Infoway justifies messaging standard policy

By Shane Schick

Canada Health Infoway says it is prepared to offer implementation support and education services to encourage vendors adopt a messaging standard that many of them feel will require costly upgrades to their products and lacks demand among customers.

Last week, several health-care industry groups published a position paper regarding the Health Level 7 (HL7) standard they had sent to Infoway late last year. The trade groups, which include the L’Association de l’industrie des technologies de la santé (Association of health technologies industry) and the Canadian Health Information Technology Trade Association (CHITTA) want the agency to reconsider a policy whereby it only funds electronic health record (EHR) projects based on version 3 of the standard.

HL7 is considered a key standard for allowing the interchange of clinical, financial, and administrative information in an EHR, but HL7v3 is a much different version than its predecessors, such as the more popular HL72.5, which the trade groups already support.

Infoway chief technology officer Denis Giokas said that while HL7V2.5 works very well on point-to-point integration and in departmental settings, large scale integration across cities, provinces or the country requires the additional HL7v3’s semantic interoperability and strict adherence to vocabulary standards.

“It’s not just about two systems exchanging data, but each system being able to understand that data,” he said. “V3 a lot more rigour in that context in terms of the methodology in arriving at the specification and the formal mechanisms it uses to describe and define data such that it is relatively unambiguous.”

Giokas said Infoway had responded to the industry associations’ position paper but had heard no other feedback in return until comments appeared in an article on

Toronto-based Interfaceware, which focuses on products based on HL7, has deployed its software to 6,000 sites, and only one of them was based on HL7v3, according to product manager Rob Moyse. 

“We see it come up all the time in RFPs in Canada,” he said. “In terms of actual concrete V3 reality, though it’s not there yet. We’re not going to support it until there is a demand.” 

Moyse said the HL7v3 Is probably in line with where messaging in general should be headed, it faces a classic chicken-and-egg problem.

“Nobody out there wants to be the first adopter of a communications language that nobody else speaks,” he said. “It’s like me saying, ‘Let’s go back to Latin.’ Who wants to be the chump that learns Latin and can’t speak to anybody?”

HL7 is governed by a non-profit of the same name based in the U.S. but which has established a number of international affliliates, including one in Canada. That affiliate was run out of the Canadian Centre for Health Information, but in April of this year Infoway took it over. The agency has been given funding of $7.4 million to support and maintain the standard in Canada, including conformance testing and other services which Giokas said could help ease vendors’ concerns. 

“We’ll be offering toolkits to help vendors more cost-effectively implement the standards,” he said.


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Shane Schick
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