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HL7 Basic OverviewHIMSS Las VegasFebruary 21, 2012Grant M. WoodIntermountain Healthcare Clinical Genetics Instituteand HL7 Clinical Genomics workgroup 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Topics Need for Electronic Healthcare InformationExchange Role of Healthcare Standards and Benefits What is HL7 and Examples of Standards 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Need For Integrated SystemsDoctors need to be connected with each other– especially during transfer of care 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Need For Integrated SystemsDoctors need to be connected withpharmacists – reduce harmful errors 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Need For Integrated SystemsHospitals need to be connected with eachother – especially for medical record transfer 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Need For Integrated SystemsLaboratories need to be connected to thepatient’s electronic health record 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Need For Integrated SystemsDoctors need to be connected to the patient’spersonal health record 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Global Healthcare Trends Rising cost of healthcare Paper to Electronic Records Under or not insuredAging populationHigh cost of chronic careDemand on public health hospitalsSystem and organizational inefficienciesBetter clinical outcomesCost effectivePublic Health Prevention effortsBioterrorism and pandemic events: Anthrax, Avian Flu, TB, etc 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Global Healthcare Trends Consumer Empowered National-Regional IT Networks Patients and providers seeking greater access andcontrol over informationPersonal Health Records empower a consumer tomanage their own healthCanada, Finland, Denmark, Austria, USA, UK, AustraliaGovernment selected healthcare standardsEmerging government-sponsored conformance testingBiotech Era Personalized medicine is beginning to emerge, e.g.genomic data and test for cancer drug 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Healthcare InformationExchange Challenges Across healthcare institutions and others groups needing healthcare data(insurance, public health, research): How can clinical data be shared among different healthcare enterprisesusing different technology? How can the same patient be identified across different institutions? How can data exchange be secured and access to patient data bemonitored?Within healthcare institutions: How can patient’s clinical data from different sources (lab, pharmacy,clinician notes, etc) be brought to patient’s point of care and into anelectronic medical record? 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Many Types of Healthcare InformationNeed to be ExchangedPharmacy MedicationListsLab TestResultsGovernmentAgencies,Public Health,ResearchHospitalizationSummariesPayers / FinancialSystemsPatientHome HealthMonitoringDevicesMedicalImaging ResultsDoctors Orders andClinicians Notes 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Healthcare IT Stakeholders Patients Payers Consumers Employers General Practitioners Suppliers Specialists Review Boards Outpatient Healthcare Practice GuidelinesProviders Government Agencies Residential Care Providers Standards Enforcement HospitalsAgencies 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

HL7 Has Produced a Family of StandardsPatient Administrationand DemographicsClinical Research (e.g.Genomics) and PublicHealth/Disease SurveillanceSchedulingand managinghealthcareresourcesOrders and Results forClinical Lab/Pathology,Imaging (radiology,ultrasound, etc.)Signs and Symptoms,Diagnosisand TreatmentsSharing and re-useof information frommany healthcaredomainsClaims andReimbursementsPharmacy prescriptions,dispensing andadministrationPatient Care messages,Clinical Documents(referrals, H&P,Summary record, etc.) 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

The HL7 Organization Founded in 1987, Health Level Seven International (HL7), with members inover 55 countries, is a not-for-profit, ANSI-accredited standards developingorganization HL7 is dedicated to providing a comprehensive framework and relatedstandards for the exchange, integration, sharing, and retrieval of electronichealth information that supports clinical practice and management, deliveryand evaluation of health services HL7's 2,300 members include approximately 500 corporate members whorepresent more than 90% of the information systems vendors servinghealthcare Over 43 healthcare standards from anatomic pathology to vocabularyTake a Flash tour g/IntroToHL7/player.html 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

HL7 Mission - Interoperability Goals HL7's mission is to provide standards for interoperabilitythat: improve care deliveryoptimize workflowreduce ambiguityenhance knowledge transferWide range of healthcare standards: clinical, clinicalgenomics, administrative, clinical research, electronicclaims attachments, public health, personal health, etc 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

HL7 High Level Goals Develop coherent, extendible standardsthat permit structured, encoded healthcareinformation of the type required to supportpatient care, to be exchanged betweencomputer applications, while preserving themeaning Promote the use of HL7 standardsworldwide through the creation of HL7International Affiliate organizations 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

HL7 High Level Goals Stimulate, encourage and facilitate domainexperts from healthcare industry stakeholderorganizations to participate in HL7 to develophealthcare information standards in their areaof expertise Collaborate with healthcare informationtechnology users to ensure that HL7standards meet real-world requirements, andthat appropriate standards developmentefforts are initiated by HL7 to meet emergentrequirements 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

An International Organization with Over 30 HL7 eceAnd growingSpainChinaHong oSwitzerland

Healthcare Standards Improve Patient CareImprovequality of careElectronicdocumentsprovide valueto cliniciansEnsureclinicianshave latestknowledgeBenefits of Standards:Empower patientto manage theirown healthImprove patientsafety/ Minimizepreventableerrorsincrease efficiency,improve quality,Improve clinicalworkflowlower cost,and reduce riskImprove publichealth minateduplicatemedical testsLower costof healthcaredelivery 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Standards Drive Increased Business forHealthcare IT Vendors and Service Providers Speed of development, faster time to market Lower development & installation costs, over customized interfaces Enhanced interoperability of product Clients prefer the flexibility of products with standardized interfaces More scalable solution Standards create best practices for the international community Bigger market beyond that for proprietary products 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Additional HL7 Programs and ActivitiesEducationSummitsWorking groupmeetings withan desSpeakersand booth tCountryAffiliates withworkshops,educationIT professionalCertification 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Still to Come HL7 Family of Standards Version 2 messagingVersion 3 messaging and documentsThe Reference Information Model (RIM)Clinical Document ArchitectureEHR specificationsClinical Genetics Research on annual cost savings wheninteroperable systems are implemented Other products, activities, and benefits HL7has to offer 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Domains in the NormativeHL7 V3 standard Accounting & BillingClaims & ReimbursementMaterials ManagementPatient AdministrationPersonnel ManagementSchedulingBlood bankCare ProvisionClinical Decision SupportClinical Document ArchitectureClinical GenomicsDiagnostic Imaging ImmunizationLaboratoryMedical RecordsMedicationOrders and ObservationPharmacyPublic HealthRegulated ProductsRegulated StudiesSpecimenTherapeutic Devices 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

RIM 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Need a Standard Coding, Terminology, andVocabulary System for Common “0”Male“1”FemaleA and B differsyntactically andcannot interoperatewithout translation.“1” Male“0” ��U”UnknownA and C differsemanticallyA cannotrepresent theconcept“Unknown” 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

HL7 Messages and DocumentsMessages A message is eventdriven and includes aspecific workflow.Order LabTests It could includebi-directional flow ofdataLab TestResultsDocuments The Clinical DocumentArchitecture (CDA) canfacilitate clinical documentexchange within andbetween medicalinstitutions. CDA can be used to abring patient’s clinicaldocuments into to patientcentric EHR. A collection of informationabout an encounter Can be digitally signed 2010 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.