HL7 Germany ESPERIENZE INTERNAZIONALI : HOW HL7 GERMANY GOES FHIR AND BEYOND ... I° HL7 Italia FHIR Workshop : potenzialità e prospettive comuni, Florence 4 dicembre 2015 Dr. med. Kai U. Heitmann Heitmann Consulting and Services (DE) CEO HL7 Germany
HL7Germany
ESPERIENZE INTERNAZIONALI:
HOW HL7GERMANYGOESFHIRAND BEYOND...
I° HL7 Italia FHIR Workshop : potenzialitàe prospettive comuni, Florence4 dicembre 2015
Dr. med. Kai U. HeitmannHeitmann Consulting and Services (DE)CEO HL7 Germany
Agenda
§ FHIRStructuresinGermany▶ TechnicalCommittee:aStrategyandaTaskList▶ HL7:ThreeGenerationofStandards!▶ Tooling– now and inthe Future
§ FHIR’sdiaboliccomponents▶ CriticalFactorsandCriticism
§ Conclusion
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TechnicalCommittees
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§ BoardofDirectorsdrivesandsupervisestheTechnicalCommittees
HL7 Germany Board of Directors
CDA and XML / V3
Messaging andVersion 2 Terminologies
Tools, Conformance
and TestingFHIR
CEO
FHIRTechnicalCommittee
§ InformationandEducation§ CommunityFormation§ MeetingsandWorkGroups§ CreateandmaintainProfilesandValueSets
▶ Connect-a-thons▶ Infrastructure▶ ToolsandBestPractice
§ BringFHIRintoPolitics,ScienceandIndustry§ InternationalRepresentation/Reports
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Informationand Education
§ WebsiteTopTopics§ Tutorialsatour AnnualMeetings
§ Hack-a-thons§ Videos(hl7.tv)§ Presentationsatothermeetings
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Informationand Education
§ Calmdownyourmembership▶ “Don‘tkicktheotherstandardsoutofthedoor”▶ …warn,encourage… andshowBestPractices
§ ExpectationManagement§ MigrationStrategies§ PilotProjects§ Blessingandcurse:NewandyounggenerationofAppbuilders– withnomedicalbackgroundatall
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HL7-Standards-Family
§ Version2.x▶ Messages(1987..)▶ v2.xml(2003..)
§ Version3▶ Messages(1995..)and Services▶ Documents =ClinicalDocumentArchitecture CDA(1999..)
§ FHIR (FastHealthcare Inter-operability Resources,2012..)
First FHIR Workshop HL7 Italy, Florence, 4 December 2015
FHIR
CDA
HL7v2
7
InteroperabilityParadigms
§ REST▶ Coreof FHIR,with GETandPOSTetc.
§ Documents▶ LikeCDA,Bundlesof Resources
§ Messages▶ Likev2undV3,Bundlesof Resources
§ Services▶ ServiceOriented Architecture
§ Alsoimportant – Formats:XMLvs JSONFirst FHIR Workshop HL7 Italy, Florence, 4 December 2015 8
Convergenceof Problems/Solutions
§ Segments§ Datatypes
HL7v2
§ Profile§ Z-Segments
§ Machine only
§ Ad-hocCoverage
§ Model(V3)§ Datatypes
HL7R1.1
§ Templates§ InformalExtensions
§ Human/Machine
§ 100%Coverage
First FHIR Workshop HL7 Italy, Florence, 4 December 2015
§ Resources§ Datatypes
PartiallyHL7R2/ISO21090
§ Profile§ FeaturedExtensions
§ Human/Machine
§ 80%Coverage
FHIRCDAHL7v2
9
ConvergenceofProblems/Solutions
Patient Summary
Patient
Author
Custodian
Family History
Current Medication
Medication
Problems
Problem
§ Templates/Profile
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A life withoutmapping is possible
but useless
Whathappenswhen?
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CDA
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
FirstMeetingHospital
UniversityofPA..
