[cmiles74]

I have worked in the field and I strongly disagree with this statement. The implication is that one can submit suggestions to the HL7 organization and hope to see improvement or changes in the spec. I would contend this is only the case for the larger vendors who are already established in the field, and quite happy with the current state of the (pretty much entirely non-interoperable) specification.

[nradov]

Well you can't just toss in a suggestion and hope that someone acts on it. Ideas by themselves are worthless. But anyone willing to be persistent and do the hard work of nailing down details can absolutely get their changes incorporated into the standards. I've done it several times, including when I worked for a very small vendor.

The various work groups aren't really controlled by vendors at all. Provider and payer organizations are also heavily represented.