HL7 FAQs

Health Level Seven International is one of several American National Standards Institute (ANSI) -accredited Standards Developing Organizations (SDOs) operating in the healthcare arena. Most SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven's domain is clinical and administrative data.

The name HL7 comes from the seven levels of the Open Systems Interconnection (OSI) model. Level Seven is the Application Level.

HL7's Mission:

HL7 provides 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. In all of our processes we exhibit timeliness, scientific rigor and technical expertise without compromising transparency, accountability, practicality, or our willingness to put the needs of our stakeholders first.

HL7 Standards:

View the HL7 Standards

HL7's Strategies:

1. Develop coherent, extendible standards that permit structured, encoded health care information of the type required to support patient care, to be exchanged between computer applications while preserving meaning.
2. Develop a formal methodology to support the creation of HL7 standards from the HL7 Reference Information Model (RIM).
3. Educate the healthcare industry, policy makers, and the general public concerning the benefits of healthcare information standardization generally and HL7 standards specifically.
4. Promote the use of HL7 standards world-wide through the creation of HL7 International Affiliate organizations, which participate in developing HL7 standards and which localize HL7 standards as required.
5. Stimulate, encourage and facilitate domain experts from healthcare industry stakeholder organizations to participate in HL7 to develop healthcare information standards in their area of expertise.
6. Collaborate with other standards development organizations and national and international sanctioning bodies (e.g. ANSI and ISO), in both the healthcare and information infrastructure domains to promote the use of supportive and compatible standards.
7. Collaborate with healthcare information technology users to ensure that HL7 standards meet real-world requirements, and that appropriate standards development efforts are initiated by HL7 to meet emergent requirements.

A standard is a document, established by consensus that provides rules, guidelines or characteristics for activities or their results. (As defined in ISO/IEC Guide 2:1996)

In this context, interoperability refers to the ability of two or more computer systems to exchange information.

• Main Entry: in·ter·op·er·a·bil·i·ty
  • Function: noun
  • Date: 1977
  • : ability of a system (as a weapons system) to use the parts or equipment of another system
  • Source: Merriam-Webster web site
• interoperability
  • : ability of two or more systems or components to exchange information and to use the information that has been exchanged.
  • Source: IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990

"Functional" interoperability is the capability to reliably exchange information without error

"Semantic" interoperability is the ability to interpret, and, therefore, to make effective use of the information so exchanged.

In our context, 'effective use' means that the information can be used in any type of computable algorithm (appropriate) to that information.

You can contact the HL7 Staff.

Health Level Seven members are organized into Work Groups.

• HL7 members are encouraged to participate in all Work Groups.
• Work Groups are responsible for defining the HL7 standards.
• Each Work Group is chaired by two or more co-chairs.

Please see the HL7 Process Introduction for more information.

HL7 Working Group Meetings (WGMs) are held three times per year at varying locations. These working group meetings serve two important purposes:

1. They give the HL7 Work Groups a chance to meet face-to-face to work on the standards;
2. They provide an invaluable educational resource for the healthcare IT community.

Please see the First Time Attendees page for more information.

See the HL7 Events Calendar for dates and locations.

All HL7 Meetings are "Open"; anyone can attend. Find the appropriate Work Group from the link below. Most Work Groups have an electronic mailing list (listserv). Join the appropriate list and listen to the conversations to decide whether the group is discussing topics that interest you. Joining the list will also allow you to receive the conference call notifications where you may participate in Work Group calls.

HL7 is a volunteer organization, so you can contribute as much, or as little, as you are able to.

HL7 Work Groups

Membership in HL7 is available to everyone interested in the development of a cost-effective approach to system connectivity. Involvement and support from HL7's members is crucial to the ongoing expansion and enhancement of the HL7 standard and the overall success of the organization.

More information on membership can be found by following this link

HL7 offers three main categories of membership: Individual, Organizational, and Affiliate.

