Friday, November 25, 2005

Misleading Claims regarding HL7 V3

As an example under the heading "problems with HL7 V3", consider the following claim,
  • HL7 V3 is the standard of choice for countries and their initiatives to create national EHR and EHR data exchange standards as it provides a level of semantic interoperability unavailable with previous versions and other standards. Significant V3 national implementations exist in many countries, e.g. in the UK (e.g. the English NHS), the Netherlands, Canada, Mexico, Germany and Croatia. Within the US, jurisdictional agencies needing support for large scale integration (e.g. CDC, FDA) have adopted V3.
from a 'white paper' issued by a group of European messaging experts in November 2005. Again, we believe that the claim that there exist 'significant V3 national implementations' is at best misleading. The NHS is certainly attempting a national implementation of V3 in the United Kingdom, though this is for the purposes of messaging (for which HL7 was of course originally designed) not as a 'national EHR ... standard'. Even in regard to the fulfilment of these purposes, moreover, the NHS is confronting considerable difficulties in implementing V3.

We are sceptical that there are significant 'national implementations' of V3 which would justify the claim that it is the EHR 'standard of choice' in the other countries mentioned. In particular, none of the countries mentioned is using the "functional specifications" for EHR under development within the V3 framework (which may have something to do with the fact that the specifications in question were designed with the rather special case of the USA in mind).


Anonymous said...

Barry, have you heard about the V3 implementations in Holland and Croatia. V3 messaging has been mandated as the messaging standards for these projects.

Barry Smith said...

Indeed. And I have attempted to find out more, specifically, about the Croatia implementation, but for some reason those involved in it seem not to want to answer my questions. As to the Dutch implementation, there it is clear: the attempt is being made to enable local EHR systems to contribute to a virtual national EHR system by exchanging data through HL7 V3 messaging. My point is that the EHR systems themselves, here, are entirely RIM-free, and the same applies also to the proposed terminologies.