Senior Technical Manager Close Encounters of the Structured Kind - HL7 in the NHS - Anthony Mottram 11 December 2003 Close Encounters of the Structured Kind HL7 in the NHS Anthony Mottram Senior Technical Manager

History of structured messaging in the National Health Service 1986-1989 – ADI (Application Data Interchange) Required specific end to end software definitions Low level coding – usually in C Very unreliable Dependent upon communication protocol Supplier driven

History of structured messaging in the National Health Service 1989-1990 – Northern Flat File Development Precursor to CMDS – episodic data from mainframe PAS Flat file format – dubious data content Helped to identify numerous errors in data integrity Dependent upon communication protocol Supplier driven

History of structured messaging in the National Health Service 1994 – ASTM1238 Developed at John Radcliffe Hospital, Oxford Intended specifically for clinical results First move towards producing a structured message for the NHS Independent of communication protocol Supplier driven

History of structured messaging in the National Health Service 1994 – EDIFACT International standard for numerous purposes UK structure defined & controlled by the NHS First used for CDS but extended to clinical messaging Early use of the VGP segment allowed too much freedom Independent of communication protocol, but tied to X.400

History of structured messaging in the National Health Service 200? – HL7 version 3 International standard specifically for healthcare organisations Defined & controlled by the NHS & HL7 UK Intended for all health-orientated messaging Previous versions already in use world-wide Actively being defined and developed Independent of communication protocol

What’s wrong with the messages we already use? Communication errors have fatal consequences Patients die Unambiguous communication is essential Hip replacement – which one? – there are two John Smith – which one? – there are thousands Local dialects lead to misunderstanding Full blood count? – number of tests – lab-dependent Amoxycillin? – strength - dosage

Why HL7? HL7 is a world-wide health-orientated message structure Contribution from international expertise in healthcare Operates as an approved standards authority Delivers open standards

Why HL7 version 3? Previous versions relied on end-to-end agreement Versatile structure provides for changing needs Uses the latest technology Human and machine readable in the same structure Accommodates local anomalies in a national format Removes ambiguity – prevents errors Effective in-built message and communications tracking

Conclusion Focused entirely on the need of the Health Service Versatile enough to cover all aspects of healthcare Total commitment from suppliers and healthcare professionals

Someday all messages will be like this And we will all understand each other. It’s good to talk HL7v3