HL7 Activities in Europe

1. HL7 Activities in Europe Concepts & Implementations in Health Information Projects Dr. Kai U. HeitmannUniversity of Cologne (Germany)Institute for Medical Statistics, Informatics und Epidemiology Board member HL7 user group Germanypast Co-Chair XML Special Interest Group HL7 USAInternational Representative elect HL7 Board of Directors HL7 UK ConferenceLondon, UK, December 11+12, 2003

2. HL7 Activities in Europe What happened so far? – …history What happens at all? – …layers What happens far away? – …countries

3. Development of European Affiliates Finland1996 Denmark2003 UK2000 Lithuania2002 Ireland2003 Poland2003 The Netherlands1996 Germany1995 Czech Republic2001 France2003 Switzerland2000 Spain2003 Croatia2001 Italy2003 • 14 European Affiliates (of 26+1 total)

4. Development of European Affiliates • 14 Affiliates • First affiliates ever (DE, NL) were from Europe • Meetings • 1st International Affiliates Meeting 2000 • Dresden, (DE) • 2nd International Affiliates Meeting 2001 • Reading (UK) • 1st International Conference on CDA 2002 • Berlin (DE) • 3rd International Affiliates Meeting 2004 planned • Spring Working Group Meeting planned

5. HL7 Activities in Europe What happened so far? – …history What happens at all? – …layers What happens far away? – …countries

6. “Layers” of activities “payload”content “proprietary” HL7 v2.xHL7 v2.XML CDA HL7 v3 … exchangeformat 1234… HL7 |^~ XML … transportsecurity MLLP ebXML WS-* FTP/S S/MIME HTTP/S … • Content vsexchange format vsInfrastructure/framework for transport and security • International solutions / standards • Legal requirements

7. “Layers” of activities in Europe • v2 messaging standard • since 1985 • Widespread, used in hospitals • XML encoding for known content • „New“ messaging standard • early implementor projects • V3 based documents • Infrastructure and Framework • Education HL7 v2.x HL7 v2.XML HL7 v3 CDA InfrastructureSecurity Training

8. HL7 Activities in Europe What happened so far? – …history What happens at all? – …layers What happens far away? – …countries

9. Short Trip through Europe Finland1996 UK2000 Ireland2003 Czech Republic2001 Croatia2001 • 14 European Affiliates (of 26+1 total) The Netherlands1996 Germany1995

10. HL7 Activities in… Croatia

11. Croatia • April 2001: HL7 Roadshow in Zagreb • with W. Ed Hammond, Klaus D. Veil, Joachim Dudeck and Kai U. Heitmann • HL7 Croatia in September 2002 • Croatian Society for Medical Informatics (CSMI) • Croatian Society for Medical and Biological Engineering (CROMBES) • Supported by • Ministry of Health of the Republic of Croatia • Croatian State Office for Standardization and Metrology • Croatian Public Health Institute

12. Croatia HL7 v3 InfrastructureSecurity Training • Activities • Education • Workshop „HL7 Communication Standard“ • Module „HL7 – International Communication Standard in Healthcare“, 6th International HIT Conference „Biotechnology and Public Health“ • Infrastructure • WebService Based Infrastructure for the Exchange of Information • Large Mobile Phone vendor

13. HL7 Activities in… Bulgaria

14. Bulgaria InfrastructureSecurity Training • Bulgarian Health Informatics Standards Plan • Started in 2001, first version in 09.2002, until 2005 • Standards Candidate Evaluation • Six main areas of interest • Health Information & Records Management • Messaging & Communications • Electronic Health Records • Clinical Vocabularies • Security • Privacy • Not a HL7 affiliate yet

15. HL7 Activities in… Czech Republic

16. Czech Republic HL7 v2 Training • HL7 Roadshow in Prague • HL7 Czech Republic • November 2001 • Constitutive meeting with the Ministry of Health Dec 01 • Data standard of the Ministry of Health of the Czech Republic • focused on communication between LIS and HIS • Not HL7 compatible • CSNI endorses CEN and ISO standards • harmonization of HL7 with these is desired • No localizations of HL7 yet, but planned • Envisaged: local vocabularies from the Data standard of the Ministry of Health

