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HL7 – a Quick Introduction HL7 – A Quick Introduction John Quinn HL7 TSC Chair Senior Executive, Accenture HIMSS 2006 Copyright 2006, HL7 Health Level Seven • ANSI-accredited Standards Development Organization • Established 1987 • Approx. 3,000 members • 28 affiliates in Canada, Europe, Asia-Pacific, Latin America, Africa, etc. ISO’sISO’s OpenOpen SystemsSystems InterconnectInterconnect (OSI)(OSI) model:model: “Application“Application Level”Level” – – level level 77 Copyright 2006, HL7 2 HL7 Mission Statement HL7HL7 isis anan internationalinternational communitycommunity ofof healthcarehealthcare subjectsubject mattermatter expertsexperts andand informationinformation scientistsscientists collaborationcollaboration toto createcreate standardsstandards forfor thethe exchange,exchange, managementmanagement andand integrationintegration ofof electronicelectronic healthcarehealthcare informationinformation .. HL7HL7 promotespromotes thethe useuse ofof suchsuch standardsstandards withinwithin andand amongamong healthcarehealthcare organizationsorganizations toto increaseincrease thethe effectivenesseffectiveness andand efficiencyefficiency ofof healthcarehealthcare deliverydelivery forfor thethe benefitbenefit ofof all.all. Approved by the HL7 Board August, 2005 Copyright 2006, HL7 3 U.S. Health Messaging Standards Development Efforts HL7HL7 (Health(Health LevelLevel 7)7) ACR/NEMAACR/NEMA (DICOM)(DICOM) (American(American CollegeCollege ofof RadiologistsRadiologists // National National ElectricalElectrical ManufactManufacturersurers Association)Association) (Digital(Digital ImageImage Communications)Communications) X12X12 (X12N)(X12N) HITSP ASTMASTM (E31)(E31) Health Information Technology (American(American SocietySociety ofof TestingTesting Materials)Materials) Standards Panel IEEEIEEE (Institute(Institute ofof ElectricalElectrical andand ElectronicElectronic Engineers)Engineers) NCPDPNCPDP (National(National CouncilCouncil ofof PrescriptionPrescription DrugDrug Producers)Producers) ADAADA (American(American DentalDental Association)Association) Copyright 2006, HL7 4 Materials Clinical Management System Billing, claims HL7 X12N reimbursement X12N / HL7 (Non-US only) Retail Pharmacy Orders & Reimbursement NCPDP HL7 Immunization Healthcare Database Waveforms HL7 Information System HL7, X12N Images, DICOM Agency Reporting pictures HL7 HL7, X12N IEEE MIB, ASTM Bedside Adverse Provider Instruments Events Reporting Repository Copyright 2006, HL7 5 HL7 Diversifies … • Electronic Data Exchange in Healthcare Environments – Version 2 & Version 3 •Arden Syntax • Visual / Context Integration (CCOW) • Version 2.x XML (XML encoding of HL7 messages) • Clinical Document Architecture (CDA) • Electronic Health Record System (EHRS) Functional Model Copyright 2006, HL7 6 HL7 • Working group meetings –3 times each year – about 500 attendees Board of Directors Business affairs Elected Technical Steering Committee Technical affairs Appointed officers plus chairs of the committees & SIGs The Working Group The working HL7 Any member can register for any committee or SIG Technical Committees Special Interest Groups Create normative specifications Collaborate in area of interest to or chapters in the standard contribute to the work of the TCs The Membership Non-Member Participation Non-members can register and Members get discounts at meetings and have participate in most activities, no-charge access to the Standards including some ballots Copyright 2006, HL7 7 Version 2.6 Chapters* 1. Introduction 12. Patient Care 2. Control 13. Clinical Laboratory 3. Patient Administration Automation 4. Order Entry 14. Application Management 5. Queries 15. Personnel Management 6. Financial