Development Without Implementation Is Meaningless

On June 4, I welcomed my third grandchild—my first granddaughter—into the family. Molly and her mother are doing very well. Unfortunately, they face the same challenges related to healthcare information exchange and interoperability as I faced when we welcomed my daughter, Molly’s mother, into the world some three decades ago. Giving credit where due, it is not for lack of trying. HL7 has been developing and promoting the use of health informatics standards for the last two of those three decades and a number of consortia have attempted to facilitate implementation of those standards. What success has been achieved is best described as limited.

HL7 is aware that, as elegant as its solutions may be, if they are not subsequently implemented by the healthcare community they do not represent solutions at all. While we continue to expand the viability and scope of our standards, we must refocus on our efforts to provide implementation guidance for our users. Recognizing this need, HL7 recently combined the Implementation Committee, a Board appointed committee, with the Conformance Special Interest Group to form the Implementation/Conformance Technical Committee (IC TC). The IC TC is tasked with supporting all post-publication activities of users of the standards. This includes the localization of HL7 standards to suit specific real-world situations, the creation of implementation guides, and the mechanism to specify conformance.

HL7 is also cognizant of the efforts of certain regional and national consortium and various federal agencies to produce guides for the implementation of HL7 standards. An early effort, the HL7 Version 2 Electronic Laboratory Reporting (ELR) Guide developed by the CDC and widely adopted by public health agencies, has been available for several years. The CDC was also instrumental in fielding an Immunization Registry Guide. The EHR-Lab Interoperability and Connectivity Standards (ELINCS) project, undertaken by the California HealthCare Foundation (CHCF), has developed a proposed national standard for the delivery of real-time laboratory results from a lab’s information system to an electronic health record.

This activity has led HL7 to develop policy and process for the adoption and support of externally developed implementation guides and specifications. Thanks in large part to a grant from CHCF, HL7 is proving this process through review, adoption, and publication of an ELINCS guide. It is our belief that future opportunities to facilitate the development and adoption of implementation guides will abound. Whether your interest is in enhancing the standards or working toward viable implementation solutions, we’re hopeful that you will join us in Atlanta for our Plenary and September Working Group Meeting. Let’s work together to ensure that broad and reliable healthcare information exchange and interoperability becomes a reality long before Molly begins her own family.

Warm Regards, Chuck

Charles (Chuck) Meyer Chairman of the Board Health Level Seven, Inc.

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