Friday, August 03, 2012

Re-fur-bish (verb): To bish, again, with fur

Rene Spronk, in his new proposal to "Renovate HL7 version 3" recognizes that HL7 v3 has failed. As he points out, almost all implementations of v3 today are not in keeping with the original intentions of the v3 developers.  “I've been working on the HL7 version 3 standard for about 10 years - but based on experiences gained during consultancy projects with implementers, and based on experiences of implementers …, I see no other way forward for HL7 v3 then to embark on a renovation project.”

'Renovation', according to the dictionary means: to restore to an earlier, better state. For Rene, to renovate means:  to optimize "for the kind of HL7 v3 implementations that we actually see in use today".  He proposes three alternative paths to such renovation:
Proposal 1.  involves adding a new layer of "re-usable elements" to HL7 v3 and "getting rid of the 100s of different R-MIMs".  
But where will these new re-usable elements come from? And who, given the failures thus far, will trust a methodology based on the RIM to yield elements which will actually be reused?

More interesting are the proposed second and third alternative paths:
Proposal 2. is to renovate HL7 v3 by "moving everything to CDA R3, and to cease development related to HL7 v3 messaging."
Propose 3. is to renovate by "moving everything to FIHR [= Fast Healthcare Interoperability Resources] and to cease development of HL7 v3".
Thus in both cases ‘renovation’ in the sense of: abandonment. 

Everything in the FHIR (pronounced ‘Fire’) is, to be sure, required to have a ‘mapping to the RIM’. But this, we presume, is simply for reasons of nostalgia ... for earlier, better times.


Rene Spronk said...

Just a few additions to deal with the intended semantics of my qouted words:

The semantics of Renovate ( "2. To impart new vigor to; revive".

Moving stuff over to CDA R3: all messaging R-MIMs will be reusable as part of CDA R3, so there'll be a fair bit of moving. We'll have messaging models as part of a document - in a way, that's renovation.

Moving stuff over to FHIR: all of the v3 modeling at least has given those involved a pretty good idea what data should be part of FHIR resources. That's not renovation, that's innovation.

Anonymous said...

I have a hard time believing that anything useful can come from any HL-7 V3 implementation. The whole process is maddening. Standards are developed in the absence of any systems, only a very modelers can model data into the V3 RIM, and can anyone get any data out of big V3 systems in a timely, useful and practical manner. Billions of dollars have been wasted trying to develop HL-7 V3 compliant RIM-based health information system. An uncountable number of lives have been lost because we do not have an Electronic Health Information system that catches medication errors, known allergies or stops bad medicine. I just have a hard-time believing that something so obviously flawed has lasted this long and is still taken seriously.

Anonymous said...

Kill it with FIHR?