Hello Andrew,

brief comments inline.

Thursday, May 11, 2006, 10:44:53 AM, you wrote:

>> In the Web services hype there is a tendency to try and reinvent the
>> wheel. We have a messaging specification that supports Orders and
>> results and medications with atomic data. It is responsible for the
>> majority of Data transmission that occurs today - and it occurs
>> millions of times a day now and seems to work. That is of course HL7
>> V2, and we already have international and local standards that are
>> published and actually available for free. HL7 is not a document
>> structure it is a full blown messaging specification that has survived
>> 20 years... and will continue to survive because it works. If you want
>> XML documents, no problem, HL7 V2 has well defined XML encoding specs.
>>
>> All we lack is the transport layer to move this around and the
>> terminology and standards on how to use the terminology to achieve
>> more semantic interoperability.

AP> Andrew, if I can make an observation about HL7 as an outsider
AP> to health informatics, but as someone who has seen standards
AP> work in more technical areas - I'm interested in the lack of
AP> 'definitiveness' about hl7, which to me seems at odds with
AP> successfully using it as a message standard in completely
AP> distributed environments i.e. between a GP and a path lab
AP> that have never talked to each other before..

As an outsider you need to understand the standard and if you don't it
will take a lot longer. It something that does take effort and time to
digest.

AP> I can recount a tale of a recent software development - when
AP> a path lab was asked for an electronic feed of hl7 results, its
AP> reply was "how do you want the HL7 done", to which the
AP> reply was "the standard way", at which point they laughed
AP> hysterically.. is this the wonderful 20 year old message
AP> specification that we are banking on - one where a three
AP> week negotiation period is needed between two vendors
AP> in order to align their "standards". Where interoperability
AP> demos need to be planned 3 months in advance so that
AP> the systems can actually handle the data of either side.

They "should" be able to send you their HL7 V2.3.1 as per the
Australian standard, certified by AHML and using LOINC codes specified
by IT-14-6-5. The fact that cannot is a problem, A compliance problem.

They may have laughed a lot longer and louder if you asked them for
Data in the 'Andrew Patterson XML Format' you had just devised.

Maybe you should have talked to us, I am sure we could have done it in
a day ;-)

Seriously, 3 weeks is a lot better that the performance of the
Healthconnect format we are all supposed to have by now. How many
years have we been waiting....


AP> Technical standards work because the _goal_ is to
AP> remove ambiguity - so whilst they aren't always perfect,
AP> the end game is to have a standard where all parties
AP> know that this bit goes in that spot.. but I don't need to
AP> have a week long interoperability chat before my
AP> RFC822 emails can be parsed..

I think health is a bit more complex than EMail!!!!

AP> HL7 seems not to have that as a goal - I don't know
AP> if that's because medical
AP> data modelling is inherently complex (which I believe
AP> it is) or whether it's just not even seen as a goal given that
AP> its mainly used between large hospital systems etc where
AP> there is always that time to have an interoperability
AP> discussion. I have seen various sites describe HL7
AP> as a "framework for negotiation" - if we want to avoid
AP> centralised infrastructure in australian health messaging
AP> (where the central server can 'fix' things up for us)
AP> surely we need a standard that definitively tells us
AP> how things are done, not 'heres a starting point
AP> for negotiation'.

That a lot better than starting from scratch every time!

AP> Obviously as a company that has invested heavily
AP> in HL7v2, you guys are keen to push Hl7 (as is
AP> your right). I don't want to put you in the position of
AP> having to defend the whole of HL7 by yourself, but I
AP> was wondering if you had any thoughts on this
AP> issue and whether you think its a problem, or whether
AP> I've completely misunderstood HL7 as a standard??

I think you will find that every path lab in the country and every
vendor has invested heavily in HL7 V2. I think its your position that
is on the outside.

AP> Andrew



-- 
Best regards,
 Andrew                            mailto:[EMAIL PROTECTED]

Andrew McIntyre
Buderim Gastroenterology Centre
www.buderimgastro.com.au
PH: 07 54455055 FAX: 54455047

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