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Report from the HL7 WGM in Cambridge

Publication date: Oct 16, 2013

HL7 held its annual plenary meeting in Cambridge USA. This post discusses some of the topics or issues covered during the meeting.

FHIR hack-at-thon

On Saturday-Sunday prior to the HL7 Working Group Meeting (WGM) the 4th FHIR connecthathon was held. This was the best attended connectathon to date, with lots of clients (written in a multitude of programming languages including mine written in Tcl). The first day was basically a hack-a-thon, with lots of ad-hoc testing and bug fixing. The second day was reserved for more formal scenario based testing. At this point in time there is no formal validation of an application's capabilities, as such I'm hesitant to label this event as a connectathon. The size of the event is however such that formal evaluation of a systems capabilities is likely to be tested beginning one of the test events in 2014.

Impressions of the 4th FHIR connectathon

Video interviews

Jointly with Kai Heitmann of HL7.tv we recorded a series of video interviews. The interviews fall into two categories:
  1. an interview with someone who's actively involved in the development or deployment of interoperability standards. During this meeting we interviewed Keith Boone (a.k.a. Motorcycle Guy, blog: motorcycleguy.blogspot.com and Twitter: @motorcycle_guy) about some of the topics that seem to be close to his heart.
  2. a series of interviews was held with those involved in the early history of HL7 and its precursors. During this meeting we interviewed John Quinn - HL7 CTO and co-creator of HL7 version 1, Clem McDonald - main creator of the ASTM 1238 standard and HL7 v2 chapters 4 and 7, Mark Shafarman - involved in the development of the main HL7 precursor since 1980, Mark McDougall - HL7 Executive Director since 1991.

Snippet of the interview with Keith Boone (source: HL7.tv)

These video interviews in the latter category have not been edited as of yet, they serve to further document the "early history of HL7" whitepaper. New information was also surfaced during these interviews: for instance, if you have been involved in HL7 at the international level for a while: did you know that Mark Shafarman has been involved in the development of HL7 (or direct precursor protocols) since 1980? HL7 has a "25+ year member" category, and whilst not having been a member of HL7 from its inception, Mark has been working with 'HL7' for 33 years. Other interesting tidbits have (and will be) added to the whitepaper.

Clem McDonald on FHIR

HL7 User Groups: Application Implementation and Design

HL7 which has many HL7 standards development oriented groups, and just one 'HL7 implementer' group: RIMBAA. We (RIMBAA) decided to change our name to reflect that which we actually do: be the implementer community. Hence our new name: 'Application Implementation and Design' (AID). Over the years we've tried to impress upon the organization that it should take care of the HL7 implementation community: the easier the implementation of its standards, the higher the adoption of those standards.

Our recommendations, and input from others to the board of HL7, have recently motivated the board to create a taskforce to examine how HL7 could facilitate 'HL7 User Groups' (i.e. for those that 'use' standards, as opposed to those that 'create' standards). The taskforce met two times during the WGM - effectively brainstorm type discussions given the near zero experience of the organization with user groups.

RIMBAA (now: AID) effectively is a HL7 User Group (a specific user community, being the software implementers and software designers). It has held many a meeting to share best practices related to the implementation of HL7 standards (the next such meeting will be in Amsterdam on November 28, see HL7 wiki for details). Many if the affiliates are effectively 'user groups', centered around the exchange of experiences related to the use of HL7 standards in a particular country. The taskforce has recruited about a dozen volunteers to work on the next steps - one such step will be to test some of the ideas related to 'user groups':

  1. by creating a brand-new clinically oriented user group (probably the HL7 CIC and Advisory Board should pitch in on this), and
  2. by expanding/morphing the RIMBAA/AID working group into a implementation oriented user group. I'm not sure what changes that's going to bring, probably not a lot, given that it mostly already acts as a user group. There may be some changes in the way that RIMBAA/AID fits within the organization: next to a Technical Steering Committee (TSC, for groups that create standards - the TSC reports directly to the board) we may ultimately be in need of a USC (User group Steering Committee). We may be organizing different types of events, or combine them with HL7-themed connectathons. A connectathon is after all a user oriented event.


As you may be aware of, Ringholm acts as the outsourcing partner of multiple European HL7 affiliates (as well as IHE country organizations) for the delivery of HL7, IHE and DICOM training courses. On other continents there are other commercial providers who have teamed up with a local affiliate. Whereas the affiliates have been open about such a cooperation with a commercial entity (and have a long history of doing so), HL7 international hasn't.

HL7 International seems to be ready to start considering such cooperation, in the realization that it's near to impossible to cater to the world's educational requirements when it comes to a subject like HL7 (or: the wider issue of healthcare systems interoperability). One has to mostly speak the local language, be aware of how healthcare is organized and financed, be aware of local customs, and be aware of the state of healthcare interoperability - which is already difficult for us, and we're only focused on the delivery of training courses in less than a dozen of European countries, and we always try to use local tutors/trainers. Yes, one can offer introductory webinars aimed at a global English-speaking audience. Any face to face training, if it is to be done well, will require local involvement.

Having some kind of partnership agreement with HL7 International would offer additional opportunities for training courses in countries that either don't have an HL7 affiliate (they have the best connections and marketing database to organize local events), or in countries where the affiliate is somehow unable to organize its own training courses. We look forward to the new challenges that this opportunity may bring - we may be adding yet other (European) countries to our list.


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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.
See http://www.ringholm.com or call +31 33 7 630 636 for additional information.
Rene's Column (English) Rene is the Tutor-in-chief of Ringholm.