Frequency of use of HL7 message types

If we were to create a diagram that depicts the frequency of the number of message types supported by software applications, what would it look like?

This is a relatively difficult question because of the lack of reliable data. After conferring with a number of knowledgeable implementers the shape of the diagram (not to any particular scale) is as follows:

Diagram #1

HL7 version 2

The diagram shows that most applications support a certain number of HL7 v2 message types (or rather, trigger events). There are some applications that only support one or two message types, and there are a lower number of systems that support a very large number of message types.

The curve is not a Gaussian Bell curve: the two peaks in the curve reflect the fact that most applications are either ancillary/departmental applications (which support relatively few message types) or HIS/PAS and EHR applications (which have to support a larger number of message types). The value of X (as shown in the diagram) probably lies between 4 and 6, and Y between 15 and 25.

For an implementer the main element of re-use in HL7 version 2 is the segment. So what's the frequency of the number of segments supported by software applications?

Diagram with 1 peak, a skewed bellcurve.

Diagram #2

Even a simple application that receives ADT messages has to support (however minimalistically) at least 3 segments (MSH, PID, PV1). The mean value probably lies around 15.

HL7 version 3 messaging

Note: this section focuses on HL7 version 3 messaging, and doesn't include CDA.

Diagram #1 shows that most applications support a certain number of HL7 v3 message types. There are some applications that only support one or two message types, and there are a lower number of systems that support a very large number of message types.

Given that HL7 version 3 messages tend to be used to support inter-organizational workflows (e.g. regional and/or national data exchanges) we again have two peaks: most applications are either used to support a smallish part of the workflow (and support relatively few message types) or they provide some kind of EHR-like functionality (a large number of message types).

The main element of re-use in HL7 version 3 messaging is either the message type itself (the R-MIM), or a RIM class. HL7 version 3 is based on a methodology (called MDF 99) whereby the message types are object oriented specializations of the reference information model (RIM).

So what?

However interesting these diagrams may be, the big question obviously is what conclusions one should or could draw from them, especially when it comes to the implementability of HL7 version 3 (and CDA). This will be the subject of an upcoming column.

-Rene

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Index of columns:

HL7 Version 3 Tooling (Nov 16, 2022)
Bye bye IHE XDS and CDA. (Sep 01, 2021)
Combining the best of IHE XDS with HL7 FHIR (Jun 27, 2019)
FHIR DevDays and the year in review (Dec 27, 2018)
Creation and Curation of FHIR Profiles - process and governance (Dec 14, 2017)
Impact of the GDPR on the use of interoperability standards (Jun 27, 2017)
Next XDS Release (Oct 27, 2016)
Five years of FHIR (Aug 11, 2016)
Update from the trenches on CDA R2.1/R3 and HL7v2. (Oct 15, 2015)
Most often implemented IHE Profiles (Jun 08, 2015)
Mapping HL7v2 messages to FHIR. (Apr 13, 2015)
Recent and Future developments of the DICOM standard (Mar 06, 2014)
Documenting the history of HL7 (Sep 03, 2013)
Interoperability Standards - the no-sales pitch (Jul 09, 2013)
CDA Implementation Guides - (not) invented here (Apr 17, 2013)
Usage of IHE Profiles (Feb 25, 2013)
10 year anniversary - Dutch Ringholm HL7 v2 training courses. (Feb 19, 2013)
HL7 Connectathons (Sep 09, 2012)
Frequency of use of HL7 message types (Jul 24, 2012)
Reflections on the HL7 membership model - the affiliate life cycle (Dec 28, 2011)
RFH (Resources for Health): HL7 version 3 taken to the next step (Aug 18, 2011)
Timezone Hotel (Mar 29, 2011)
The changing role of HL7 country organizations (Jul 16, 2010)
How to lower the hurdle for HL7 v3 implementers (Jan 21, 2010)
The HL7 roadmap for CDA R3 and the CCD (Jan 17, 2009)
HL7 based Tree inventory system (Jan 30, 2007)
Workflow Bribery (Sep 15, 2006)

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