17. HL7 Activities in… Finland

18. Finland CDA InfrastructureSecurity • Use of CDA Release 1 • Database of „CDA headers“ • Connection implementation within four health districts in Finland • „open interfaces“ • HL7 Finland defined application level protocol • Based on ebXML • Future: exchange of other documents like referrals, prescriptions and health certificates

19. Finland CDA InfrastructureSecurity • CDA Release 2 • specifications ready by 1/2004 • OpenCDA project 5/2003 - 1/2004 • funded by MoHSW and HL7 FI (together 260 k€) • Plans for similar project for 2004 • standarization activites build in a broad sense around HL7 TC (formal mandate) • areal funding for 2004-2005 towards 2007 • MoSHW will distribute 20 + 10 M€ for the areas • one technical requirement is to use CDA...

20. Specialized care epicrisis

21. HL7 Activities in… Ireland

22. Ireland HL7 v2.XML • HL7 version 2.4 with XML encoding • coordinated by HeBE (Health Board Executive) • sponsors a messaging group • coordinates the work of projects in the different Health Boards • lab messaging in the Southern Health Board • will roll out to all GPs in 2004 • Based on v2.xml

23. HL7 Activities in… United Kingdom

24. United Kingdom HL7 v3 InfrastructureSecurity • GP 2 GP Project • Early Implementor Project based on Version 3 • Infrastructure Framework • Support by NHS • BBC news from Monday this week: • BT wins £1.6bn 10-year NHS deal • aims to connect more than 30,000 GPs and 270 acute, community and mental NHS Trusts in a single national system.

25. United Kingdom Tools enhancement for HL7 Version 3 Modelling

26. HL7 Activities in… The Netherlands

27. The Netherlands HL7 v3 InfrastructureSecurity Training • HL7 Project Office • Projects, Training (focussed on Version 3) • National IT Institute for Healthcare • Projects (among others) • Modelling the perinatology domain • Domain analysis, Modelling • Implementation guidelines • Proof of concept: Modelling • Medication Registry as one of the first steps to a EHR in the Netherlands • Implementations with several vendors at large exhibition • Visit: Presentation given by Tom de Jong, tomorrow

29. HL7 Activities in… Germany

30. Germany HL7 v2.x CDA InfrastructureSecurity • Content: SCIPHOX Project (CDA) • Infrastructure Framework • New Project by Ministry of Health (bIT 4 Health) • Consortium of 5 vendors/organisations • Introduction of the Health card for patients • Health professional card for providers • Conformance: v2 Profiles for specific use cases

31. Germany: Cards as the key For a Telematic Infrastructure

32. The SCIPHOX project and CDA CDA • uses CDA R1 model as a start • framework for basic sharedinformation (CDA Header) • sender, recipient, patient, event etc. • definition of structures (CDA Body) • Structure of information units based on analysis • Story boards (discharge/referral documents, long term diabetes documentation, emergency info) • localization • Complementary local requirements • Formal voting procedures for specifications

33. HL7 Activities in Europe – Conclusion • Lot of education required • Modelling Methodology • Version 3 and CDA • Early implementor projects • Version 3 and CDA • Practical implementations • Feedback for the standard • Infrastructure Framework needed • Funding • collaboration with national bodies (MoHI) • European money • Awareness of standards HL7, CEN

34. Thanks …for your attendance! Questions? Later? mailto:Kai.Heitmann@medizin.uni-koeln.de

35. Contributions to this presentation • Entity::Living Subject::Person • Gjuro Dezelic (HR) • Vit Koksa (CZ) • Timo Tarhonen, Timo Itälä, Vesa Pakarinen (SF) • William F. Goossens, Irma Jongeneel de Haas,Tom de Jong (NL) • Klaus Veil (AUS) • Brian O‘Mahony (IRL)