The Standard

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US Realm Steering Committee February 2022 Update

[fa icon="calendar"] Feb 11, 2022 2:28:19 PM / by HL7

US Realm

On behalf of the HL7 US Realm Steering Committee (USRSC), we are pleased to share an update on last year's priorities and highlight our focus for 2022.

2021 Highlights

Visibility was a key theme of our work in 2021 and included supporting pilot work on a standards dashboard, tracking accelerator activity and promoting key ballots.

Before we dive into 2022, we want to highlight a few key points for all US Realm (USR) members.

2022 Activities In-Flight
Visibility remains a top priority in our 2022 efforts to coordinate, align and promote projects.

New Accelerators

  • Helios: Public Health launched!
  • FAST: FHIR at scale task force coming soon!

Prior Accelerators

  • Argonaut: Rapidly develop and pilot FHIR-based APIs, and Core Data Service Specifications
  • CARIN: Advance the ability for consumers and their authorized caregivers to easily get, use and share their digital health information
  • CodeX: Coordinate a multi-stakeholder community addressing the need to obtain high-quality, computable data for cancer care and research
  • DaVinci: Help payers and providers positively impact clinical, quality, cost and care management outcomes
  • Gravity: Expand available Social Determinants of Health (SDOH) core data for interoperability and accelerate standards-based information exchange
  • Vulcan: Bring together stakeholders across the translational and clinical research community in order to bridge existing gaps between clinical care and clinical research


Several key implementation guides from an infrastructure and content perspective are scheduled to be updated.

  • C-CDA Companion Guide: January 2022 companion guide ballot to add USCDI v2 guidance
  • US FHIR Core: Jan 2022 ballot to add USCDI v2 guidance
  • C-CDA web publishing using FHIR Structured Definition  
    • Complete QA and implement changes (e.g. “How to read C-CDA in FHIR Structure Data format”
    • Determine if the next update of C-CDA will use new infrastructure
    • Develop Minimal Viable Product (MVP) and socialize how to view and use
  • USR work process improvements are under development and underway
    • Deploy Project Dashboard to capture status of standards in HL7
    • Update US Core and C-CDA Road Maps
    • Collaborate with Melva and Gay to define process improvements metrics on HL7 standards lifecycle (e.g. PSS, NIB, etc.)
    • Summarize results of FHIR Usage Survey (currently out for completion)

Visibility, Communication & Alignment | Key 2022 Themes for  USR Program Team

In 2021, the USR team focused on members' ability to discover and identify ongoing work within the USR. We'll continue refining this work with the goal of being able to answer these questions by the end of 2022 and continue aligning key standards.

  • What are the active HL7 USR projects?
  • Which software developers have deployed or included which standards in their roadmap?
  • What are the governance policy guidelines for USR standards development?
  • What are the strategies for detailed review of enforcing USR guidelines and alignment of the USR standards as the develop?
We also aim to improve certain administrative aspects of the USR. By the end of 2022 the USR PM will begin to:
  • Implement 2022 aspects of the governance plan and strategic roadmap
  • Evaluate the effectiveness of the governance plan to enforce USR guidelines and alignment of USR standards as they develop
  • Identify standards development and implementation activities that deviate or align with the USR strategy roadmap
  • Identify 2023 activities to support standards development for the USR

The US Realm Needs You!

We need your help to improve coordination, communication, and visibility within the USR. Here are three things you can do:  

1) Quality is a realm-wide responsibility
  • Please be on the lookout for the three Ds: duplication, deviations (in the terminology used from those specified in USCDI and US Core profiles) and dependencies (when other profile or IG developers may not be aware).

2) Feedback is key

  • Please look for opportunities to participate in the design and development of key infrastructure and content implementation guides, give feedback on dashboard information and web publishing and let the USRSC know when you see an opportunity for improvement with the USR.
3)  Nominate someone (or yourself)
  • USRC is seeking nominations (including self-nominations) of candidates to provide representation specifically in an EHR/implementer role.
  • Position is expected to serve as both a representative of the stakeholder community and a liaison reporting back to appropriate work groups and/or constituencies.
Nominations with a brief supporting paragraph outline nominees' interest and experience should be sent to Anne Wizauer by February 22, 2022.

Responsibilities & Expectations
USRC members MUST be:
  • Able to routinely attend one hour weekly teleconferences
  • Able to attend at least one WGM per year, preferably all around if possible
  • Active participants in HL7 standards development

We look forward to a great 2022 with all of you!


Brett Marquard and Steve Posnack

Chairs of the US Realm Steering Committee

Topics: FHIR, HL7, HL7 community, Argonaut Project, health IT, C-CDA, Da Vinci, CARIN Alliance, documentation templates and payer rules, FHIR Accelerator, FAST, Gravity, Vulcan, FHIR Community, US Realm

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