At 12:05 pm +1000 11/5/06, Andrew Patterson wrote:
HL7 V3 goes a long way to eliminating variability, but this is no
small task and real implementations are sparse.
See this is where I think the disconnect between proponents
of HL7 and I are..
I have spent the last 2 weeks "outputting" HL7v3 from a
clinical system and from my point of view the specs
go nowhere near eliminating variability - I was left
with about 50 "choices" as to how the HL7 would be structured
(is a 'progress note' an observation and how should it be coded -
if I have a set of 'allergy' observations, where do I put them in a
patient record and how do I distinguish them from other observations).
So here I am, making choices as a technical person that I
don't feel at all comfortable making. I don't want to make those
choices - I want to be told what to do in the areas that I have
no expertise. I want to know that HL7 as an organisation has
locked 400 doctors in a room and told them they can't come out
until they make some decisions on stuff like this. Because if
the standards organisation isn't going to make these choices,
who is?
I understand that what you are describing doing is rather clearer
than you describe in HL7V3.
I think clinical information is orders of magnitude more complex
than, for example:
banking records
accounting data
billing data
mailing lists
etc
I don't think HL7 V3 gives you the choices you think you have, but
learning about HL7V3 is not a weekend course.
If you really want to know about HL7, you have to go to an HL7
conference in the USA and talk to the people that know lots.
And HL7v2 is worse than this? I am worried that the
organisation as a whole doesn't see this as an issue? How can
you have a 20 year old messaging format where people
can't point you to an unambiguous definition
for a pathology response?
The major advantage of HL7 is industry participation - there are
hundreds of participants working together towards a common goal.
Standardisation is informed by implementation.
Its more than informed by it - standardisation without parallel
implementation is completely useless in my experience..
That's the present NEHTA problem.
Ian
Andrew
--
Dr Ian R Cheong, BMedSc, FRACGP, GradDipCompSc, MBA(Exec)
Health Informatics Consultant, Brisbane, Australia
Internet: [EMAIL PROTECTED]
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