THE NEW HL/7
By Clyde Smith
HL/7 isn’t just HL/7 anymore! The organization has been growing rapidly in the last few
years and continues to reach out into new areas in healthcare. For those of us who have been
interfacing for several years, the HL/7 we remember was an all volunteer group who developed
ADT, Orders, and some Results Query Messages. Today, the most recently adopted version of
the standard, Version 2.5.1 includes 15 chapters and 5 Appendices of information and was
adopted in February, 2007…approximately 20 years after the first working group meeting was
held. This growth in the HL/7 standard itself is only a small portion of the growth that the
organization is seeing today.
HL/7 now is responsible for some of the following standards and initiatives:
The Reference Information Model (RIM)
The RIM is a visual representation of the data required in the various areas (or
domains) and identifies the required messages to support the life cycle of care in that area
and the content required at each step. In addition to the RIM, special interest groups are
focused on insuring that the RIM includes proper templates (message structures), vocabulary,
and message structure (XML).
HL/7 Version 3.0
This specification will be more detailed than any previous HL/7 specifications or
standards we have seen to date and will be based on the work done by the RIM team and their
associated special interest groups.
Clinical Document Architecture (CDA)
The CDA used to be known as the Patient Record Architecture (PRA) and is a mechanism
designed to allow patient documents to be stored, retrieved, and read in a machine readable
format that is readable by any XML enabled device (web browsers, cell phones, etc.).
The Clinical Context Management Specification (CCOW)
This specification allows multiple systems to maintain a synchronized context. If a new
patient is viewed on the clinical system, the lab system receives a message to automatically
display the selected patient as well. This will help aid Physician and Clinician adoption in
organizations with multiple systems. It is often a part of the Identity Management strategy
of organizations.
Arden Syntax for Medical Logic Systems
This standard is a language designed to assist physicians and clinicians with decisions
and is typically delivered via alerts. The logic for making these decisions or issuing these
alerts is encoded into MLM’s, each capable of making a single decision. Although this
standard was initiated by ASTM, HL/7 balloted version 2.0 and will continue to support the
standard from that version forward.
With the growth in scope, HL/7 can no longer rely on volunteers to guide the overall
direction of the organization. The year 2007 has seen HL/7 add a CEO and a CTO to the team
to provide focused leadership and direction in the continued growth and adoption of HL/7.
With a mission statement that urges the organization to “provide 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”, I think it is clear
that HL/7 will become a larger part of our world. I encourage you to get to know more about
these standards and how they will affect each of us in the near future. If you would like
some assistance in that area, please feel free to reach out to VCS at
vcs@getvitalized.com.