Scott Severance is an Epic Interface Analyst at Southcoast Health, located in Fairhaven, Mass.
HL7 is a Standards Developing Organization accredited by the American National Standards Institute (ANSI) to author consensus-based standards representing a board view from healthcare system stakeholders. HL7 has compiled a collection of message form... International recently celebrated its 30th anniversary, which caused me to reflect on my career. I’ve been working with HL7 for a long time. Many other people worked with HL7 long before I even entered the game. I really enjoy what I do and I think HL7 is fantastic. The beauty of HL7 — and likely the reason it has been effective for so long — is the balance between the structure and versatility it provides. Those two forces are essential for integration to occur in a dynamic environment like healthcare.
I am guilty of comparing the HL7 world to fields that are widely accepted as more exciting and thrilling. Some of those fields include professional sports and elite military Special Forces. I get a lot of grief about these comparisons, but let me make my case…
Defensive coordinators of football teams often apply the “bend but don’t break” philosophy. This means that it is okay for a defense to give up first downs here and there but not to give up big plays. Elite military forces have a “no single point of failure” philosophy where they work to ensure that there is no single way that unit can be compromised.
I feel that the HL7 standard allows a “bend but don’t break” philosophy with no single point of failure. HL7 provides the structure to ensure that standardization in integration is maintained. This keeps a certain amount of order and rigidity in place that everyone can adhere to. HL7 also provides flexibility to allow custom mapping to take place for unique situations. It’s important to have this balance in place and HL7 gets it right.
One of the first large integration projects I worked on previously failed before I became involved. Clinical team members and IT team members experienced some challenges around the HL7 differences between the two systems. It was a fairly complicated radiology orders interface. The systems were very different and there were challenges with workflow. The clinical team members said there was no way we could get it done.
We used translation tables, made the appropriate changes to workflow, and the integration was fairly standard. We followed the HL7 Standard as closely as possible. Where there were problems, we used custom fields and documented things well. We used translation tables, made appropriate changes to workflow, and found the integration to be straight forward.
The structure that HL7 provided us gave us a starting point. As barriers were identified, we used the flexibility that HL7 allows to overcome challenges. The project was a success. It was also the first time I was able to truly experience the magic that the HL7 standard brings to healthcare integration.
Thirty years is a long time for anything to continually be effective in healthcare. I wish HL7 International a very happy birthday. We all know how long you’ve been around but it’s okay if you don’t want to tell anyone your real age…we understand perfectly.