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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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





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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

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“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





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Short Trip through Europe• 14 European Affiliates (of 26+1 total)

UK2000

Ireland2003

The Netherlands1996

Germany1995

Finland1996

Czech Republic2001

Croatia2001

HL7 Activities in…

Croatia

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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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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


Bulgaria

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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


Training


Czech Republic

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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


Finland

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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


CDA

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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...


CDA

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Specialized care epicrisis


Ireland

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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


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.


HL7 v3

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United Kingdom

Tools enhancement for HL7 Version 3 Modelling


The Netherlands

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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


HL7 v3 Training

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Germany

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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


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?

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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)

HL7 Activities in Europe

Documents

hisnot hl7 compatiblecsni

desiredno localizations

europe14 european affiliates

constitutive meeting

medical statistics

czech republichl7 roadshow

czech republicfocused

data standard