• Individual membership is geared toward those with a personal interest in the standard.
• Organizational memberships include benefits crucial to those who rely on the standard as part of their business plan—the most critical of these being the right to distribute excerpts of the standard to clients (as part of technical documentation or proposals)—or distribute the standard within your organization.
• Affiliate membership.

More information on membership can be found by following this link

The method for logging into the website hasn't changed; there is still a Log In link available in the upper right hand corner and at the top of the left navigation menu. Your login and password also remain the same. If you've forgotten then, you can use the Forgot Login link available on the Login screen to have them emailed to you.

In the upper right hand corner, click the Log In link. On the resulting page, click the link labeled "Forgot or don't know your user name or password? Click Here" You will be emailed your username and password.

The system may not recognize you as logged in, or your membership may have expired. To confirm that you are logged in, look in the upper right hand corner of your browser and make sure that your name is listed next to the Log Out link. If your name is not listed you will need to log in.

It is also possible that your cookies have become corrupt, to correct this log out of the website and log back in again. If you are unable to log out, you will want to delete your cookies and close your browsers.

If you're sure that you are logged in properly, click My HL7 then My Membership to confirm that your membership is active.

If you are still unable to access your account, please contact memberInfo@HL7.org.

Only Benefactors are provided with a generic username and password for their full-time employees. This login does not have voting privileges. Please contact the key member for your organization who can provide you with this login. If you do not your organization's key member, please contact HL7 headquarters at HQ@HL7.org or 734-677-7777.

Log into HL7.org; click My HL7; click My Account and My Membership; Click Change Password in Account Options; Update your password; Click Save Changes.

Log into HL7.org; click My HL7; click View My Account and My Membership; Click Update My Profile in Account Options; Update your email address; Click Save Changes.

Log into HL7.org; click My HL7; click My Account and My Membership; Click Update My Addresses in Account Options; Click the pencil icon next to the address that you want to update; Update your address; Click Save Changes.

Log into HL7.org; click My HL7; click My Account and My Membership; If you have an active membership your renewal date and renewal rate will appear under My Membership.

Log into HL7.org; click My HL7; click My Account and My Membership; Click Update Organization's Contact Info and Update Organization's Profile.

Log into HL7.org; click My HL7; click My Account and My Membership.

To change the organizational voting members, the key contact person should send an email to memberInfo@HL7.org indicating the names of the persons to be deleted and include the new people to be added. The full contact information for the new additions should include names, title, mailing address, phone/fax and email address. Normal changes take 2-3 business days to be made to the database and uploaded to the website. Once the changes have been uploaded, the new persons are sent an email with their login information.

The membership year is annual, beginning with the date the payment for membership is received.

Many of the standards are available for download from the Standards section of the website, or can be purchased on CD in the bookstore (discounted rates apply for members). You must be a member in good standing to access the Member's Only documents on the Standards section of the website. To access the downloads, log into the HL7 website with your provided login information and click on the Standards link in the main navigation in the header, then click the standard that you wish to download documents for. Affiliate members may also access this information by following their affiliate download link to the HL7 website. If you are an affiliate member and need additional help finding this link, please contract your affiliate.

Please review the section entitled "Why can't I get into my account?" above.

If you are still unable to submit, you may not have permissions to access that page or your membership may have expired. Please contact webmaster@HL7.org.

From the HL7 Development Framework, Section 2.2.1, HL7 Work Effort; An HL7 work effort represents an activity being undertaken by an existing Work Group or Board appointed committee to achieve specific objectives or to produce specific work products.

