HL7 Standards Development

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HL7 Finland Meeting - 1999

• HL7 Standards Development
• in
• Australia / New Zealand
• Klaus Veil
• HL7 Australia

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Sydney, Australia
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Background Information

• In Australia, standards are created by STANDARDS
  AUSTRALIA (SAA) - a government-supported
  organisation representing all stakeholders.
• The Australian Federal and State Governments
  often elevate Standards created by SAA to
  legislation level.
• These standards have achieved widespread
  acceptance in Australia New Zealand.

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SAA HL7 Working Groups
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Patient Administration

• Patient Administration Standard AS4700.1
• Based on HL7 Chapter 3 and parts of Ch. 2.
• Currently being revised to match HL7 V2.3.1.

• AS4700.1 has become the accepted way of
  implementing Patient Administration messaging in
  Australia/NZ.
• Fully endorsed by Australian Government in March
  1997.

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Clinical Pathology

• Pathology Orders and Results AS4700.2
• Based on parts of HL7 Chapters 4 7.
• Currently being revised to match HL7 V2.3.1.
• An extended Order Message (ORM) for referrals to
  Reference Labs and Knowledge Bases has been
  approved by the O/O TC.
• Proposal to adopt HL7 Secure Transactions as an
  Australian Standard document.

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Registries Messages

• Support from all Australian States (s!).
• Initial focus on notifications generated by
  pathology labs.
• Existing specs and formats collected.
• 100 Common Data Elements identified.
• Proposed to use Result (OBX) segments to report
  data items not native to HL7.
• Translations table for existing format data items
  to HL7 elements (live table?).
• Going to public comment October 1999!

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Drug Prescriptions

• Australian Standard for Drug Prescriptions
  (AS4700.3)
• formal modelling approach.
• 8 data entities with 76 transaction types
• collapsed into 19 HL7 messages
• New Zealand has adopted AS4700.3 as an NZ
  Standard.
• Govt. funded implementation project has commenced
  (HL7 messages coding system).

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Referral Messages

• Working Group (IT14/6/6) has recently been
  re-established
• NZ Spec. being reviewed (Z-segments?!?).
• Interchanges being defined.
• HL7 Table values being identified.
• Standard (AS4700.5) planned for June 2000.

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Community Health

• Australia has identified to HL7 that this area is
  currently not adequately covered in HL7 V2.3.

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Govt. Standards Policy

• Recent broad-based summit on requirements for
  Australian health standards
• Continued promotion, development and maintenance
  of HL7 messaging standards.
• New areas GP, Psychiatric, Community and
  Tele-health, etc.
• Expansion of Nat. Health Data Dict. (NHDD).
• Cooperation/delineation with UN/EDIFACT.
• Tight work-program 5 HL7 Standards to be
  released until end 2000!

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HL7 ? UN/EDIFACT
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New Zealand Developments - 1

• Re-established its position as HL7 International
  Affiliate.
• HL7 well-established in NZ
• Central PMI accessed via HL7.
• gt60 of clinical pathology results are sent
  electronically using HL7.
• Software and network to carry the clinical
  pathology results was locally developed.

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New Zealand Developments - 2

• NZ has adopted the Australian Drug Prescrip-tion
  standard as a NZ standard.
• NZ is leading in HL7 development tools design
  (Orion Symphonia, etc.)

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• Find out more about HL7 Australia at
• http//www.HL7.com.au
• Thank You!

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HL7 Finland Meeting - 1999

• International
• HL7 Standards Development
• Klaus Veil
• HL7 Australia

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International Developments - 1

• HL7 V2.3.1 was released April 1999.
• HL7 is moving from a USA-national standard (gt90
  market share) to a truly international
  Standard.
• 7 International HL7 Affiliates
• Australia Canada Finland
  Germany Holland Japan New Zealand
  England?, Singapore?, Russia?

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International Developments - 2

• HL7 V2.3.2 to be balloted November 1999, to be
  published as V2.4 early 2000
• US-specific terms eliminated.
• Patient names and addresses fulfil international
  requirements (aboriginal naming, etc.).
• Local national requirements NMS, PM, etc.

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V2.4 HL7 International?
Version 2.4 HL7 International
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HL7 Version 3

• Why Version 3?
• The development process.
• Core methodologies.
• Progress so far.
• When will V3 be ready?

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How can HL7 help you?

• Include Finlands needs?
• Communication?
• Links to other HL7 International Affiliates?
• HL7 in Europe
• Joint Meeting of European Affiliates 2000.
• HL7 Board meets in Europe in 2000.
• HL7 Working Meeting 2001 in Europe (January or
  April 2001, Holland?)

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Case Study Pathology on the Desktop

• Pathology Labs wanted to reduce costs and improve
  service by delivering Pathology Reports direct to
  the Gen. Practitioner desktop.
• No messaging standards existed at the time.
• A simple print-file-based message format was
  established PIT.
• Spreading of PIT was encouraged by Pathology
  Laboratories paying s to implementors.

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Pathology on the Desktop - 2

• AS4700.2 supports easy migration to HL7 while
  retaining PIT format (Appendix C).
• Many GP PC/desktop software systems now support
  HL7.

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Pathology on the Desktop - 3

• Lessons learnt...
• If no viable and endorsed Standards exists -
  industry will create its own.
• Important that any endorsed standard has a
  technological future.
• Important factors
• a Champion to move things forward.
• Quick build-up of expertise.
• well-managed incentives.

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Case Study Prescription Messages

• Main goal cost reduction!
• Small sub-set of the 76 interactions chosen
• Prescribing Authority (71 and 72)
• Prescription (3)
• Dispenser Query (12 and 13)
• Adverse Drug Reaction report (41 and 42)
• Prescribing Authority (using ORM/ORR) now being
  implemented as a 1st stage.

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Dos Donts
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• Find out more about HL7 Australia at
• http//www.HL7.com.au
• Thank You!