Management 16. Non-US Claims (new to 2.6) 7. Observation Reporting 17. Materials Mgmt. (new to 2.6) 8. Master Files Appendix: 9. Medical Records / A. Data Definition Tables Information Management B. Lower Layer Protocol 10. Scheduling C. BNF Definitions 11. Patient Referral D. Glossary Copyright 2006, HL7 * 2.6 is scheduled to be published in8 2006 Committees & Special Interest Groups Architecture Review Electronic Services** Pediatric Data Standards Board** Emergency Dept. Personnel Management* Financial Management* Anesthesia Pharmacy Government Projects (US) Arden Syntax Process Improvement** Imaging Integration Anatomic Pathology Public Health & Implementation** Attachments Emergency Response International Affiliates** Cardiology Publishing** Java Common Message Regulated Clinical Element Types*** Laboratory Research Information CCOW* Health Care Devices Management (RCRIM)* (formerly Clinical Trials) Clinical Decision Marketing** Scheduling & Logistics* Support* Medical Records/ Security* Clinical Genomics Information Management* Service Oriented Arch. Clinical Guidelines Modeling & Methodology* Structured Documents* Community Based Orders & Observations* Technical Steering Health Services Organization Review** Committee** Conformance Outreach for Clinical Templates Infrastructure & Research* Tooling** Messaging* Patient Administration* Vocabulary* Education** Patient Care* XML Electronic Health Patient Safety Records* * Technical Committees, ** Board Committees, ***Task Force Copyright 2006, HL7 9 As of 2/13/06 HL7 Standards • Informative or normative • Balloting (normative) – committee-level: 66.6% – membership level 90% – ANSI-certification –ISO fast track • Informative & Draft Standard for Trial Use (DSTU) 66.6% Copyright 2006, HL7 10 HL7 Standards • Version 2.x – used worldwide, 90% of US hospitals – “pipe & hat”: HL7-proprietary, EDI-like PID||2247^^^Primary|098018500^^^MRN||FIX -INTF^PAT||19650618|Female| • Version 2.XML – a normative XML encoding for V2 <PatientGroup> - <PID PID07_DateOfBirth="19650618" PID08_Sex="Female" Copyright 2006, HL7 11 HL7 Standards • Version 3.0 (November 2005) – based on Reference Information Model (RIM) – technology independent: so far, XML schemas, JAVA API • RCRIM/CDISC lab reporting is a V3 standard, as is Structured Product Labeling • First normative V3 spec was CDA R2 Copyright 2006, HL7 12 Some Elements of HL7 Version 3.0 • Message Development Framework (MDF) • Use-case Model • Reference Information Model (RIM) • Domain Information Model (DMIM) • Restricted Message Information Model (RMIM) • Hierarchical Message Description (HMD) • Common Message Element Definition (CMET) • Implementable Technology Specification (i.e., XML) Copyright 2006, HL7 13 HL7HL7 VersionVersion 33 ApprovedApproved forfor publicationpublication anan pro-pro- motionmotion toto ANSIANSI asas anan HL7HL7 StandardStandard inin September,September, 2004.2004. Copyright 2006, HL7 14 HL7 Version 3 Copyright 2006, HL7 15 HL7 Version 3 Copyright 2006, HL7 16 HL7 Standards • Clinical Document Architecture – ANSI/HL7 CDA R1.0-2000, R2.0-2005 – first certified XML spec for healthcare – first balloted portion of HL7’s “V3” – first RIM-based specification • CDA used for HIPAA Attachments – Joint effort with ASC X12N – Two operating paradigms • “Human Decision Making” • “Computer Decision Making” Copyright 2006, HL7 17 HL7 Standards • CCOW – Clinical Context – “Composite Applications” • Clinical Document Architecture – ANSI/HL7 CDA R1.0-2000 R2.0-2005 – first certified XML spec for healthcare – first balloted portion of HL7’s “V3” – first RIM-based specification Copyright 2006, HL7 18 Thank you! any questions? Copyright 2006, HL7 19.
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