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 - PowerPoint PPT PresentationTRANSCRIPT
How HL7 UK is supporting implementation of healthcare
messaging
Philip Scott MSc MBCS CITPHead of IT Projects & Development
Portsmouth Hospitals NHS Trust
PhD student, University of Portsmouth
HL7 UK board memberCo-chair, HL7 UK NHS Implementers group
BCS Health Informatics Forum – 25 April 2006
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• See www.hl7.org.uk for training providers and web
resources
• Or read a book…
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 affiliatesArgentina
Australia
Brazil
Canada
China
Croatia
Czech Republic
Japan
Korea
Mexico
New Zealand
Spain
Sweden
Switzerland
Taiwan
Denmark
Finland
France
Germany
Greece
India
Ireland
Italy
Turkey
UK
Version 2.0
HL72UK vA.2
Version 2.1
Version 2.2
Version 2.3
Version 2.3.1Version 2.4
Version 2.5
Timeline of HL7 versionsVersion 1.01987
1994
1999
2005
1988
1990
1997
2000
2003
1996 V3 – development starts
V3 Normative Edition
CCOW
XML CDA v1
Scope of the HL7 v2 standard Chapter
1. Introduction2. Control3. Patient Administration4. Order Entry5. Query6. Finance7. Observation Reporting8. Master Files9. Medical Records10. Scheduling11. Patient Referral12. Patient Care13. Clinical Laboratory Automation14. Network Protocols
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!
“Rampant optionality”
Standards are great,let’s all have one!
Let there be v3…• Reference Information Model (RIM)
• Abstract cross-domain information model
Refinement from RIM to Message
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, relationships• NPfIT Message Implementation Manual (MIM)
available to members via HL7 UK web site
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 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 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 support• A current issue: LSP standardisation
• Why is this an issue?
• What are current LSP plans?
• What is a better approach?
1 - NASP Interface – HL7 V3 2 - Existing Systems Interface – HL7 2UK (VA.2) 3 & 4 - Departmental Systems Interface – HL7 V2.3/V2.4
CSC P1R1 Data Centre
CSC P1R1 Interfacing
P1R1 NASP
EBS ETP PDS GPtoGP
NASP MHS
Trust A
Existing System 1 (ES -A1)
Existing System 2 (ES -A2)
Existing System 4 (ES -A4)
Trust Interfacing Engine - A (TIE-A)
Existing System 3 (ES -A3)
Trust B
Existing System 3 (ES -B3)
Existing System 4 (ES -B4)
Existing System 2 (ES -B2)
Existing System 1 (ES -B1)
Trust Interfacing Engine -B (TIE-B)
1b
Data Centre Hosted Departmental System
TheatresMaternity
P1R1 PAS
i.IE
Lorenzo
i.CM i.PM
NASP Interfacing Engine (NASPIE) Interfacing Engine (EBIE)
Existing System Interfacing Engine (ESIE)
1a 3a
2a
2b
2b
2b
2b
2b
2b
4a
4b
4a
4b
4b
LRS SSB SDS
Maternity IE
Theatres IE
CSC Alliance HL7 Message UsageCSC Alliance
Fujitsu
Fujitsu Data Centre
Trust System
Trust System
Trust System
Trust System
Trust System
Trust System
Trust TIEH
L7 2
.3
HL7
2.3
HL7
2.3
HL7
2.3
Hosted TIE
DIEHL7 V2.3
OpenEngine
Millennium
HL7 V2.3
BT
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
GP Lab 1v3 request/report
Lab 2
PMIPGP using two labs may receive PMIP and v3
Specialty
v2.4 UK A.2 report
v2.3 report
Specialty system using two labs may receive two kinds of v2
Each translation point adds maintenance and risk of error
NHS implementation support
Future issues…• v2 v3 mapping/migration
• HL7.org restructuring to form HL7 US
• IHE profiles
• IHC de-constrained v3 specs?
• v3 message complexity
Future Issues…
