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The changing role of HL7 country organizations

Publication date: Jul 16, 2010

The role of HL7 country organizations (affiliates) has changed over the past five years, the importance of being a platform for the exchange of experiences has increased, whilst their role in the creation of localized specifications has diminished.

HL7 country organizations, or 'affiliates' as HL7 calls them, used to have a pretty clear mandate:

  • Localize (and potentially: translate) the HL7 version 2 standard for local use
  • Ensure that all local requirements are met by the standard, and if not, bring forward and defend proposals to extend the standard
  • Be an exchange platform for the exchange of implementation experiences
  • Provide education in the form of training courses, brochures, conferences.
HL7 version 2 has a fairly limited scope (it's limited to hospital internal workflows), and in the all-volunteer environment of HL7 the effort required was limited as well. The volunteers were mostly representatives of either hospitals or software vendors, i.e. those with a direct interest in the implementation of the standard.

HL7 Norway Expertteam, May 2010
HL7 Norway expertteam, May 2010

HL7 currently has a wide range of standards, including HL7 version 3, functional models and service specifications. These standards (let's use HL7 version 3 as an example) are more complex and larger in size, and have more of a "toolbox" character: if for example a particular scenario isn't covered by the standard one can create one's own models. HL7 version 3 also has a scope that's much wider than HL7 version 2: it covers all healthcare processes.

The main stakeholders have changed as well: they now include governmental, regulatory and National health Infrastructure Network (NHIN) organizations.

HL7 Norway

HL7 Norway was created in April 2010. Espen Moller, the interim chair of HL7 Norway states that "the main incentive for becoming an affiliate was to have the ability to create our own implementation guides, and to build up knowledge about HL7, especially HL7 version 3 messaging."

Another key reason he mentions is the desire to have a platform, a focal point, for knowledge about HL7 version 3. At HL7 Working Group Meetings (where all HL7 country organizations meet and work on the creation of international standards) he values the "networking, knowledge building" and the fact that the meeting "important to get some perspective, to get input, on our own project".

"The world is smaller than we think, we're all working on similar issues". See below for the full interview.

Changing Role

So how has the role of an HL7 country organization changed? What are its responsibilities today?
  • The work has become much larger in scope and is mostly done by an organizational stakeholder (e.g. a semi-governmental organization). That organization typically engages with the HL7 country organization: the level of engagement could vary from just asking them to review/ballot the localized specifications, up to full cooperation in the development of such specifications. The role of the HL7 country organizations when it comes to the development of localized specifications has diminished.
  • The scope of the educational activities of the HL7 country organizations has had to be widened in scope: there are an increasing number of standards, with an increasing scope. In addition to that new educational channels have opened up such as e-learning, distance learning, 10 minute streaming videos, and trainer-lead classroom-style training. These new channels and a wider set of standards probably require more professionalization of the educational offerings. As such the role of the HL7 country organization (other than as the organization that outsources its educational efforts) is getting smaller.
  • The role of "being an exchange platform for HL7 standards users" has increased. HL7 has always been an open standards environment where any and all could discuss the use and development of its standards. To me, engaging with other (national) standards organizations as well as (for more long term reasons) with HL7 organizations in other countries is an inherent part of offering a platform for the exchange of ideas and experiences.

HL7 country organizations definitely have a role to play, but it has changed from the role it had up to about 5 years ago.


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