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Documenting the history of HL7

Publication date: Sep 03, 2013

Documenting the early history of HL7 was this years summertime pet project - it turned out to be a bit more complicated than I thought.

A summertime pet project

A draft version of the The early history of health Level 7 whitepaper has just been published. A draft was published in order to allow for a wide audience to review it, and in an attempt to get hold of historic documents that we haven't been able to locate as of yet.

Stepping back in time about 2 months: during the European summer holiday season there's not a lot of business for a company that presents training courses, so it's generally a good time to update the various training materials, to create entirely new ones (like the XDS/VNA/ECM training course), and to undertake a pet project like writing a whitepaper about 'the early history of HL7'.

Ed Hammond (chair emiritus and one of the founders of HL7 in 1987) held a keynote presentation about the history of HL7. That was my initial starting point - pretty quickly however I found out that the story started much earlier than 1987, and that it involved a lot more people than my earlier whitepaper on the history of the HL7 RIM. Multiple persons had been involved in the development of the RIM from its inception up to the current day - but when it comes to the early history of HL7 the involvement and the recollections are fragmented. We'll be video interviewing some of the key players later this year / early next year, those interviews will be added to the whitepaper at a later point in time.

Ed mentioned that the genesis of HL7 came from one Don Simborg. Using Google Scholar (a fine site, even if one doesn't work in academia) quickly yields some details of his project at a hospital in San Francisco from 1979 onwards. In 1984 he was the founder of Simborg Systems, one of the very first LAN based (best of breed) hospital information systems. Luckily enough his e-mail address was known to one of the other 'old farts' (not my words, but those of one in that same group). Likewise, one contact led to another.

Getting hold of resources

Writing this paper also means trying to get hold of as many contemporary resources as possible. Academic papers are sometimes hard to get hold of, but given time, and with assistence from those that work in academia and have access to libraries, they can be traced. Getting hold of old standards and protocol specifications has proven to be much trickier: The HL7 version 1 specification was made available by Bas van Poppel - it was located in the archives of a Dutch HIS vendor. HL7 version 2.1 (1990) was still in the archives of various HL7 Fellows (one has to have been an HL7 member for at least 15 years to qualify for becoming an HL7 Fellow). As of the time of writing, we don't have a copy of HL7 version 2.0 (1989). Even harder to get hold of: HL7 Newsletters from the 1987-1992 timeframe (I haven't seen any, Ed seems to have some in his archives), and photos of the actual meetings. This predates the era of digital photography by about 15 years, so I'm effectively asking people to dust off their photo albums.

The real quest is for the protocol specifications of the earliest precursor project at University of California at San Francisco (UCSF) (1979-ca. 1986) and for the Simborg StatLAN product (1984-ca. 1988). We've asked Don Simborg, Wes Rishel and other former UCSF/Simborg employees, but no luck thus far. The librarians of UCSF have been very helpful, as have other contacts at UCSF that we approached, but their archives turned up empty. One of the UCSF contacts kind of suggested to "follow the money": the UCSF project received a grant from the National Center for Health Services Research organization in 1980 or 1981. If there's a grant, there must be a grant report, hopefully with the protocol specification as an attachment. The organization (accoring to Wikipedia) has been renamed a few times, and was terminated in 1989. It's records (27.5 feet of standardized archival boxes) are now part of the US National Archives in College Park MD.

So how does one, as a European, on a $0 budget for a summertime pet project, get hold of a document sitting in a box in College Park USA?

I asked some contacts at NIH (10 miles away in Rockville) may prove to be helpful, I'll have to wait and see. In the meantime, should you know of a way to get hold of the UCSF specification, or any other relevant bits of history that I'm not aware of - please let me know.

Update: the NIH tracked down a contact at AHRQ who were able to confirm the existence a number of grants (as well as their IDs), but they also stated that the grant files have been destroyed – consistent with the NARA disposal authority for such files. In short: a dead end.

-Rene

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Ringholm bv is a group of European experts in the field of messaging standards and systems integration in healthcare IT. We provide the industry's most advanced training courses and consulting on healthcare information exchange standards.
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