1/31/2001Copyright 2001, HL71 Interoperability and Innovation An Overview of HL7 HIMSS

1/31/2001Copyright 2001, HL72 Semantic interoperability Functional interoperability Interoperability & Innovation Main Entry: in·ter·op·er·a·bil·i·ty Function: noun Date: 1977 : ability of a system (as a weapons system) to use the parts or equipment of another system Source: Merriam-Webster web site interoperability : ability of two or more systems or components to exchange information and to use the information that has been exchanged. Source: IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990]

1/31/2001Copyright 2001, HL73 Interoperability & Innovation Main Entry: in·no·va·tion Function: noun Date: 15th century 1 : the introduction of something new 2 : a new idea, method, or device : novelty Source: Merriam-Webster web site

1/31/2001Copyright 2001, HL74 Interoperability & Innovation HL7’s mission is clinical interoperability “To provide standards for the exchange, management and integration of data that supports clinical patient care and the management, delivery and evaluation of healthcare services.” Source: HL7 Mission statement (1997) HL7’s strategy is innovation – both by ourselves and by our users

1/31/2001Copyright 2001, HL75 Who is HL7? Over 500 organizational members About 1500 total members Up to 500 attend the Working Group Meetings International affiliates in: –Australia- Argentina- Canada –China- Finland- Germany –India- Japan- Korea –The Netherlands- New Zealand- Southern Africa –Switzerland- Taiwan- The United Kingdom

1/31/2001Copyright 2001, HL76 How is HL7 organized? Collaborative volunteer organization Paid staff limited to the secretariat Primary funding is membership dues Technical Steering Committee Technical affairs Appointed officers plus chairs of the committees & SIGs Technical Committees Create normative specifications or chapters in the standard Special Interest Groups Collaborate in area of interest to contribute to the work of the TCs The Working Group The "real" HL7 Any member can register for any committee or SIG Board of Directors Business affairs Elected

1/31/2001Copyright 2001, HL77 The Working Group Draws equally from providers, software vendors, and consultants Group sets aside their individual interests, rolls up their sleeves and collaborate to get the tough work done HARD WORK - five, 12-hour days, three times a year plus active electronic collaboration in between

1/31/2001Copyright 2001, HL78 What has HL7 produced? Founded in 1987 Produced Version 1.0 and 2.0 in ‘87 and ‘88 Approved HL7 message standards - –2.1, 2.2, 2.3, and 2.4 in ‘90, ‘94, ‘97, ‘99 and ‘00 Approved CCOW standards –1.0, 1.1, 1.2, 1.3 in ’99, ’00 and ‘01 Approved Arden Syntax standard in ‘99 Approved XML-based Clinical Document Architecture standard in ‘00 Accredited as an SDO by ANSI in 1994 –All HL7 approvals since ‘94 are “American National Standards” Published implementation recommendations for: –Object broker interfacing ‘98 –Secure messaging via ‘99 –HIPAA Claims attachments ‘99 –XML encoding of Version 2 ’00

1/31/2001Copyright 2001, HL79 Computing trends – last 15 years Rather than consolidating in large data centers, computer architectures have become increasingly fractionated Computers are smaller, faster, cheaper Networks give instantaneous access to anyone, anywhere, any time Medical technology has rapidly expanded the data demands placed on health care computing As a result, distributed architectures have become the norm for most medical centers, with a concomitant requirement for system interoperability.

1/31/2001Copyright 2001, HL710 Interoperability - where is HL7 used? 1998 CHIME survey of CIO’s found –80 % of respondents use HL7 in their IT activity –a further 13 % plan to implement it in future –use is over 90% in hospitals over 400 beds HL7 is no longer an extra feature in computer applications, it is now a known requirement CCOW standard installed and in use in growing number of installations Clinical Document Architecture seeing rapid deployment in major medical centers Claims attachments will be part of HIPAA NPRM

1/31/2001Copyright 2001, HL711 Innovation - users Interoperability has permitted users to select “best of breed” applications and still bind them to an enterprise data architecture Flexible clinical standards support the full gamut of clinical “topics of communication” Implementation guides have let users take advantage of their legacy data and interfaces in newer technical environments

1/31/2001Copyright 2001, HL712 Innovation - vendors Interoperability standards enable development and implementation of “best of breed” niche products. Mergers and acquisitions are possible because standards allow linking of once-distinct products Rapid adoption of new technologies is supported by implementation recommendations for existing standards Once a back-office standard, HL7 is now carrying data to the desktop and coordinating the applications that appear there

1/31/2001Copyright 2001, HL713 HL7 innovation - ideas Open acceptance of new ideas remains a key-stone of HL7’s success Fostered by a working group unified around the standards Welcoming of new or expanded topics –XML & web technologies- Vocabulary –Medical Logic- Workstation components –Structured documents- Lab automation –Record architectures- Personnel management

1/31/2001Copyright 2001, HL714 HL7 innovation - ideas Welcoming of new new communities International participation –From six to fifteen affiliates in last 2-1/2 years –Affiliates are not just ‘passengers’ but are helping drive the standards –Strong collaboration with CEN European standards activities –HL7 active in ISO Healthcare Informatics TC New domains of interest –Vocabulary, medical logic, health record communication, financial management

1/31/2001Copyright 2001, HL715 HL7 innovation - methods Initial efforts based on a pragmatic ‘just do it’ approach to standards Saw the need to revise and formalize the process –to assure consistency of the standards –to meet plug’n’play demands –to be able to adopt and leverage new technologies for both HL7 and its users Adopted the new methodology in 1997 –based on best development & design practices –supports ‘distributed’ development across committees –is technology neutral

1/31/2001Copyright 2001, HL716 HL7 innovation - methods Methodology based on shared models –Reference Information Model (RIM) of the health care information domain –Defined vocabulary domains Drawn from the best available terminologies Directly linked to the RIM Supported by robust communication techniques Harmonization process that –Assures each member and committee a voice in the process, yet –Produces a single model as the foundation for HL7 standards

1/31/2001Copyright 2001, HL717 HL7 innovation - devices Reference Information Model –Unique representation of health care domain –64 classes with 350 attributes in six critical class hierarchies –Designed to support “informatical” detail of clinical events, their results and context Vocabulary Domain Specifications –Support the RIM Hierarchies and the coded attributes –Link to the “best” of the available clinical and operational terminologies

1/31/2001Copyright 2001, HL718 HL7 innovation - devices HL7 Model Repository – data base holding the core of HL7 semantic specifications –RIM- Use case models –Vocabulary domains- Interaction models –Message designs- Message constraints Tool sets designed against the repository to –Permit management of repository content –Review and browsing of semantic specifications –Design of abstract information structures based on the RIM for use in messages, templates, documents,. Etc. –Publish HL7 specifications and standards –Support implementation of HL7 standards

1/31/2001Copyright 2001, HL719 New capability for HL7 usersfor HL7 itself Impact – Who we are & What we do

1/31/2001Copyright 2001, HL720 Interoperability and innovation An overview of HL7? No – core competencies of HL7 –have resulted in strong growth of HL7 and its capabilities A symbiotic cycle –We innovate to provide interoperability to our users –The users use interoperability to innovate in their domains –User innovations lead to new ideas and new participants for HL7 –HL7 “interoperates” with these new ideas and people to innovate in its own domain

1/31/2001Copyright 2001, HL721 Health Level Seven is its members, their ideas and contributions is a group that innovates in standards to meet health care interoperability needs is desirous that you benefit by joining us in our endeavor