A Work Group shall consider a work effort to be a project if one or more of the following is true of that work effort:

• involves a group outside of HL7 (may require Board approval)
• requires external funding (may require Board approval)
• is going to be balloted
• requires cross-committee participation
• is determined to be a project by the committee

An HL7 Project:

• has an objective (statement of what is going to be produced),
• will have a finite existence (the end date to be determined by the resources available and the start date), and
• if additional funding is required, it will have a budget (including resources and funding sources)
• will have at least one participant available to contribute and must have a project leader, if only an interim to get the project started
• will have at least two implementers (unless the project is intended to support the HL7 infrastructure)
• will have an estimated schedule

Project Management Institute's PMBOK Guide and the publication "The Fast Forward MBA in Project Management" indicate the following:

• Typically, a project is a temporary endeavor undertaken to create a unique product or service. All projects have two essential characteristics. (1) Every project has a beginning and an end. (2) Every project produces a unique product. HL7 also recognizes 'Maintenance' projects which usually repeat on an annual basis; these maintenance projects do not need to be re-submitted or have a definite end date.
• Temporary means that every project has a definite beginning and a definite end. Temporary does not necessarily mean short in duration, it just means that projects are not ongoing efforts. Furthermore, projects involve something that has not been done before and which is, therefore, unique.
• Projects shouldn't be confused with ongoing operations. Ongoing operations have the opposite characteristics of projects in that they have no defined end and they produce similar, often identical, products. Examples of ongoing operations are (a) an insurance company processes thousands of claims every day; (b) a bank teller serves over 100 customers daily, providing a few dozen specific services.
• The objective of a project is to attain the objective and close the project. The objective of an ongoing operation is typically to sustain the business.

Theoretically, 'activity' is the action verb within a 'task'. However, for HL7 projects, 'task' and 'activity' can be considered synonymous terms.

Task/activities should be:

• Specific - a single, well defined, discrete activity. The 8/80 is a good guideline -- no task should be smaller than 8 hours or larger than 80 hours.
• Achievable - it should be something that can be done as a single deliverable and can be defined as being completed or done such as a document being produced.
• Measurable - it should be an activity that can be measured such as a deliverable produced, an elapsed period of time or number of iterations

Yes, all projects need to have a Project Scope Statement completed and submitted to the HL7 PMO. A lot of work done by Education, Marketing, Electronic Services, ArB, PIC, etc. does not need to go through the ballot process, however, visibility of that work is necessary. Project Scope Statements are the foundation for communicating project information. They also serve as a tool for Project Facilitators to gather the right information to begin a project as well as track the project's progress.

A single PSS can indicate multiple deliverables for the standard being addressed, so, no, a separate PSS does not need to be created for each Implementation Guide or support document for that standard. Simply identify all of the Implementation Guides and documents in the Project Objectives and Deliverables section that are to be produced for the project.

You may or may not have to as it depends on the change. Oftentimes, the scope or objectives of a project may change during its lifecycle, perhaps, due to regulatory changes or tying back to a different standard.

If the change in scope or objectives is minor, simply update the existing project scope statement, and within Project Insight, indicate the modifications in the appropriate fields. You can also use the 'Misc. Notes' text box for documentation.

If the change in scope or objectives is major, the Project Facilitator should submit a new Project Scope Statement, as many of the original information will not accurately reflect what is being done anymore.

Since 'major' and 'significant' are subjective terms, examples may provide better comprehension of a "major" or "significant" change to a project scope statement.

A "major" or "significant change" in project scope is when the impact is that:

• The Project End date extends by 6+ months
• Additional HL7 funds are required
• The Project Intent changes (i.e. the project changes from "Revising a Standard" to "Creating a Standard")
• The change in scope will result in an item that qualifies as 'substantive change' as defined in GOM Section 14.08.04.
• The Ballot Type changes to a Normative (i.e. the project changes from planning for an Informative ballot to a Normative ballot)
• The Realm changes from 'Realm Specific' to 'Universal' (since additional project resources may be necessary to support that change)
• The deliverable's backwards compatibility changes from 'Yes' to 'No'

First, check the Steering Division's meeting minutes. Look to see if your project was on one of their agendas, and if so, if it was approved or the SD had further questions. Your first point of contact with the SD should be their Project Facilitator. If you can't contact them, contact the Steering Division Representative and Alternate.

If the SD has approved your project, they will submit it to the TSC for approval via the HL7 GForge's tracker system. To view which approvals your project has gathered, find your project by using the Searchable Project Database tool, located in the Resources column on the home page.