v2.0published
v2.1published
ChartermemberofANSIHISPP
Version3.0NormativeEdition2005
v1.0published
ImplementationSupportGuidepublished
v2.2published
v2.2ANSI
v2.3PublishedandANSI
Version 2.3.1PublishedandANSI
ArdenSyntax2.0 2.4
CCOW
MoreThanMessages
CDARelease1
1993:HL7Germany
v2.5published
v2.6published
CDARelease2
FHIR
CDA
FHIRDSTU2
FHIR1st draft
FHIRDSTU1
CommunityFormation
§ BLOG,CommunityMailingList,Twitter,Facebook,“smotare conbierra”
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FHIRProfiles+ValueSets
§ Creation▶ GermanProfiles▶ GermanDatatypes▶ GermanExtensions▶ GermanValueSets
§ Maintenance▶ Registryforprofiles,extensionsandvaluesets▶ Multi-PurposeTooling(TerminologyServers,Forge,ART-DECOR)
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§ ...is anopen-source tool andamethodology forvarious stakeholders ofhealthcare information exchange
ART-DECORin4bullets (1)
© auremar - Fotolia.com
© WANG HSIU-HUA - Fotolia.com
ART-DECORin4bullets (2)
§ ...supportscomprehensivecollaborationofteammemberswithinandbetweengovernancegroups
§ ...allowsseparationofconcernsanddifferentviewsononesingledocumentationfordifferentdomainexperts
§ ...supportscreationandmaintenanceofHL7templates(DSTU),valuesets,datasetsandmore
§ Oneofthemainobjectives▶ Separationofconcernstowardsacomprehensivespecification
▶ Differentviewsononesingledocumentation Withchangingfocusondifferentartifacts Fordifferentdomainexperts
ART-DECORmainobjective
OverviewART-DECOR®
ART-DECOR®
§ Used inGermanyfor▶ Creation andMaintenanceof CDA-relatedDefinitions Templates ValueSets
▶ Datasets(e.g.functional view onadiagnosis,anallergy,aprocedure)
▶ Terminology Referenceand Service▶ ApplicationPrototypeBuilding▶ BuildingBlockRepository(BBR)
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ART-DECORtemplates
ART-DECOR®andFHIRSupport
§ TerminologyServices§ ProfilesandExtensionRegistry
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ART-DECOR®Projects(some)
§ Internationalprojects(mainlyinEurope)▶ Austria (ELGANationaleHealth programme)▶ Netherlands(nationalscreeningprogramme onbowelcancer)
▶ Netherlands(Nictiz,multipleprojects)▶ Norway(HL7,regionalHealthnetworks)▶ epSOS/EXPAND(EuropeaneHealth programme)▶ Germany(HL7,nationaleHealth programme)▶ HL7PolandiEHR withCDA▶ EuropeanTemplatesandValueSetRepository(nascent)
▶ IHEProfileandValueSetRepository(indevelopment)
§ art-decor.org▶ Documentation▶ Internationalsite andinternationalprojects host
▶ blog.art-decor.org etc.
▶ Sourceforge§ decor.nictiz.nl
▶ Dutch projects host▶ Documentation,specification
ART-DECOR@ internet
FHIRPersons (DE)
§ SimoneHeckmannFHIRTCLead
§ CEO,BoD and other TCLeads
§ WorkingGroups
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Politics,Science,Industry
§ BringFHIRintoPolitics,ScienceandIndustry§ eHealth Law
▶ ContactwithPoliticians▶ Position/OpinionPapers▶ Hearings▶ “Bundestag”
§ Easier:Science,Industry– becausewearebetterinreachingourmembers
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Foto © Bundesregierung / Henning Schacht
Politics,Science,Industry
§ HL7Newsletter▶ DE,CH,AT,LU
§ PressReleasesHL7Germany
§ OpinionPaperswithotherorganizationse.g.IHE,VendorAssociationsetc.
Anwendertreffen Health-Comm 28. und 29. Oktober 2015 Nürnberg
InternationalRepresentation
§ FHIRConnect-a-thons§ FHIRDeveloperDays§ Reportstomembership§ WorkwithFHIRandtoolstomakeitabetterstandard
§ Re-thinkandre-fineconcepts§ Identifythreats
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HL7Germany
FHIR‘S DIABOLICCOMPONENTSWe arenotyet there...
Foto © Fotolia.de: miroslavmisiura
CriticalFactors andCritisism
§ InsteadofadoringtheModelersnowadoringtheImplementers
§ 80/20Rule§ Governance,Governance,Governance§ Health-ITisnotcomplexbecauseoftheITbutbecauseofHealth
§ Problemsremainthesame▶ Whatisanallergy?
§ ManyProblemstoseenyet,yettocomeFirst FHIR Workshop HL7 Italy, Florence, 4 December 2015 28
Toolingand Supportgrowing
§ Beyondtechnicalandsemanticalconnectivity
§ Usersatfrontends
§ Documentview
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TimeTableforTests
§ Sept2015:DSTU2published§ Jan2016:DSTU2.1ballot§ Spring2016:DSTU2.1published§ 2017:FirstNormativespecification§ Additionalreleasesevery12-18months
First FHIR Workshop HL7 Italy, Florence, 4 December 2015 Foto © Fotolia.de: fotomek30
HL7Germany
CONCLUSION
Conclusions:Strategyand Tasks
§ InformationandEducation§ CommunityFormation,MeetingsandWorkGroups
§ CreateandmaintainProfilesandValueSets▶ Connect-a-thons,Infrastructure▶ ToolingandBestPractice
§ BringFHIRintoPolitics,ScienceandIndustry§ InternationalRepresentation/Reports§ VivaItalia!…butdon’tforgetEurope
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HL7Germany
GRAZIE!THANK YOU!Questions?
Dr.med.KaiU.Heitmann,MD,FHL7HeitmannConsultingandServices,Germany
CEOHL7GermanyART-DECORExpertGroup