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HL7 UK - new landscape, new opportunities

Publication date: Jun 26, 2013

The UK mandate to use Open Standards and the freeing up of HL7s IP will have a major impact on the operations of HL7 UK as well as on the use of health IT in the UK.

Philip Scott, chair of HL7 UK, held a presentation using the above title during the HL7 UK meeting held on June 18th in London. His presentation was all about the repositioning of the UK affiliate, about its value proposition – influenced in part by decision of HL7 to give away its standards for free. The other presentations and discussions were related to changes within the NHS, and the way it will be using (open) standards.

Philip introduced his presentation by stating that: "we’ve seen some of the most far-reaching changes in the NHS for many years, and significant changes in HL7 International have happened since last year. This has been an especially busy year for HL7 UK Management Board, and this session will present the fruits of that work as plans and opportunities for 2013-14 and beyond."

View of the meeting room; Nicholas Oughtibridge presenting

The HL7 UK management board has worked on a value proposition model. In high-to-low order the following value propositions were identified: support standards implementation, provide strategic advice for HIT purchasers, provide marketing opportunities for HIT vendors/consultants, provide educational support to new implementers, validate professionals, validate products, develop UK standards and profiles, provide route into internationalization of UK-initiated standards. Whereas the latter two value propositions used to be relatively high on the list before they ended up as the bottom two on the current list (not a real surprise given the changing role of HL7 UK). The main change is the implementation focus, which is likely to lead to a FHIR hack day and maybe some sort of connectathon.

Open standards

Changes in the English NHS include the termination of CfH/DHID, and the creation of NHS England and HSCIC (Health and Social Care Information Centre). There are major changes of (non ICT related) NHS structures, these have led to massive NHS uncertainties.

The Health and Social Care act 2012 provides a new legal framework for the publication of information standards. Healthcare providers have to "give due regard" to these published standards. A Government ICT strategy published in 2011 contained the first real commitment to open standards. An Open Data whitepaper was published in 2012. A set of UK government open standards principles was published in 2012 – effectively a mandate for all government departments to use open standards.

Nicholas Oughtibridges presentation

Nicholas Oughtibridge (Head of Information Standards Quality, Appraisal and Assurance, HSCIC) presented some of the criteria as published in these ‘open standards principles’. Two interesting issues came up:

  1. Does HL7 comply with the open standards principles? It probably does, some minor issues around providing access to implementation guides still has to be sorted out.
  2. Given that HSCIC publishes ITK, an open standard, does it comply with the open standards principles? Clearly it doesn’t do so (e.g. one has to have a fully transparent process, and be open to participation by all interested parties). The impact on new developments by HSCIC on the ITK is as of yet unknown. There is likely to be some form of migration path (which will take quite some time) to move towards a fully open process.
Kathy Farndon (Head of Information Standards, NHS England) stated that there have been a lot of changes that are quite revolutionary in nature (both the restructuring of CfH into HSCIC as well as embracing the "open standards" approach), and that she would like HL7 UK’s support for these changes.

The impact of Being Open

From a long term perspective the decision to embrace open standards principles will have a major impact on interoperability: it will increase the adoption of open standards, and may force some application vendors to open up their data using open APIs.

HL7 UK, like many other HL7 affiliates, has to reorganize itself to deal with these changes, and with HL7 standards now being freely available. Their decision to refocus on facilitating the implementation of standards seems like a right leap forward.


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