HL7 Activities in Europe
Concepts & Implementations in Health Information Projects
Dr. Kai U. HeitmannUniversity of Cologne (Germany)
Institute for Medical Statistics, Informatics und Epidemiology
Board member HL7 user group Germanypast Co-Chair XML Special Interest Group HL7 USA
International Representative elect HL7 Board of Directors
HL7 UK ConferenceLondon, UK, December 11+12, 2003
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HL7 Activities in Europe
What happened so far? – …history
What happens at all? – …layers
What happens far away? – …countries
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Development of European Affiliates• 14 European Affiliates (of 26+1 total)
UK2000
Ireland2003
The Netherlands1996
Germany1995
France2003
Spain2003
Finland1996
Poland2003
Czech Republic2001
Lithuania2002
Denmark2003
Italy2003
Switzerland2000
Croatia2001
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Development of European Affiliates• 14 Affiliates
– First affiliates ever (DE, NL) were from Europe
• Meetings– 1st International Affiliates Meeting 2000
• Dresden, (DE)– 2nd International Affiliates Meeting 2001
• Reading (UK)– 1st International Conference on CDA 2002
• Berlin (DE)– 3rd International Affiliates Meeting 2004 planned– Spring Working Group Meeting planned
HL7 Activities in Europe
What happened so far? – …history
What happens at all? – …layers
What happens far away? – …countries
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“proprietary”HL7 v2.x
HL7 v2.XMLCDA HL7 v3 …
“payload”content
1234… HL7 |^~ XML …exchange
format
“Layers” of activities
• Content vsexchange format vsInfrastructure/framework for transport and security
• International solutions / standards
• Legal requirements
MLLP ebXML WS-* FTP/S S/MIME HTTP/S …transportsecurity
7
“Layers” of activities in Europe
• v2 messaging standard– since 1985– Widespread, used in hospitals
• XML encoding for known content
• „New“ messaging standard– early implementor projects
• V3 based documents
• Infrastructure and Framework
• Education
HL7 v2.XML
InfrastructureSecurity
HL7 v2.x
CDA
HL7 v3
Training
HL7 Activities in Europe
What happened so far? – …history
What happens at all? – …layers
What happens far away? – …countries
9
Short Trip through Europe• 14 European Affiliates (of 26+1 total)
UK2000
Ireland2003
The Netherlands1996
Germany1995
Finland1996
Czech Republic2001
Croatia2001
HL7 Activities in…
Croatia
11
Croatia• April 2001: HL7 Roadshow in Zagreb
– with W. Ed Hammond, Klaus D. Veil, Joachim Dudeck and Kai U. Heitmann
• HL7 Croatia in September 2002– Croatian Society for Medical Informatics (CSMI)– Croatian Society for Medical and Biological Engineering
(CROMBES)– Supported by
• Ministry of Health of the Republic of Croatia• Croatian State Office for Standardization and Metrology• Croatian Public Health Institute
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InfrastructureSecurity
HL7 v3 TrainingCroatia• Activities
– Education• Workshop „HL7 Communication Standard“• Module „HL7 – International Communication Standard in
Healthcare“, 6th International HIT Conference „Biotechnology and Public Health“
– Infrastructure• WebService Based Infrastructure for the Exchange of
Information• Large Mobile Phone vendor
HL7 Activities in…
Bulgaria
14
Bulgaria
• Bulgarian Health Informatics Standards Plan– Started in 2001, first version in 09.2002, until 2005– Standards Candidate Evaluation
• Six main areas of interest– Health Information & Records Management– Messaging & Communications– Electronic Health Records– Clinical Vocabularies– Security– Privacy
• Not a HL7 affiliate yet
InfrastructureSecurity
Training
HL7 Activities in…
Czech Republic
16
Czech Republic• HL7 Roadshow in Prague
• HL7 Czech Republic– November 2001– Constitutive meeting with the Ministry of Health Dec 01
• Data standard of the Ministry of Health of the Czech Republic– focused on communication between LIS and HIS– Not HL7 compatible
• CSNI endorses CEN and ISO standards– harmonization of HL7 with these is desired– No localizations of HL7 yet, but planned– Envisaged: local vocabularies from the Data standard of the
Ministry of Health
HL7 v2 Training
HL7 Activities in…
Finland
18
Finland• Use of CDA Release 1
• Database of „CDA headers“
• Connection implementation within four health districts in Finland
• „open interfaces“
• HL7 Finland defined application level protocol– Based on ebXML
• Future: exchange of other documents like referrals, prescriptions and health certificates
InfrastructureSecurity
CDA
19
Finland• CDA Release 2
– specifications ready by 1/2004
• OpenCDA project 5/2003 - 1/2004– funded by MoHSW and HL7 FI (together 260 k€)
• Plans for similar project for 2004 – standarization activites build in a broad sense around
HL7 TC (formal mandate)
• areal funding for 2004-2005 towards 2007– MoSHW will distribute 20 + 10 M€ for the areas– one technical requirement is to use CDA...