Yes, we recommend updating the Ballot Strategy section of the Project Scope Statement as well as Project Insight. Include the ballot name and release/version your project is coordinating with.

There are three ways to view HL7 projects, all located at www.HL7.org > Participate > Tools and Resources > Project Tracking Tools:

1. The Searchable Project Database (located on the www.HL7.org Homepage and titled 'Search current projects from Project Insight)
2. An Excel spreadsheet of all HL7 projects is available via GForge > TSC File tab.
3. Project Insight (a Project Insight User ID and Password is required - this differs from your HL7 User ID and Password). Contact the HL7 PMO for more information. The URL is: http://healthlevelseven.projectinsight.net/l.aspx?ReturnUrl=%2fdefault.aspx.

The most recent version of the Project Scope Statement Template (MS Word document) is located at www.HL7.org > Participate > Templates.

Current Steering Division leaders can be found via their Steering Division webpage. Current Steering Division Project Facilitators can be found via a PDF file at www.HL7.org > About > People and Organizations > HL7 Facilitators.

Contact the HL7 PMO or any member of the HL7 Staff. They'll be able to gather this information for you via their internal staff website.

Yes, for both cases.

In this case 'withdrawing a standard' refers to many things, such as choosing not to extend a standard that has reached its 5 year end-of-life or identifying the need to sunset a standard. By creating a PSS and following the approval process, you give the opportunity to communicate the withdrawal to the HL7 membership and allow them to weigh in on any potential work needed to successfully withdraw the standard. GOM Section 14.13 has more information on withdrawing a standard.

Reaffirmation of a standard requires a normative ballot.

Look up your project using the Searchable Project Database, (located on the www.HL7.org Homepage). The search results will reflect SD and TSC approval statuses either by reflecting the date the group approved the project or indicated 'Awaiting Approval' if the group has not approved the project.

The same approval process should be followed whether it's a new project or a scope change to an existing project. When the scope is changed in a project, an adjusted or new Project Scope Statement will be approved by the primary WG and the SD, providing the TSC using the same time line and deadlines as submissions for new projects.

Best practice: Use Microsoft Word's 'Track Changes' tool to highlight the changes being made to the Project Scope Statement.

All ballot types (Comment Only, Informative, Normative, DSTU) need to go through the project approval process, however, as identified in the Project Scope Statement, a single project can define ballot plans for multiple types of ballots for the project, for example, Comment Only >DSTU > Normative or Informative > Normative.

When a work group has balloted a standard at DSTU, informative, or normative ballot, and decides the standard will be withdrawn, the withdrawal form is needed for ANSI notification and must be approved by the Work Group and the TSC.

Follow the process documented on via www.HL7.org > Participate > Balloting > HL7's Collaboration with ISO and JIC.

The ideal way is to post it in meeting minutes, so that they are documented and easily referenced. If that's not possible, an email to the Listserv will suffice.

A project entry should be opened in Project Insight indicating the annual work and the respective years. This project should have a Project Status of '3 Year Plan Item'; note that a Project Scope Statement isn't needed for this entry because it's a 3 Year Plan item and only high level information is necessary. This project can then remain 'as-is', or modified so it indicates accurate future years.

When the Work Group actually begins the annual work, they should complete a PSS indicating the scope of work involved and gather the necessary approvals for the PSS. A new project in Project Insight will be created (and will have a Project Status of 'Active Project'). Once the scope of work has been completed for this project, it will be closed/archived.

Hence, the 3-Year Plan project always remains open; the 'Active Project' PSS will be the project reflecting the specific annual maintenance being done.

An example of the above situation can be found for Project Service's annual updates to the PSS Template. Project 531 is the 3YP entry indicating the need for the work in 2010, 2011, 2012, 2013 and beyond. Project 581 was created to identify the specific work that would be done for the 2010 updated template. In January, 2010, project 581 was closed because the new PSS template was released to membership, however project 531 was modified to remove references to '2010' and remains open to indicate the need for the work each year.

