6.2.4 Endeavour to reach consensus on matters of the HL7 Canada Affiliate through strong communication and collaboration skills.
6.2.5 Have an appreciation of how health information standards facilitate an interoperable Electronic Health Record (iEHR).
6.2.6 Demonstrate an ongoing commitment to the Canadian health care system, whether through employment, consulting, academia or through related activities.
6.2.7 Demonstrate an ongoing interest in furthering of health information standards on a pan-Canadian basis.
6.2.8 Understand the HL7 International governance structure, role of the Affiliate(s), and related processes within HL7 International.
6.3 Member Removal
6.3.1 In consultation with the InfoCentral Communities and in consideration of relevant governance terms of reference and procedures, a Council member may be removed from the HL7 Canada Council for cause by an affirmative vote by the Council following a process that may include, and is not limited to:
6.3.1.1 The Chair discussing the issue with the Council member concerned to determine a resolution.
6.3.1.2 The Chair discussing the issue with the HL7 Canada Council to determine a resolution.
6.3.2 Upon a member's removal, his or her seat shall be declared vacant and put forward to be filled as listed in 4.3.2.
6.4 Member Resignation
6.4.1 Any member of the Council may resign at any time by notifying the Chair in writing.
6.4.2 The resignation shall take effect as agreed by the member and the Chair.
6.5 Compensation
6.5.1 The Council is voluntary and not compensated.
6.5.2 Travel expenses are not covered.
7 Meetings
7.1 Conflict of Interest
7.1.1 The Chair will, at the commencement of every meeting as a standing item, call for any known Conflicts of Interest.
7.1.2 The Council members will, at the commencement of every meeting, declare any known or potential Conflicts of Interest.
7.2 Regular Meetings
7.2.1 Meetings will be held as part of the HL7 Community that are scheduled on a regular basis.
7.2.2 On occasion, meetings may be required with less notice, under special circumstances (see Special Meetings).
7.2.3 When possible, meetings shall be held in conjunction with other events that members are likely to attend (e.g. related conferences, etc.).
7.2.4 Ballot deliberation teleconferences shall be held in conjunction with scheduled HL7 International ballot cycles.
7.2.5 Any InfoCentral Community member can attend HL7 Canada Council meetings as an observer.
7.3 Special Meetings
7.3.1 Should circumstances dictate and, at the discretion of the Chair, meetings can be convened to deal with urgent matters with minimal notice.
7.3.2 If not, all Council members are able to attend, a forum posting of decisions shall be distributed to Council members following the meeting with opportunity to comment by absentee Council members.
7.4 Agenda
7.4.1 The Chair shall develop and share meeting agendas, taking advantage of the InfoCentral collaboration tooling. Council members are encouraged to submit HL7 relevant agenda items for discussion as far in advance of meetings as possible to allow for proper planning and notification. Agenda items may also be received from other InfoCentral Communities.
7.4.2 The agenda shall be produced and distributed two days in advance of each meeting to Council members and posted on the HL7 Community InfoCentral. Interested parties can subscribe to such notifications.
7.5 Meeting Materials
7.5.1 Materials shall be made available and accessible to Council and Community members, through the most appropriate means available (e.g. email, web sites, direct mail, etc.) in advance of each meeting.
7.5.2 Council members are encouraged to review all materials received in advance of meetings and contribute actively to discussions.
7.6 Meeting Conduct and Decision Making
7.6.1 Meetings shall be structured to ensure the viewpoints of all members are shared and considered.
7.6.2 Members shall be given an opportunity to speak. However, the Chair may limit discussion on topics deemed to be non-constructive.
7.6.3 The Council shall rely on Robert’s Rules of Order if formal guidance for meeting activities is required.
7.6.4 It is the responsibility of the presiding Chair to guide the Council to efficient and effective outcomes.
7.6.5 The Council shall follow, in this order of precedence, the HL7 Canada Council Terms of Reference in such a way that they do not conflict with the HL7 International Bylaws, Policies & Procedures, the HL7 International Bylaws, Policies & Procedures and Robert’s Rules of Order.
7.6.6 If the HL7 Canada Chair is not present at a meeting, the Chair shall choose one of the Council members to chair for the meeting.
7.7 Quorum
7.7.1 Quorum shall be deemed to be met when at least 60% of the Council, including the Chair, are in attendance either in person or via video/teleconferencing.
7.7.2 If quorum cannot be met, the meeting may continue but may not make any binding decisions. Work items may still be reviewed, discussion can still occur, but formal decisions cannot be made in the absence of quorum.
7.8 Council Votes
7.8.1 Council shall use consensus based decision-making practices for decisions.
7.8.2 The ideal situation is always to achieve 100% agreement from all Council members.
7.8.3 Voting practices require at least 2/3 (67%) majority approval from Council members participating in the meeting with a minimum of 50% of confirmed Council members in favour of the motion.
7.8.4 The HL7 Canada Chair can vote on motions.
7.8.5 Those Council members who wish to abstain from voting on a motion may do so and their abstention shall not count towards the affirmative or negative vote tallies used to determine approval percentages.
7.8.6 The decisions, including opposing votes, made by the Council shall be noted in the meeting minutes and shall reflect the level of consensus, and note significant diverse viewpoints.
7.9 Action without Meeting
7.9.1 Votes conducted by email shall be allowed, upon request, for any formal motion already discussed in a meeting where quorum was not achieved and a motion was not voted on.
7.10 Minutes
7.10.1 Minutes shall be distributed to Council members at least seven days following a meeting and posted on the HL7 Community on InfoCentral. Interested parties can subscribe to such notifications.
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