InfrastructureSecurity
CDA
20
Specialized care epicrisis
HL7 Activities in…
Ireland
22
Ireland• HL7 version 2.4 with XML encoding
• coordinated by HeBE (Health Board Executive)– sponsors a messaging group– coordinates the work of projects in the different Health
Boards
• lab messaging in the Southern Health Board– will roll out to all GPs in 2004– Based on v2.xml
HL7 v2.XML
HL7 Activities in…
United Kingdom
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United Kingdom• GP 2 GP Project
– Early Implementor Project based on Version 3
• Infrastructure Framework– Support by NHS
• BBC news from Monday this week:– BT wins £1.6bn 10-year NHS deal– aims to connect more than 30,000 GPs and 270 acute,
community and mental NHS Trusts in a single national system.
InfrastructureSecurity
HL7 v3
25
United Kingdom
Tools enhancement for HL7 Version 3 Modelling
HL7 Activities in…
The Netherlands
27
The Netherlands• HL7 Project Office
– Projects, Training (focussed on Version 3)
• National IT Institute for Healthcare
• Projects (among others)– Modelling the perinatology domain
• Domain analysis, Modelling• Implementation guidelines• Proof of concept: Modelling
– Medication Registry as one of the first steps to a EHR in the Netherlands
• Implementations with several vendors at large exhibition• Visit: Presentation given by Tom de Jong, tomorrow
InfrastructureSecurity
HL7 v3 Training
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HL7 Activities in…
Germany
30
Germany• Content: SCIPHOX Project (CDA)
• Infrastructure Framework– New Project by Ministry of Health (bIT 4 Health)
– Consortium of 5 vendors/organisations– Introduction of the Health card for patients– Health professional card for providers
• Conformance: v2 Profiles for specific use cases
InfrastructureSecurity
CDAHL7 v2.x
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Germany: Cards as the keyFor a Telematic Infrastructure
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The SCIPHOX project and CDA• uses CDA R1 model as a start
• framework for basic sharedinformation (CDA Header)– sender, recipient, patient, event etc.
• definition of structures (CDA Body)– Structure of information units based on analysis– Story boards (discharge/referral documents, long term
diabetes documentation, emergency info)
• localization– Complementary local requirements
• Formal voting procedures for specifications
CDA
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HL7 Activities in Europe – Conclusion• Lot of education required
– Modelling Methodology– Version 3 and CDA
• Early implementor projects– Version 3 and CDA– Practical implementations– Feedback for the standard
• Infrastructure Framework needed
• Funding– collaboration with national bodies (MoHI)– European money
• Awareness of standards HL7, CEN
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Thanks
…for your attendance!
Questions?
35
Contributions to this presentation• Entity::Living Subject::Person
– Gjuro Dezelic (HR)– Vit Koksa (CZ)– Timo Tarhonen, Timo Itälä, Vesa Pakarinen (SF)– William F. Goossens, Irma Jongeneel de Haas,
Tom de Jong (NL)– Klaus Veil (AUS)– Brian O‘Mahony (IRL)
