Governance

A proposed approach for the governance of HCX specifications

Objective

Specifications are fundamental to the success of the envisioned claims network. Specifications need to create consensus amongst a broad base of health system stakeholders to ensure that they can act as this common foundation. This document proposes a governance approach for the open specifications in line with key design principles outlined in the National Digital Health Blueprint and further contextualized for HCX specifications.

Proposed Governance Approach and Process for Specifications at Swasth during the pilot period

As evident, creating functional specifications will require a robust process and deep collaboration between multiple stakeholders. The process must:

1. Enable the delivery of universal health coverage (UHC) in India

2. Drive healthcare outcomes and inclusion as well as patient safety and privacy

3. Foster consensus*

4. Ensure content is fit for purpose*

5. Ensure content is implementable*

6. Establish an appropriate implementer community*

7. Ensure ongoing maintenance of the standards*

(* Points 3 to 7 have been adopted from the must-have criteria followed by HL7)

Hence, the development and maintenance of standards must follow an open and consultative process with widely inclusive, committed groups that can bring together necessary skills, viewpoints, and networks.

​The HCX community proposes to maintain and improve specifications through an inclusive, open, and consultative process. The broad outline of the process would be:

1. ​Swasth would establish a governance council with representation from across the healthcare ecosystem (insurance, TPA, patient groups, provider representatives, small provider associations, academic institutions/experts in the area, the regulator, and relevant public bodies)

2. The governance council will facilitate the formation of topic-specific working groups

3. Working groups will create clear criteria for the evaluation of a proposal

4. Ideas for new specifications/enhancement is proposed by one of the group members

5. The working group evaluates the idea

6. If approved, development/enhancement begins

7. Resultant specifications/enhancement will be reviewed by peer group for implementability

8. The resulting specifications/enhancement will be put out for public consultation

9. The working group reviews public consultation feedback and incorporates the necessary changes. (Any inputs not included will receive responses too)

10. Specifications will be published for wider adoption

11. Specifications will be maintained in open repositories like GitHub, Confluent (or similar) based on the nature of the output

12. Specifications are made available through most permissible licenses like MIT or Creative Commons

13. Swasth will also create a fully independent ethics and conflicts committee to act as an appellate authority for all our work, including stewardship of specifications

14. All deliberations, minutes, and documents produced by the ethics and conflicts committee, specifications governance council, and working groups will be made publicly available