Tuesday, August 17, 2010

Assuring Strong HL7 V.3 Message Adaptation

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July 2010, Gartner Inc, a leading information technology research company, reached the gloomy prediction for HL7 v.3 messages that suggests a market penetration of "Less than 1 percent of target audience". In its "Hype Cycle for Healthcare Provider Technologies and Standards, 2009", Gartner places HL7 V.3 messages just before the Trough of Disillusionment with the sad indication of "Obsolete before plateau" which means most chances HL7 V.3 messages is most likely to find itself abandoned for the sake of its future successor or it predecessor, HL7 V2.x messages.

          Gartner's Hype Cycle for Healthcare Provider Technologies and Standards, 2010

How come, that HL7 V.3 message, which introduced a much better and clearer message structure, looses the adaptation battle to the relatively ill-structured predecessor, HL7 V2.x?
The reasons for that are many. The main reason goes under the rule of "If it works, don’t fix it". HL7 V.3 messages experienced a very slow adoption rate primarily due to the very successful adaptation of its predecessor. Many healthcare systems have already established inter-system communication using HL7 V2.x messages, and the return of re-aligning those systems to comply with the new messages standard does not seem to conquer the required investment.

Moreover, the HL7 V.3 introduced not only XML structured messages, which for many organizations was a tough structure to swallow; it also introduced much more rigid syntactical rules.
Adopting healthcare systems to the HL7 V.3 standard is indeed a challenge, and Gartner 2010 prediction seems to be based on solid evidence. However seeing how large organization and governmental institutes in some countries have made the transition to HL7 V.3, healthcare system vendors are slowly starting to follow suit.

Another reason for making HL7 V.3 successfully pass Gartner's Trough of Disillusionment and reach the Plateau of Productivity is the fact that application and data integration tools such as Magic Software iBOLT Integration platform reduce the complexity of turning HL7 V2.x messages to HL7 V.3 messages and vice versa.

iBOLT for HL7, provides a special HL7 adaptor which automatically transforms HL7 FV2.x messages to common XML structure which can then be easily transformed into the required HL7 V.3 messages. The transformation of XML documents is done using iBOLT's visual data mapper.

Using iBOLT for HL7, organizations having legacy healthcare systems at their hands can reduce their vendor lock by taking control over the integration required between their new and legacy systems and transform HL7 messages by themselves, orchestrate and fully manage every integration processes.

The high risk and costs that were initially foreseen with the introduction of HL7 V.3 message standard are no longer valid and are no longer relevant. Conforming to the HL7 V.3 standard is achievable with much lower risk and much lower costs using iBOLT for HL7.

As more and more healthcare systems users and vendors choose iBOLT to successfully cross the chasm of HL7 standard generations the more likely we are to see in Gartner's next Hype Cycle report the HL7 V.3 proudly placed on the Plateau of Productivity and with a much more established market penetration.

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  1. Eh - not really true. There is a reason V3 isn't going anywhere. It's going to unsuccessful for all the reasons that V2 was successful. V2 was a pragmatic standard that matched what vendors were already exchanging. V3 is an overly complicated nightmare. It's poorly thoughtout, designed by committee and a beast to understand. The only people game to try it are governments and there are no happy success stories here - just huge budgets and very little to see in tangible results.

  2. The high adoption rate of HL7 v2 in some countries certainly slows the adoption rate of HL7 v3. HL7 v3 was explicitly created to support Inter-organizational workflows and the exchange of complex medical data (think: EHRs, decision support systems). Most countries (note I'm not using the word: governments), and notably the USA, are struggling how to deal with these issues. For intra-hospital communiction there is little need to upgrade to v3.

    Note that Gartner did use the label "HL7 v3 messages" (and I'm sure this was done purposefully), and not "HL7 v3". HL7 v3 includes other interoperability paradigms: e-Documents (CDA), and HL7v3 based services. One of those interoperability paradigms may surface as being the main kind of implementation of HL7 v3. The US MU requirements certainly confirm this: it requires v3 eDocuments (CDA).

    As for the comment by Anonymous: "v2 is a pragmatic standard that matched what vendors were already exchanging" - in other words: the standard matched the day-to-day use-cases. When development of v3 was started it was based on v2 use-cases - the development methodology of the models was however brand new and rather theoretical. Now that v3 is being increasingly implemented the HL7 organization is retrofitting the v3 standard to deal with the implementation experiences (see http://hl7.me/sg for the HL7 v3 implementers group). In that sense some of the implementer pragmatism will have an effect on the standard - without losing the ability to do fine-grained modeling, which is simply a requirement if one wishes to support EHRs or decision support. One can't have it both ways.