The implementation success has been somewhat patchy, with at least some proponents scaling back their enthusiasm for full adoption of the V3 Standard as some see it is lacking the necessary robustness and internal consistency for ongoing use.
The following blog from Professor Barry Smith had the effect of reminding me there are a variety of views on the topic - some of which may not be all that heartily embraced by HL7 and NEHTA. If the dissenters are right the implications are pretty serious.
The views expressed here are quite provocative but I believe need to be aired.
Monday, February 28, 2011
One of the disturbing aspects of the HL7 phenomenon is the degree to which so many of those who have strong critical views are reluctant to express these criticisms in public. Here a sample criticism of the HL7 RIM, by a leading healthcare IT specialist in Asia who has given me permission to quote from his email communications, as follows:
It is abundantly clear that V3 is an unnecessarily complex, incoherent and confusing messaging standard while V2 is simple, workable, elegant and deployed at more than 95% of healthcare institutions wherever HL7 is used.
Why not scrap V3 and simply work on improving the V2.x standard (say V2.7)?
I am concerned about the growth and proliferation of a meaningless standard because it is fraught with danger and is leading to:
(a) Increase in the cost of Hospital IT implementation
(b) Making coding complex which could lead to errors and thereby lower care of (and even endanger) patients
(c) Increasing the cost of software
(d) Increasing the cost of training and implementation
(e) Forcing the use of two standards in parallel when one could have sufficed
(f) Diverts funds from useful IT apps to feed V3
The only people/groups that could possibly gain from this are:
(a) HL7 org and their collective egos
(b) Trainers who will make money from teaching this "complex" 'new' standard
(c) IT companies that make money from pushing newer versions and widgets to "upgrade" to V3
Here is another example of a desperate push through a back door: Pushing and converting a perfectly good CCR to a CCD by unnecessarily insisting on a RIM based approach (where none was required) shows desperation to push the RIM, come what may.
It is my personal opinion that there should be no shame in accepting that a certain approach has failed. We are doctors and scientists and accept, humbly, that we do not always succeed. The real shame and loss would come from stubbornly trying to flog a dead horse putting time, money and people at stake, just so as not to declare failure. I say, be brave enough to move on and use the excellent collection of thinkers at HL7 to develop a fresh, focused and simple solution. To try and capture the complete medical domain (present and future) into one core model is not only foolish but also unachievable. We as doctors know that and therefore only focus on our core specialty.
The full blog and many others are found here:
It is definitely worth reading this blog where some Australian contributors express their concerns.
While I am not sufficiently across the details of some of this to be able to form a trustworthy opinion a number of very smart people I have chatted with have expressed similar concerns.
I highlight the material for people to review and consider on that basis. Form your own conclusions, from a position of being aware that there are a range of views out there about the whole HL7 V3 project and just where it is leading!