How hl7 uk is supporting implementation of healthcare messaging
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BCS Health Informatics Forum – 25 April 2006. How HL7 UK is supporting implementation of healthcare messaging. Philip Scott MSc MBCS CITP Head of IT Projects & Development Portsmouth Hospitals NHS Trust PhD student, University of Portsmouth HL7 UK board member

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How hl7 uk is supporting implementation of healthcare messaging

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


Topics

Topics

  • Brief history of HL7

  • Summary of v2  v3

  • HL7 UK purpose, activities, relationships

  • NHS implementation support

  • Future issues

  • Questions


But this is not an hl7 tutorial

But… this is NOT an HL7 tutorial

  • See www.hl7.org.uk for training providers and web resources

  • Or read a book…


Brief history of health level 7

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


Timeline of hl7 versions

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


Scope of the hl7 v2 standard

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


Issues with v2

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”


Let there be v3

Let there be v3…

  • Reference Information Model (RIM)

  • Abstract cross-domain information model


Refinement from rim to message

Refinement from RIM to Message


Hl7 uk purpose activities relationships

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


Hl7 uk purpose activities relationships1

HL7 UK purpose, activities, relationships

  • NPfIT Message Implementation Manual (MIM) available to members via HL7 UK web site


Nhs implementation support

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


Nhs implementation support1

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.


Nhs implementation support2

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.


Nhs implementation support3

NHS implementation support

  • A current issue: LSP standardisation

  • Why is this an issue?

  • What are current LSP plans?

  • What is a better approach?


Csc alliance

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


Fujitsu

Fujitsu


How hl7 uk is supporting implementation of healthcare messaging

BT


Nhs implementation support4

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


How hl7 uk is supporting implementation of healthcare messaging

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


Future issues

Future issues…

  • v2  v3 mapping/migration

  • HL7.org restructuring to form HL7 US

  • IHE profiles

  • IHC de-constrained v3 specs?

  • v3 message complexity


Future issues1

Future Issues…


Questions

Questions…

Email: [email protected]

Or [email protected]

Phone: 07766 254169


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