HL7 Activities in Europe

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

4

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

6

“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

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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

24

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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Later? mailto:Kai.Heitmann@medizin.uni-koeln.de

Thanks

…for your attendance!

Questions?

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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)