HL7 as an International Organization
The whole idea of regional offices for HL7 goes back to Ed Hammond’s third HL7 chairmanship in 2008-2009, inspired by the vision to turn HL7 into a truly international organization. This began with changing the organization’s name from Health Level Seven, Inc to Health Level Seven International.
It was not the first time that HL7 Europe came up in discussions. In the 1990’s, the European HL7 affiliates abandoned the idea thinking there wasn’t enough common ground: HL7 was the place for global standards development and localization was national business: France, Italy, and Germany had as much in common as with Australia, Canada, and Japan.
But that changed with epSOS. Under the leadership of a dynamic Swede, Fredrik Linden, the 36.5 MEuro epSOS large scale pilot project (2008-2013) was a game changer. epSOS pushed cross border ePrescription and patient summaries at the front of national and European eHealth policy agendas.
HL7 Clinical Document Architecture (CDA®) was chosen by the epSOS industry forum as the exchange format of patient summaries. The eHealth Network of 28 health ministry representatives catalyzed the process of advancing EU-wide eHealth services by adopting the ePSOS specifications as the basis for European guidelines. HL7 Board of Directors member Jeremy Thorp has been instrumental in the development and the revision of the guidelines.
The HL7 Foundation is Formed in Europe
At that pivotal time, the HL7 Foundation was established to serve as the European office of HL7. Its mission is to promote HL7 standards in Europe, to convey the European requirements to HL7 work groups, to form relations with European umbrella organizations and to participate in EU funded projects and initiatives.
HL7 Foundation Advances CDA, FHIR and the EHR System Functional Model
After five years of growth, the HL7 Foundation has expanded its efforts with the active engagement of the European Strategic Advisory Board, chaired by Christof Gessner. The HL7 EU realm is gaining traction and receiving tooling support from Giorgio Cangioli, Dr. Kai Heitmann, and the ART-DECOR team. Progress is being made in detailed clinical models and profiles for the EHR-S Functional Model. Finally, HL7’s Fast Healthcare Interoperability Resources (FHIR®) is attracting a lot of interest among implementers and HL7 CDA adoption is spreading.
HL7 Foundation and EU Projects
In parallel, membership in the mHealth assessment guidelines work group, the European Network and Information Security Agency (ENISA) eHealth expert group, the Alliance for the Internet of Things Innovation, and the eHealth Stakeholders Group offer input, advice, and insights into the EU policy agenda.
Participation in EU funded projects ANTILOPE (eHealth testing), Semantic Healthnet, EXPAND, eHGI, and Trillium Bridge helped increase the visibility and impact of HL7 in Europe. Trillium Bridge “Bridging Patient Summaries across the Atlantic” was the first project led by the European office of HL7. Funded by the European Commission, Trillium Bridge served as the operational arm of the EU/US memorandum of understanding on eHealth. Its key recommendation advanced the concept of a globally consistent patient summary standard serving as the springboard for accessing core patient information when and where is needed. The HL7 IPS/InterPAS project scope statement, currently under revision aims to further this vision.
The Path Forward
Looking forward, a common eHealth services infrastructure is emerging in Europe. It heralds even bigger challenges and opportunities for the European office of HL7 and its community. Stay tuned for four related strategic questions in part II.