Canada’s health sector is debating whether to move ahead with the latest version of an electronic messaging standard for patient records or to stick with the one that several organizations have already adopted.
The Association of health technologies industry (AITS) and the Canadian Health Information Technology Trade Association (CHITTA) have issued a position paper to Canada Health Infoway urging the agency to reconsider its support of Health Level 7 (HL7) Version 3. The paper calls instead for Infoway to endorse HL7v2.5, which the associations say provides greater interoperability. ITAC, which merged with CHITTA earlier this year, also contributed to the paper.
HL7 is considered a key standard for allowing the interchange of clinical, financial, and administrative information in an electronic health record (EHR). Infoway’s mandate is to establish a national EHR by 2009.
“We believe that there needs to be a concerted effort by all provinces, under the leadership of Infoway, to agree to adopt a consistent messaging standard across the country,” the paper says, adding that HL7v2.5 does a good job of accommodating intra-laboratory requirements, among other benefits. “If all provinces could be persuaded to adopt HL7v2.5, then Infoway would need to create only one API to move their data from this agreed messaging standard to the v3 necessary for the EHR as defined by Infoway.”
Spokespeople for Infoway did not respond to calls for comment at press time.
Dennis Niebergal, a CHITTA board member and president of Calgary-based health vendor Clinicare, said the problem is that many organizations are already working with HL7v2.X, and version 2.5 would be a natural progression. Infoway, however, only funds projects based on version 3, he said.
“They’ve got some valid reasons why they should use it. It’s more future-oriented, it’s more complete,” he admitted. “The challenge is that going to HL7v3 is going to be a big investment.”
That’s because HL7v3 uses what’s called a reference information model to explicitly represent all the semantic and lexical connections that exist between the information carried in the fields of HL7 messages. HL7v2X, in contrast, is more straightforward, Niebergal said, but lacks the classification of terms of HL7v3.
HL7 is developed by a non-profit organization of the same name based in Ann Arbor, Mich. It came out with HL7v3 in December of last year and issued a 2006 version just six weeks ago, according to spokeswoman Andrea Ribick.
“It doesn’t build upon a Version 2. It’s a completely different standard,” she said. “As far as the implementation goes, we don’t say, ‘You need to do this.’ We just do the standard.”
Besides the reprogramming work it could require of vendors, Niebergal said health-care organizations might wonder whether implementing one standard now and another one later would be worth the duplication of effort.
“People say the vendors should just do it (adopt HL7v3), but the customers have to ask for it, and the vendors will charge the customers,” he said.
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