Tuesday, May 03, 2011

Thomas Beale of openEHR Puts A Position on HL7 Renewal Plans. Well Worth a Read!

Thomas sent me a short e-mail yesterday to alert me to these two blog entries. Knowing that this process is a topic of interest to many who read here I pass on the links:

First we have:

What needs fixing in e-health?

or, e-health seen through the prism of an ancient pantheon of gods…

Grahame Grieve’s recent blog entry on the HL7 Fresh Look Task Force seems a good excuse for me to have another big picture look at e-health. The fact that HL7 is doing this indicates two things at least: that it thinks something is wrong in the HL7 organisation, and that it thinks something is not going right in e-health in general. That’s good to see. HL7 has been the single most influential standards body in e-health for at least 15 years. It has spent massive effort in the last decade on an effort called HL7v3, or ‘version 3′. This effort has not been a resounding success, indeed the evidence indicates the opposite. I have historically been one of the strongest critics of the technical architecture of this effort, so my statements here won’t come as any surprise. To give credit where it is due however, I have come to see that HL7 was trying to the right kind of thing, just that they lacked the appropriate expertise to do it. Solving the challenges in the area of e-health is no mean feat, and maybe some of them are unsolvable, so take that statement as a commiseration rather than a criticism.

One thing HL7 has created (whether intentionally or not) is professional networks, intellectual discussion groups and friendships. The value of this cannot be overstated: in my view, almost all good ideas come from dialectic processes, and dialectic processes cannot exist with only one person in the room. If I managed to make any contribution to e-health myself, it is largely due to having not only learned a great deal from people I met on the way (many at HL7 meetings) but from discussions and sometimes furious debates with them.

There is a huge amount more here:


and second we have:

How could HL7 refresh?

Continuing on from the basis established in the previous post, here I will say what I think HL7 do to help here. My suggestions are as follows:

  • For practical reasons, it should keep going with HL7V2
  • HL7 should continue to exist as a meeting place for great minds, and possibly evolve into some sort of conference.
  • It should concentrate on obtaining, recording, organising e-health requirements. This probably needs its own framework and/or ontology. This is serious work and requires serious resources.
  • And from requirements, conformance criteria & models could be developed. Not the narrow ones of today.
  • if it has any pretensions of being the ‘one sole heaven’ in the intellectual design space, it will have to be far more ecumenical in how it does this.

A huge amount more detail here


What can one say to these two very long and I think pretty thoughtful - if not a little protective of a lot of previous work - posts.

1. I really like the recognition of the complexity and just ‘how hard’ all this actually is.

2. I think there are a range of interesting ideas and perspectives provided that are more than work an airing.

3. I think what is found here is at least a part of the agenda HL7 needs to address.

4. I think most readers of this blog need to read these for themselves and form their own views.

Thanks Tom (and Grahame) for the effort of putting this all up.

My summary is that the biggest task is to work out what is working that we should keep and then work out how to move forward from that base. It will be a great deal harder that any of us realise I suspect.


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