How HL7 UK is supporting implementation of healthcare messaging Philip Scott

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
Co-chair, HL7 UK NHS Implementers group
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 affiliates
Argentina
Denmark
Japan
Turkey
Australia
Finland
Korea
UK
Brazil
France
Mexico
Canada
Germany
New Zealand
China
Greece
Spain
Croatia
India
Sweden
Czech Republic
Ireland
Switzerland
Italy
Taiwan
Timeline of HL7 versions
1987
1988
1990
1994
1996
1997
1999
2000
2003
2005
Version 1.0
Version 2.0
Version 2.1
Version 2.2
V3 – development starts
Version 2.3
CCOW
Version 2.3.1
Version 2.4
XML CDA v1
HL72UK vA.2
Version 2.5
V3 Normative Edition
Scope of the HL7 v2 standard
Chapter
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Introduction
Control
Patient Administration
Order Entry
Query
Finance
Observation Reporting
Master Files
Medical Records
Scheduling
Patient Referral
Patient Care
Clinical Laboratory Automation
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!
Standards are great,
let’s all have one!
“Rampant optionality”
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 selfhelp 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?
CSC
HL7 Message Usage
CSCAlliance
Alliance
P1R1 NASP
EBS
PDS
ETP
GPtoGP
LRS
SSB
SDS
NASP MHS
2b
4a
2b
2b
2a
Interfacing Engine (EBIE)
3a
1a
NASP Interfacing Engine
(NASPIE)
P1R1 PAS
Data Centre Hosted
Departmental System
i.IE
Maternity
IE
Lorenzo
i.CM
i.PM
Maternity
Theatres IE
Theatres
Trust A
2b
4b
2b
2b
Existing System Interfacing
Engine (ESIE)
4b
4b
2b
CSC P1R1 Interfacing
4a
1b
CSC P1R1 Data Centre
Trust B
Trust Interfacing Engine A (TIE-A)
Existing System 3
(ES -A3)
Existing System 4
(ES -A4)
Existing System 1
(ES -A1)
Existing System 2
(ES -A2)
Trust Interfacing Engine -B
(TIE-B)
Existing System 1
(ES -B1)
Existing System 2
(ES -B2)
Existing System 3
(ES -B3)
Existing System
4 (ES -B4)
1 - NASP Interface – HL7 V3
2 - Existing Systems Interface – HL7 2UK (VA.2)
3 & 4 - Departmental Systems Interface – HL7
V2.3/V2.4
Fujitsu
Fujitsu Data Centre
Millennium
HL7 V2.3
OpenEngine
DIE
HL7 V2.3
HL7 2.3
HL7 2.3
HL7 2.3
HL7 2.3
Hosted TIE
Trust Trust Trust
System System System
Trust TIE
Trust Trust Trust
System System System
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
NHS implementation support
v3 request/report
GP
GP using two labs may
receive PMIP and v3
Lab 1
v2.4 UK A.2 report
PMIP
v2.3 report
Lab 2
Each translation point
adds maintenance and
risk of error
Specialty
Specialty system using
two labs may receive
two kinds of v2
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…
Questions…
Email: [email protected]
Or [email protected]
Phone: 07766 254169