HL7 International Health Level Seven



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HL7 International Health Level Seven 11 th International HL7 Interoperability Conference (IHIC2010) HL7 Ambassador Presentation On Introduction to Standards & HL7 By 2002-2010 Health Level Seven, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Gora Datta HL7 Ambassador May 14, 2010 1 May 2010

HL7 Ambassador This presentation is being delivered by an authorized speaker of HL7, called an HL7 Ambassador. The HL7 Ambassador personally participates and contributes to the HL7 standards in HL7 Technical committee meetings and can speak first hand about the standard. 2002-2010 Health Level Seven, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off 2 May 2010

Your Ambassador Today Gora Datta gora@cal2cal.com HL7 Ambassador World Bank ICT Expert CoLead: HL7 EHR Interoperability WG CoLead: HL7 elearning Course (ELC) Team ISO/TC215: USA PHR Expert & Global Task Force CoLead ISO/TC215: USA ehealth Expert & Global Task Force Member Senior Member: IEEE Senior member: ACM Group Chairman & CEO, CAL2CAL Corporation 2002-2010 Health Level Seven, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off 3 May 2010

Topics Need for electronic Healthcare Information Exchange Role of Healthcare Standards and benefits What is HL7 and examples of standards 2002-2010 Health Level Seven, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off 4 May 2010

Healthcare Information Exchange Why can t we make this happen? Mary Lim has been a healthy young woman who has never been hospitalized However, recently she attended her employer s health screening, and they found that she has high blood pressure

Healthcare Information Exchange Why can t we make this happen? 1. Mary decides to visit her neighborhood GP, Dr. Steven Lam, at Lam Clinics. 2. At the clinic, Susan Quek, the clinic s nurse, queries her EMR system for her details. 3. Not finding her name, Susan registers Mary in her system. 4. Dr. Steven sees Mary and, after identification of multiple problems, creates a referral letter in the EMR for Mary. Dr. Steven also authorizes Dr. Peter Tan of Eastern Hospitals to see the referral letter. 5. Susan arranges for a visit with the Eastern Hospitals.

Healthcare Information Exchange Why can t we make this happen? 1. Mary arrives at Dr Peter s office at one of the Eastern Hospitals. 2. Dr. Peter retrieves the referral letter using his own EMR. 3. Dr. Peter runs a standard blood test for hypertension and found Mary to be a type 2 diabetic. 4. Dr. Peter updates Mary s medical records in his EMR with a consultation letter back to Dr.Steven. 5. The updated information is accessible by Dr. Steven as well as to other physicians who might take care of Mary in the future.

Healthcare Information Exchange Why can t we make this happen? When Mary gets home, she shows her two medical letters to her mother so that she can share what the doctors said. HL7 CDA PHR

Global Healthcare Trends Rising cost of healthcare Under or not insured Aging population High cost of chronic care Demand on public health hospitals System and organizational inefficiencies Paper to Electronic Records Better clinical outcomes Cost effective Consumer Empowered Personal Health Records empowers consumers to manage their own health Patients and providers seeking greater access and control over information National-Regional IT Networks Australia, Brasil, Canada, Denmark, UK, USA and many more Government-selected Healthcare Standards Emerging government-sponsored conformance testing Public Health Prevention efforts Bioterrorism and pandemic events: Anthrax, Avian Flu, TB, etc. Biotech Era Personalized medicine is beginning to emerge, e.g., genomic data and test for cancer drug

Healthcare Standards can improve patient care Improve quality of care Electronic documents provide value to clinicians Ensure clinicians have latest knowledge Improve patient Safety Empower patient to manage their own health Goal: Standards are an enabler for interoperability of electronic healthcare information Minimize Preventable errors Improve public health reporting Supports Lifetime EHR Eliminate duplicate medical tests Lower cost of HC delivery

The Business Case Patients: interface with provider, payer, pharmacy, pharmacy benefits manager; reduce office waiting time; reduce paperwork; populate PHR s; self-manage healthcare Healthcare Providers (primary and ancillary): modularization; apples-to-apples comparisons; simplify interfaces; purchasing incentives; access to best practices; access patient data; streamline workflow Vendors: System definition / scope / profiles; RFP s; best-of-breed collaboration; certification

The Business Case Payers: Pay for performance; value-add services (e.g., Care Management); reduce costs Governments: public health data; identify fraud and abuse; quality assurance; compliance; reduce costs Quality-Oversight / Accreditation organizations: consent-based collection of raw data for analysis and reporting; identify providers that are outliers Standards Development organizations: reduce overlap and duplication; identify gaps

HL7 History and Future 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Version 2.0 Messages Published RIM v1.0 EHR-S Continuity Functional Identity CDA Release 1 V3 of Care Model Service First Meeting at University of Pennsylvania Hospital CCOW Arden Syntax 2.0 Message (CCD) DSTU HL7 provides standards for interoperability that improve care delivery, optimize workflow, reduce ambiguity and enhance knowledge transfer among all of our stakeholders, including healthcare providers, government agencies, the vendor community, fellow SDOs and patients. In all of our processes we exhibit timeliness, scientific rigor and technical expertise without compromising transparency, accountability, practicality, or our willingness to put the needs of our stakeholders first.

HL7 Membership Worldwide 1800 organizations plus 1000 individuals Other 8% North America 32% Europe 45% Asia/Oceania 15% 2007 figures. Based on the average 3 individuals per org rule 14

Stakeholder Location 2007 figures. Based on the average 3 individuals per org rule 15

HL7 -- What s in a Name? A generic, universal standard for data exchange in healthcare Domain Experts plus Computer Science-Engineering Functional Communication 7 Application 6 Presentation 5 Session 4 Transport 3 Network 2 Data Link 1 Physical ISO-OSI Communication Model

HL7 has produced a family of Standards for Patient Administration and Demographics Orders and Results for : Clinical Lab/Pathology, Imaging (radiology, ultrasound, etc.) Signs and Symptoms, Diagnosis and Treatments Clinical Research (e.g. Genomics) and Public Health/Disease Surveillance Sharing and re-use of information from many healthcare domains: -within hospitals Pharmacy prescriptions, dispensing and administration Scheduling and managing healthcare resources -between hospitals Claims and Reimbursements Patient Care messages, Clinical Documents (referrals, H&P, Summary record, etc.)

Interoperability Ability of two or more systems or components to exchange information and to use the information that has been exchanged from the IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990 Interoperability requires standards for both: Syntax (exchange) Semantics (meaning)

Importance of Information Model Semantic variants: exchange of information (models) Dog! EDI / XML / Web Services / PDF Syntax variants: exchange of symbols

Healthcare Information Interoperability Means Enabling the sharing and re-use of healthcare information, especially Clinical information And healthcare-related information, including research, clinical trials, administrative, financial, resource utilization, public health, supply chain HL7 standards are all based on the sharing and re-use of Healthcare information Using Messaging, Clinical Documents, and Services

Summary There are benefits for electronic healthcare information Standards are critical for exchanging healthcare information HL7 is the key organization for producing relevant healthcare standards used by governments, hospitals, labs, public health agencies, patients globally

How to get more info on HL7 Web site: http://www.hl7.org International Affiliates http://www.hl7.org/special/committees/international/index.cfm Education and Tutorials http://www.hl7.org/events/educationsummits.cfm http://www.hl7.org/events/elearning.cfm Contact info for HL7 HQ mailto:hq@hl7.org 2002-2010 Health Level Seven, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off 22 May 2010