On Sun, 2003-12-28 at 13:28, Thomas Beale wrote:
> Tim Churches wrote:
> 
> >On Sun, 2003-12-28 at 11:47, Thomas Beale wrote:
> >  
> >
> >>well, actually, even though HL7v2 had a mania of translators all over 
> >>the place, and at great cost, it did succeed quite well. Where it 
> >>succeeded best (to my knowledge) was in environments where translators 
> >>were eliminated; i.e in New Zealand, where everyone uses exactly the 
> >>same HL7 software, and to a lesser extent in Australia, where HL7v2 
> >>messages are standardised for he whole country.
> >>    
> >>
> >
> >Um, every hospital installation of HL7 in Australia of which I am aware
> >relies completely on the presence of an HL7 translation facility such as
> >STC DataGate/eGate (see
> >http://www.stc.com/products/ICAN_productsEgate.asp ) for its success.
> >And on a small army of software engineers, steeped in arcane HL7
> >knowledge, who look after the care and feeding of the HL7 translation
> >facility...
> >
> >  
> >
> that's not what I meant by "translator" - the main purpose of most HL7 
> interfaceware is to convert some other format to/from HL7 ( that's what 
> HL7 messaging is about, of course ); what I was talking about was the 
> translators needed to make different varieties of HL7 software talk to 
> each other - i.e. software that supposedly is already talking HL7 
> messages.

The latter is what what I was talking about too - HL7-to-HL7
translation. Many applications "speak" HL7, but they need an HL7
interface engine and team of minders to allow them to talk to each
other, in practice. Indeed, system architects hate point-to-point HL7
interfaces - they actively prefer everything going through an HL7 hub,
with some form of translation de rigeur within the hub.

>  This is the basis of Wes Rishel's quote that "once you have 
> seen one HL7 implementation you've seen ...one HL7 implementation". The 
> need for the former kind of data translation - legacy data to/from a 
> target format - never goes away; the only question is whether you go for 
> the ad hoc point to point approach (N^2 cost; or worse, since it's 
> unplanned - often the same A-B transformations are solved more than once 
> in different places or comapnies) or point - common standard approach 
> (N*1 cost).

It is usually considered cheaper to undertake the translation in an HL7
hub, rather than requiring each application vendor to "fix" their
particular HL7 implementation.

> Also, when I used the word "success", I meant in terms of what a judge 
> of the overall health system would conclude, not what a vendor company 
> would define as success; as we all know, vendors thrive on 
> non-interoperability and translation of data. But in terms of running a 
> health computing infrastructure for a company, it's a vast waste of money.

HL7 2.x, as it is actually practiced, is definitely better than having
no standards at all, but it is a long way from what should be
achievable, given  more completely specified standards. HL7 3.x should
help a lot, as might openEHR archetypes, but HL7 2.x and its associated
converters are well entrenched and it will take many years to replace
them with something better. That doesn't mean we shouldn't try -
particularly in "green field" sites or domains or when embarking on new
software projects.

-- 

Tim C

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