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RFH (Resources for Health): HL7 version 3 taken to the next step

Publication date: Aug 18, 2011

As part of the Fresh Look initiative HL7 went into a bit of self reflection, partly because of the low uptake of HL7 version 3 messaging: what would a good (and: new) specification look like? RFH is certainly a prime candidate.

The answer may be something like Resources for Health (RFH), a specification authored by Grahame Grieve, an active HL7 contributor from Australia. He just wrote a blogpost on the topic of Resources For Health: A Fresh Look Proposal. In the lead up to this announcement he's posted a series of comments on HL7 version 3, for example HL7 needs a fresh look because V3 has failed and HL7 needs a fresh look because V3 has succeeded - which each generated a fair number of comments. To me, his earlier blogpost Context of Interoperability (and notably the concept of Drive By Interoperability) reads like the rationale for some of the key design decisions in RFH.

Grahame's primarily a software implementer and a standards developer, and not a diplomat (it shows in some of his blogposts ;-) ) - certainly his concerns resonate with the wider HL7 version 3 implementation community. As a co-chair of the HL7 RIMBAA Working group (the HL7 v3 software developers) I've requested Grahame to address RFH during a RIMBAA session at the upcoming working group meeting (WGM) in San Diego (Tuesday September 13, from around 20:00 onwards). I'm sure it will be discussed at other venues during the WGM as well.

The concept of Resource as introduced in RFH isn't new to the RIMBAA community, which has been discussing SMIRFs as a unit for persistence. Many of the issues/questions RIMBAA addressed related to SMIRF will also apply to Resources in RFH. As such I'm sure RIMBAA implementers will have some questions for Grahame...

I've had an opportunity to look at the RFH specification ahead of its release (it is available at http://www.healthintersections.com.au/rfh/introduction.htm) - below is a 16 minute overview summary focusing on its design features and architecture. If you're deeply interested in XML you may wish to skip the video and go directly for the specification - the video purposefully doesn't contain any XML examples.

To me, RFH contains a lot of elements that turn it into an implementable standard. My main concern is not a technical one, but one of governance. If we assume RFH is adopted by HL7 as a next step in the development of HL7 version 3 - will we really be able to define a process whereby we can get agreement on the boundaries of the individual resources? Sure, we can aggregate resources into other resources, but there is some lower boundary of granularity that all will have to agree upon. Especially on the clinical side of things that won't be easy to accomplish.

We won't know until we try. RFH takes HL7 version 3 to the next step: it's based on the v3 core components (RIM, data types, vocabulary model), it extends the micro ITS/greenCDA approach, it solves the text/coded element issue, and it has a set of simple operations - leaving the definition of the dynamic behavior up to the conformance statements of the comminicating applications.

RFH certainly has the potential to blow some "fresh air" into the future development of HL7 version 3.

-Rene

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