Health Level Seven Reaches Major Milestones in Fostering Harmonization of Healthcare Interoperability Standards

HL7’s collaboration with standards groups and healthcare organizations paves the way to unified interoperability standards to improve Health Level Seven (HL7.org) today announced four major milestones toward harmonization of interoperability standards as a result of the HL7 Working Group meeting held January 8 – 13, 2007 in San Diego, CA. HL7’s four key accomplishments include the following:

• HL7 collaboration with the Object Management Group (OMG) has resulted in HL7’s Services-Oriented Architecture Committee successfully balloting three Draft Standards for Trial Use (DSTUs), two of which are now adopted and part of the Object Management Group’s technology adoption process.

• Collaboration between HL7 and ASTM has resulted in the co-development of the Continuity of Care Document (CCD) endorsed by the Healthcare Information Technology Standards Panel (HITSP) and passed HL7 balloting on January 4, 2007.

• HL7 finalized an agreement with the California Health Care Foundation to ballot the EHR-Lab Interoperability and Connectivity Specification (ELINCS) through HL7 as an implementation guide to enable reporting of lab results from laboratory information systems to electronic health records (EHRs) in the outpatient setting.

• HL7 reached out beyond its existing membership, bringing extensive clinical input into the development of the EHR-S Functional Model. The Functional Model is one step closer to becoming an industry standard, and has already proven to be a useful tool for the Certification Commission for Health Information Technology (CCHIT).

“These accomplishments represent another milestone for HL7 and healthcare information technology,” said Chuck Meyer, chairman of the HL7 Board of Directors. “HL7’s continued collaboration with standard development organizations and key groups’ working to foster healthcare informatics standards is leading the way to a cooperative and comprehensive approach to standardization supporting interoperability.”

Continuity Care Document Passed HL7 Balloting

The US Healthcare Information Technology Standards Panel (HITSP) endorsed the Continuity of Care Document (CCD) as the harmonized format for the exchange of clinical information including patient demographics, medications and allergies. In 2006, HITSP was asked to produce a harmonized IT standard recommendation to HHS.

The CCD is a joint effort of HL7 and ASTM to foster interoperability of clinical data to allow physicians to send electronic medical information to other providers without loss of meaning, which will ultimately improve patient care.

"The successful ballot of CCD is a milestone in the standards world,” said John Halamka, MD, chair of HITSP. “HL7 and ASTM worked together seamlessly to incorporate the best of their standards into a work product that will now form the basis of many HITSP Interoperability Specifications. I want to congratulate all involved and offer a special thank you to Robert Dolin, MD, co-editor of the CCD Implementation Guide and board member of HL7, and Rick Peters, MD, co-editor of the CCD Implementation Guide and Technical Consultant with AAFP, for creating a great foundation for us all."

HL7 Passes New Standard to Accommodate Standard Laboratory Reporting

The EHR-Lab Interoperability and Connectivity Specification (ELINCS) project of the California Health Care Foundation (CHCF) published ELINCS version 1.0 in July 2005 to enable electronic reporting of results from laboratory information systems to electronic health record systems (EHRs) in the outpatient setting.  This implementation guide is an HL7 V2.4-based message profile for the reporting of lab. When the HITSP created their implementation specification for reporting of laboratory results to ambulatory EHR systems, they adapted the CHCF ELINCS guide by updating it to HL7 V2.5 and added three fields necessary to meet the needs of the use case. As of this January 2007 HL7 Working Group Meeting, HL7 balloted and passed a modification to the current V2.5 standard to include these new fields so the HITSP specification can be based on an official version of the HL7 standard, V2.5.1. The next step will be for ELINCS to modify its guide to accommodate these changes. HL7 has agreed to put the modified ELINCS guide through a process to adopt it as a balloted HL7 standard product.

HL7 Collaboration with OMG Leads to Adopting HL7 Draft Standards

HL7 and Object Management Group (OMG) collaboration demonstrates the ability of two separate standard development groups to collaborate rapidly and effectively. HL7’s Services-Oriented Architecture Committee successfully balloted three Draft Standards for Trial Use (DSTUs), two of which have now been adopted and are part of the Object Management Group’s technology adoption process. The result will be a set of technical specifications adopted as OMG Standards that are supportive of the HL7 work. This is a significant milestone marking the culmination of more then 12 months of active collaboration between HL7 and OMG.

This collaboration has taken place under the auspices of the Healthcare Services Specification Project (HSSP), allowing HL7 and OMG to each use their effective, proven processes in coordination while being rapidly responsive to marketplace needs. HSSP is producing both HL7 and OMG standards. The Service Functional Models (SFMs) that passed ballot in September 2006 were for an Entity Identification Service (EIS); a Retrieve, Locate, and Update Service (RLUS), and a Decision Support Service (DSS). The work products define in business terms the capabilities needed to perform the functions necessary to provide the service being specified. Within the HL7 community, HSSP produces ‘Service Functional Models’ that are technology-independent and balloted as HL7 standards. These ‘Service Functional Models’ are then adapted into OMG Request for Proposals (RFPs) that result in OMG standards.

“One of OMG’s biggest strengths is our focus on getting disparate organizations to work together in a collaborative environment toward a common goal – that of developing interoperability standards that benefit the industry as well as the contributing organizations,” said Dr. Richard Soley, Chairman and CEO, Object Management Group. “We are excited about the joint work that is happening between OMG’s Healthcare DTF and Health Level Seven. Between OMG’s technical expertise and HL7’s domain knowledge, the HSSP project is building the foundation needed to address the interoperability challenges facing the healthcare industry.”

HL7 and Broad Stakeholder Support Bring the EHR-S Functional Model to Fruition

HL7 recently reconciled a membership level ballot on the industry’s first standard that focuses on the functional requirements for an electronic health record (EHR) System. At present, ballots are still being tallied, but the industry is now one step closer in making this standard a reality. The international standard will facilitate key advances in EHRs, such as fostering the legal EHR. As a gold standard, the EHR-S Functional Model is a useful tool for describing the important features and functions that should be contained in an EHR system. Working collaboratively with HL7, the Certification Commission for Health Information Technology (CCHIT) has used conformance criteria in the EHR Functional Model to develop its certification criteria. In addition, CCHIT has contributed conformance criteria, which were adopted by HL7. The standard was developed with broad stakeholder input. With so many industry stakeholders involved in its development, the EHR-S Functional Model is an excellent example of HL7’s efforts to foster harmonization and create interoperable standards that can be put to use in the real world.