Yes, it should. This means that the project will continue to show up in the Searchable Project Database and on Project Insight reports.

Unless specified, it is assumed that a project incorporates the current version of HL7 infrastructure (RIM, Datatypes and Vocabulary).

Project Services recommends that your Work Group's modeling facilitator monitor proposed RIM changes that may impact the standards you are developing for the duration of your project. The modeling facilitator can do this by subscribing to the harmonization@lists.hl7.org listerv. For more information on RIM change proposals, contact the MnM Work Group.

It's a rare instance that a project will create and distribute a public document in accordance to the GOM's ruling. In the instance that a project deliverable does adhere to it, the project team will need to present a proposal to the Executive Committee to provide funding to create and distribute a document publicly. GOM Section 09.01(d) indicates that the Executive Committee determines what is publicly available. More information can be found in the GOM.

Information on certification testing can be found on our website, under IMPLEMENT, Training. Study guides and sample tests can also be found there. The knowledge required to pass the test can be obtained by participation in the HL7 Working group Meetings, by attending HL7 educational sessions, fieldwork involving HL7 interfaces or simple self-study of the HL7 specification. To determine what classes are best suited for your needs, please see the latest Working Group meeting or Educational Summit brochure (available online at ) and read the tutorial descriptions. Most individuals new to HL7 take the Intro to V2.x classes, followed by V2 Message Profiles and Conformance and the V2.x Control Specialist Certification Review, which is the preparatory class for the most current Vx certification exam. Testing is also currently being offered for the Clinical Document Architecture (CDA®) and the Version 3 RIM. The test is not offered online.

Testing is offered at our Educational Summits (March, July, November) and Working Group Meetings (January, May, September). If you are interested in taking only the test at any of our meetings, you may sign up for it on-site; however it is recommended that you pre-register. The member rate is $145; the non-member rate is $215. Information on upcoming meetings can be found on our website, under EVENTS.

Online testing is not offered at this time.

Yes, the test fee is charged each time the test is taken.

In today's evolving health interoperability field, certification is important and there is definitely a value to having it. This is a point in many contracts and can certainly give you a competitive edge in the job market.

You will need to secure a copy of the standard (likely V2), which provides the messages, by domain, that any system claiming compliance to HL7 should be able to send/receive. The standards are available through the bookstore on the HL7 website under HL7 Store.

Event registration opens no later than 30 days prior to the event.

Education Summits are focused on training only. For further information/clarification please contact HL7 headquarters at 734-677-7777.

Log into HL7.org; click My HL7; click My Account and My Membership; If you have registered for any upcoming meetings will appear under My Meeting Registrations.

Please contact our meeting managers at +1 (734) 677-7777 or email RegInfo@HL7.org.

You will need to log out and then log in as that person to register them for an event. If that person does not have a login, you will need to create one for them.

There are several reasons this may occur; one may be that your membership has elapsed or that the payment is currently being processed. If you organization has joined in the last 30 days; please check the appropriate box on the registration form. The registration company will verify with our membership department before payment is processed.

You may join a work group simply by participating in its conference calls and/or by joining its listserv. For a schedule of conference calls, please go to: /concalls/default.aspx

The listserv has likely already received your request to join the list. If you are still unable to send or receive email from the list however, your request may not have been finalized. The listserv signup process generates a confirmation email which is sent to the requesting email address. Until you click the link within this confirmation email, your subscription will be held. Be sure to check your junk mail folder to fond this confirmation email. If you are unable to find the confirmation email, please send an email to support@HL7.org to have it re-sent.

Current co-chairs have access to these features; please go to /concalls; once there, click on the call to be removed or edited. The call information will come up; the Editing Options are at the bottom of the page.

HL7 V3, like V2.x, is a standard for exchanging messages among information systems that implement healthcare applications. However, V3 strives to improve the V2 process and its outcomes. The original process for defining HL7 messages was established in 1987 and has served us well. The development principles behind HL7 V3 lead to a more robust, fully specified standard.

