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Swiss and Dutch HL7 News

Publication date: Dec 31, 2008

Updates from HL7 Switzerland (a new CDA implementation guide; RIMBAA) and HL7 Netherlands (their national conference held in December 2008).

The end of 2008 nears, so allow me to report on two videos I made in 2008 but for which I haven't found the time yet to write a blogpost. The first video is about the use of HL7 in Switzerland, and the second one is about the annual HL7 Conference organized by HL7 Netherlands.


HL7 Switzerland was founded in 2000, with a focus on HL7 v2 messages (mainly ADT and Lab results). HL7 version 2 is used by almost all hospitals. In terms of the creation of a nationwide EHR Switzerland has to deal with the fact that it has 26 cantons (states), each of which is autonomous to a large degree. Each canton has its own laws when it comes to healthcare and the use of IT in healthcare. The national Swiss government is working on a national e-health strategy.

Tony Schaller, consultant with medshare GmbH and chair of the Swiss CDA Working group, sees a change in focus of HL7 Switzerland: HL7 v3 has come within focus of HL7 Switzerland, and their are some pilot projects that have implemented CDA. The new Swiss HL7 v3 CDA implementation guide (created by HL7 Switzerland, in cooperation with lots of Swiss organizations and software vendors) covers all documents (about 10 different types) needed to support the "hip replacement" clinical pathway. This implementation guide (available in four different languages) covers all of the requirements of the national e-health initiative. CDA promises to be "the" HL7 standard for Swiss healthcare.

Ronald Griessen, software architect with MCS Parametrix, observes that his employer, Parametrix - the biggest medical information system vendor in Switzerland has been using a RIM based architecture (RIMBAA for over four years. Their application has to be very flexible and adaptable, and four years ago they were looking for a generic model, and decided to use the HL7 RIM model as a generic architectural model. Their current application has a core model which is strongly influenced by the RIM. Ronald sees a benefit of the HL7 RIM above and beyond the peripherical application integration layer: inside of an application, as an architectural model.

Update (2009-04-02): see Die e-health Strategie in der Schweiz (in German) for a high level description of the Swiss nationwide EHR project.

The Netherlands

In december of 2008 HL7 Netherlands held its annual conference with over 125 attendees. Additional chairs had to be brought into the room to facilitate all attendees. As usual this one-day conference contained a mixture of v2 and v3, the relationship between HL7 and AORTA (the Dutch national healthcare IT infrastructure).

Some of the highlights were:

  • Adri Burggraaff, of the IT department of the Slotervaart Ziekenhuis in Amsterdam, held a passonate talk about the requirement for all Dutch applications to migrate to HL7 version 2.4. As of June 3009 there is a legal requirement to send the 'national person identifier' (BSN) in HL7 v2 messages - something that's simply not possible
  • Alexander Henket, consultant with E-Novation, observes that CDA in the Dutch conetext is something that will be on the increase, it will be compared to messages however, given the long history of HL7 messages in the Netherlands.
  • Ewout Kramer, architect with Furore, held a presentations about the clinical statement model and templates. He compared the design of templates for clinical statements to 'software design patterns' as used in the development of software.
The full video (in Dutch!) can be viewed here:


All the best for 2009!


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