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How HL7 UK is supporting implementation of healthcare messaging

This forum discusses the history, purpose, activities, and future of HL7 UK in supporting the implementation of healthcare messaging. It also addresses NHS implementation support and future issues. Please note, this is not an HL7 tutorial.

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How HL7 UK is supporting implementation of healthcare messaging

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  1. BCS Health Informatics Forum – 25 April 2006 How HL7 UK is supporting implementation of healthcare messaging Philip ScottMSc MBCS CITP Head of IT Projects & Development Portsmouth Hospitals NHS Trust PhD student, University of Portsmouth HL7 UK board member Co-chair, HL7 UK NHS Implementers group

  2. Topics • Brief history of HL7 • Summary of v2  v3 • HL7 UK purpose, activities, relationships • NHS implementation support • Future issues • Questions

  3. But… this is NOT an HL7 tutorial • See www.hl7.org.uk for training providers and web resources • Or read a book…

  4. Brief history of Health Level 7 • Founded in USA in 1987 • ANSI-accredited SDO in 1994 • HL7 UK founded in 2000 (~250 members) • HL7 v2 now a dominant standard • HL7 v3 in use by programmes in the UK, the Netherlands, Canada, Mexico, Germany, Croatia • HL7.org and 26 international affiliates Argentina Australia Brazil Canada China Croatia Czech Republic Denmark Finland France Germany Greece India Ireland Italy Japan Korea Mexico New Zealand Spain Sweden Switzerland Taiwan Turkey UK

  5. Timeline of HL7 versions 1987 1988 Version 2.0 1990 Version 2.1 1994 Version 2.2 1996 V3 – development starts 1997 Version 2.3 1999 Version 2.3.1 2000 Version 2.4 V3 Normative Edition CCOW XML CDA v1 HL72UK vA.2 2003 Version 2.5 2005 Version 1.0

  6. Scope of the HL7 v2 standard Chapter • Introduction • Control • Patient Administration • Order Entry • Query • Finance • Observation Reporting • Master Files • Medical Records • Scheduling • Patient Referral • Patient Care • Clinical Laboratory Automation • Network Protocols

  7. Issues with v2 • Inconsistent use • Multiple versions • Z-Segments • Interpretation • Localisation When you’ve seen one HL7 v2 interface, you’ve seen one HL7 v2 interface! Standards are great, let’s all have one! “Rampant optionality”

  8. Let there be v3… • Reference Information Model (RIM) • Abstract cross-domain information model

  9. Refinement from RIM to Message

  10. HL7 UK purpose, activities, relationships • Mission statement To support the development, promotion and implementation of HL7 standards in ways which meet the needs of healthcare organisations, health professionals and healthcare software suppliers in the United Kingdom • 4-5 working meetings each year (next June 13-14) • Subgroups on v2, v3 domains, implementation • UK representation on .org SIGs/TCs • Strong NPfIT representation and contribution • Relationships with Intellect, IST/35 • Cultivating relationships with IHE, IHC

  11. HL7 UK purpose, activities, relationships • NPfIT Message Implementation Manual (MIM) available to members via HL7 UK web site

  12. NHS implementation support • NPfIT presentations in working meeting plenaries • Annual HL7 Conference (next 25-26 October) • NHS Implementers Group • Seminars in Feb 2005 and Feb 2006 • Workshops on: • Interface project management and technical issues • Integration engines • LSP local interface standardisation • Subgroup session at each HL7 UK working meeting

  13. NHS implementation support Charter: • The NHS Implementers sub-group exists to address the needs of those who need to implement HL7 specifications in the UK. Our aspiration is to build a UK HL7 self-help community. • This includes: • raising awareness of the services and information available from HL7 UK • signposting reference and training sources • facilitating liaison between NHS implementers, suppliers and standards developers.

  14. NHS implementation support Charter: • The NHS Implementers sub-group exists to address the needs of those who need to implement HL7 specifications in the UK. Our aspiration is to build a UK HL7 self-help community. • This includes: • raising awareness of the services and information available from HL7 UK • signposting reference and training sources • facilitating liaison between NHS implementers, suppliers and standards developers.

  15. NHS implementation support • A current issue: LSP standardisation • Why is this an issue? • What are current LSP plans? • What is a better approach?

  16. CSC Alliance HL7 Message Usage CSC Alliance 1 - NASP Interface – HL7 V3 2 - Existing Systems Interface – HL7 2UK (VA.2) 3 & 4 - Departmental Systems Interface – HL7 V2.3/V2.4

  17. Fujitsu

  18. BT

  19. NHS implementation support • Pragmatic commercial reality rather than “ruthless standardisation” • Accenture/CSC: UK vA.2, v2.3, v2.4 • BT: UK A.2? • Fujitsu: v2.3 • Which v2.3? Which v2.4? Which UK A.2? • Issues: • Maintenance: no re-use possible, upgrades complex • Risk of varying semantics or data quality workarounds • Cross-boundary flows: specialty systems, cancer networks, ISTCs

  20. NHS implementation support GP Lab 1 Lab 2 v3 request/report GP using two labs may receive PMIP and v3 v2.4 UK A.2 report PMIP v2.3 report Specialty system using two labs may receive two kinds of v2 Each translation point adds maintenance and risk of error Specialty

  21. Future issues… • v2  v3 mapping/migration • HL7.org restructuring to form HL7 US • IHE profiles • IHC de-constrained v3 specs? • v3 message complexity

  22. Future Issues…

  23. Questions… Email: philip.scott@ports.nhs.uk Or philip.scott@port.ac.uk Phone: 07766 254169

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