New capabilities offered in Version 3 include:

• Top-down message development emphasizing reuse across multiple contexts and semantic interoperability
• Representation of complex relationships
• Formalisms for vocabulary support
• Support for large scale integration
• Solving re-use and interoperability across multiple domain contexts
• A uniform set of models
• Expanded scope to include community medicine, epidemiology, veterinary medicine, clinical genomics, security, etc.

The Reference Information Model (RIM) is the cornerstone of the HL7 Version 3 development process. An object model created as part of the Version 3 methodology, the RIM is a large pictorial representation of the clinical data (domains) and identifies the life cycle of events that a message or groups of related messages will carry. It is a shared model between all the domains and as such is the model from which all domains create their messages. Explicitly representing the connections that exist between the information carried in the fields of HL7 messages, the RIM is essential to our ongoing mission of increasing precision and reducing implementation costs.

Information can be found here.

The HDF documents the processes, tools, actors, rules, and artifacts relevant to development of all HL7 standard specifications, not just messaging. This initial version of the HDF methodology specification will address updates to messaging specification, and will be applicable to structured documents and context management.

Eventually, the HDF will encompass all of the HL7 standard specifications, including any new standards resulting from analysis of electronic health record architectures and requirements.

Download the current HDF

Information can be found here.

The HL7 Version 2 Messaging Standard — Application Protocol for Electronic Data Exchange in Healthcare Environments — is considered to be the workhorse of data exchange in healthcare and is the most widely implemented standard for healthcare information in the world.

HL7 Version 2.6 represents HL7's latest development efforts to the line of Version 2 Standards that date back to 1989. Version 2.6 represents a major revision to Versions 2.5 and 2.5.1, refining and updating existing messages and adding new messages and domains all based upon proposals submitted and accepted by the HL7 membership.

Global changes from Version 2.5 and 2.5.1 include the following:

• the addition of a new segment, UAC – User Authentication Credential, to ALL messages
• the replacement of the TS – Timestamp data type with the DTM – Date/Time data type
• the replacement of the CE – Coded Element data type with either the CNE – Coded with No Exceptions data type or the CWE – Coded with Exceptions data type
• the deprecation of the CNN, NDL, LA1 and LA2 data types
• the inclusion of "external" tables referencing a set of coded values defined and published by another standards organization assigned an HL7 number but without designation as an HL7 table (as was previously the practice)
• the revision of examples in all chapters to support HIPAA compliance
• the inclusion of a new chapter supporting electronic messaging transactions of claims and reimbursement data (which is produced for implementations of HL7 outside of the United States; in the United States, HIPAA law mandates an already in-use set of implementation guides of X12 messages for these purposes)
• the inclusion of a new chapter supporting electronic messaging transactions of supply chain management data within healthcare facilities

Version 2.6 was APPROVED AS AN ANSI STANDARD October 12, 2007

Information can be found here.

The CDA, which was until recently known as the Patient Record Architecture (PRA), provides an exchange model for clinical documents (such as discharge summaries and progress notes)—and brings the healthcare industry closer to the realization of an electronic medical record. The CDA Standard is expected to be published as an ANSI approved standard by the end of the year.

By leveraging the use of XML, the HL7 Reference Information Model (RIM) and coded vocabularies, the CDA makes documents both machine-readable—so they are easily parsed and processed electronically—and human-readable—so they can be easily retrieved and used by the people who need them. CDA documents can be displayed using XML-aware Web browsers or wireless applications such as cell phones.

CDA Release 1 was APPROVED AS AN ANSI STANDARD November 2000.

The Office of the National Coordinator for Health Information Technology (ONCHIT) will facilitate the effective use of information technology to improve the quality, efficiency, and safety of health care for all Americans. ONC will collaborate with the public, private, and non-profit sectors to meet the President's goal of the widespread adoption of interoperable electronic health records (EHRs) within ten years. HL7's Standards will assist in achieving interoperability.

In January 2005, HL7 participated in a Collaborative ONCHIT RFI Response. HL7 also submitted a Separate Response and Cover Letter.