The Standard

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A little history

Studying HL7 history, our standards went from a plain text, replication/messaging-based paradigm in the 1980s to the current, Internet 2.0, resource-based paradigm. We also created document-based standards such as the Clinical Document Architecture (CDA®) Release 2 and SOA based standards like Common Terminology Services (CTS).

These 30 years of history gave us a good insight on what we need as standards users and developers.

What do we need as standards users?

People who implement and use standards want open access to standards and implementation guides. They need understandable and short specifications, off-the-shelf tools, reference implementations, friendly representation of information (instances), easy access to vocabularies, automated validation of instances, affordable education, a formal extension mechanism. 

Finally, they need examples, examples, and more examples. They need lots of examples!

What do we need as standards developers?

Standards developers have different needs. They want easy profiling with graphical user interfaces (GUI) and the ability to reuse templates. They also want one-click, automated publishing, validation and QA profiles, validation of instances, global profile registry, and ease of vocabulary binding.

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A litte about me

My name is Tim Hricik and I am a consultant with Accenture. I have been with the firm since late 2011 and have been a member of the HL7 community since 2013.

In May, I had the opportunity to attend my first HL7 working group meeting (WGM) in Montreal. As I attempted to navigate the WGM, I was introduced to a fellow Accenture colleague and longtime HL7 leader, Ken McCaslin. Ken is the head of HL7’s Technical Steering Committee and kindly helped shepherd me through the agenda and activities of the WGM. He provided introductions, shared his past experiences, and gave general words of wisdom to help me get the most out of my own experience.

Subsequently, Ken asked if I would write an article that might serve as a guide for future first-time attendees. Wishing that I had had a little more information about the WGM before my first visit, I jumped at the opportunity to share my observations with others. So, for all those attending a WGM for the first time in the near future, here is a little bit about my experience and what you might expect.

What did I anticipate for the working group meeting?

I really had no idea what to expect for my first visit to an HL7 WGM, but I knew that this would likely be different from other types of conferences I had previously attended. My initial intention was to simply attend the Fast Healthcare Interoperability Resources (FHIR®) sessions and connect-a-thon in hopes of learning as much as I could about the emerging standard.

I knew the HL7 organization was actually more than just one standard, but I will admit I let myself get a bit pessimistic about what I would encounter:

• Is this going to be the usual bunch of tech people laboring and debating over dry discussions of standards?
• Am I going to be stuck attending lengthy, drawn out lectures, struggling to maintain interest and attention?
• Will it be relevant to my interest areas and career development?

I am pleased to report that with the guidance of Ken and many of the new contacts I made, my apprehension quickly dissipated and allowed me to have a productive and, more importantly, enjoyable time.

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The Power of Community in HL7

I first became involved with HL7 a decade ago as I transitioned from medical practice to clinical informatics. I attended my first HL7 meeting, as many do, to take advantage of the tutorial sessions offered around foundational standards like HL7 Version 2 and the Clinical Document Architecture (CDA®).  The most valuable takeaway from that first meeting however was not the knowledge of the standards but the beginning of my relationship with the community of individuals who are HL7.

HL7 is a diverse community

It is a remarkable community of individuals that are as diverse as the countries they call home, the organizations that employ them, and their backgrounds of education and experience. The one thing that is common and shared across the community is the sense that we move the needle as a community; move the needle a little with each use case enabled with an HL7 standard and each project that ends with consensus on a new data standard.

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HL7 FHIR: A Standard You Can Use Today! 

A Recap of the HL7 FHIR Applications Roundtable

“A standard is not used because we created it. It is a standard because people use it.”

This familiar quote from Charles Jaffe, MD, PhD, CEO of HL7, could have been the motto for the inaugural FHIR Applications Roundtable held this July at Harvard Medical School in Boston.

As so many of the smiling attendees attested, this was indeed a very different kind of meeting.
The premise was to show how widespread HL7 Fast Healthcare Interoperability Resources (FHIR®) usage already is, and the answer was – more than we could have ever imagined.

The FHIR is spreading

Although FHIR is currently designated as a Standard for Trial Use (STU), it has already captivated the development community who is drawn to its advanced, elegant technology platform. The roundtable, like most FHIR events, cements the impression that interoperability through FHIR is not a pipe dream, but a burgeoning reality.

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What is the role of HL7 standards in the eHealth Digital Services Infrastructure (eHDSI)?

eHDSI calls for EU-wide specifications and national extensions or localizations. Interoperability assets and shared terminology resources supporting HL7 standards adoption are needed to streamline large scale eHealth deployment at a reasonable time and cost.

The eStandards project, led by the HL7 Foundation, aims to create a roadmap for collaborative eStandards development fit for the purpose of large scale eHealth deployment. CEN/TC251 and IHE Europe participate in the eStandards project along with key eHealth stakeholders in Europe.

In view of these developments, it is worth reflection on:

• How should HL7 standards be promoted at the national and European level?
• What kind of tools and resources can HL7 offer to support its European members?
• What synergies does HL7 need to engage in Europe?

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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.