Monday, December 10, 2007

HL7 Watch Watch

In the first two years of its existence this weblog has drawn a significant response from the wider HL7-interested community. Positive appreciations are to be found inter alia in the following weblogs:

HL7 Connection
"Should Governments Rely on HL7?"

Future of Health IT: Trends and Scenarios
"HL7 Watch: Is HL7v3 Overrated by being rated at all?"

Australian Health Information Technology
"Is SNOMED CT a Practical Usable Clinical Terminology Today?"
Here Alan Rector is also quoted, with his wise words to the effect that:

Unless we can formalise the mutual constraints ... HL7 v3 + SNOMED = Chaos.
The documentation is beyond human capacity ... to write or to understand.

Update March 2008:

Gratifying post also at Trusted.MD:

The argument that HL7 RIM is incoherent is compelling. I'll admit that I've found HL7 RIM to be impossibl[y] confusing for years. The problem is that as a foundation for all-things-HL7, RIM causes a lot of trouble.

Update February 2009:

See also Health Informatics Blog

Update October 2009:

Interesting post from Bruce Lemma:

If you want to get something done - just stick with version 2.x. Version 3.0 was meant to remove the ambiguity that exists in version 2.x by following a more rigorous theoretical modeling framework. In practice though it doesn't. v3 is more ambiguous than v2 ever was. v3 is very complicated. A lot of effort is required just to understand the basic concepts of version 3.0.

The only people game enough to really try and work with HL7 version 3.0 are governments and universities - organizations which can afford to dissipate a lot of resources without tangible results. It's very hard to find a real v3 success story. Have a look into what the NHS (UK) and Infoway (Canada) are doing.

Both organizations have a lot in common - billion dollar budgets, strong advocates of v3 and almost nothing tangible to show for it. It will take a few more billions before people will start to admit that v3 has serious problems.

It's a bit like the children's fairy tale - "The Emperor's New Clothes". Because so many people close to the standard have invested so much into it no one wants to admit it's not working as a standard. You'll find that people from HL7 get extremely defensive if you even hint at the idea that v3 has problems. You've gotten a taste of it already on this list.

Most vendors are extremely careful to avoid being openly negative about the standard because they are afraid of being seen as anti HL7. No one wants to risk annoying organizations like the NHS and Infoway or members of the HL7 organization that have influence over buying decisions at hospitals.

Infoway practically bank rolls the HL7 organization these days. They almost managed to stop v2 education from happening at the next HL7 meeting in Canada.

So it's a pretty pickle that the HL7 organization has gotten itself into - it is almost
impossible politically for it back down at this stage.

To get a more objective view of v3 you need to look at the opinions of people that do not have so much invested in it. One amusing website I can suggest is

Good luck with your integration - and don't feel embarrassed about the problems you have with version 3.0 - you're just the little boy that's pointing out that the emperor is not wearing any clothes.

Source: HL7 Anwendergruppe Österreich.

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