version 3: is it real, or is it memorex? wes rishel vice-chair, technical steering committee...
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Version 3:Is it Real, or is it Memorex?
Wes RishelVice-chair, Technical Steering Committee
Wes@Rishel.comwww.Rishel.com
9/14/98 5©1998 by HL7 & Wes Rishel
Version 3 Message Definition ProcessUse Case Model
InteractionModel
HierarchicalMessage
Description
ReferenceInformation Model
DomainInformation
Model
MessageInformation
Model
MessageObject
Diagram
CommonMessageElement
Definition
9/14/98 6©1998 by HL7 & Wes Rishel
Use Case ModelUse Case Model
InteractionModel
HierarchicalMessage
Description
ReferenceInformation Model
DomainInformation
Model
MessageInformation
Model
MessageObject
Diagram
CommonMessageElement
Definition
9/14/98 8©1998 by HL7 & Wes Rishel
Information ModelsUse Case Model
InteractionModel
HierarchicalMessage
Description
ReferenceInformation Model
DomainInformation
Model
MessageInformation
Model
MessageObject
Diagram
CommonMessageElement
Definition
9/14/98 13©1998 by HL7 & Wes Rishel
Interaction ModelUse Case Model
InteractionModel
HierarchicalMessage
Description
ReferenceInformation Model
DomainInformation
Model
MessageInformation
Model
MessageObject
Diagram
CommonMessageElement
Definition
9/14/98 16©1998 by HL7 & Wes Rishel
Message Object DiagramUse Case Model
InteractionModel
HierarchicalMessage
Description
ReferenceInformation Model
DomainInformation
Model
MessageInformation
Model
MessageObject
Diagram
CommonMessageElement
Definition
9/14/98 31©1998 by HL7 & Wes Rishel
Hierarchical Message DescriptionUse Case Model
InteractionModel
HierarchicalMessage
Description
ReferenceInformation Model
DomainInformation
Model
MessageInformation
Model
MessageObject
Diagram
CommonMessageElement
Definition
9/14/98 32©1998 by HL7 & Wes Rishel
HMD Has Three Parts
Information Model
Mapping
Message Elements
Message Structures
Message Format 1
Message Format 2
Person Object PSN Segment Yes NoName attrib Name data field Yes --
Object from Message Object Diagram
9/14/98 34©1998 by HL7 & Wes Rishel
Rows in HMD Match Fields in Message
ENC|A|TE|ENC703421||2|19970301|I|1998011110815|ABC|IPChoice|I IPE||4 PADM|1998011110815|{3^OBSERVATION^99ARE}|{1^PHYS REFERRAL^99ARF}|ED|I|N|NECPTP|||||Y|U|19670329|Dallas,TX||HS|M|D|{Jones^Sam^Houston}|W|BAPT||X454337PCP|{Anderson^Sara^^Dr^MD}|[{WPN^^206^2721234}^{ASN^^206^5551212}]|15892BL|AccountList PTBA|X1256243|U^UNBILLED^99BAS|P|A27 PTBA|X1256997|U^UNBILLED^99BAS|C|F13EL|AccountListBL|EncPractList BG|EncPrac ENP|ATT HCP|{Winters^Hubert^S^Dr^MD}|[{WPN^^206^3914871}^{HPN^^206^5551234]|77032 EG|EncPrac BG|EncPrac ENP|CONS HCP|{Scully^Dana^^Dr^MD}|[{WPN^^206^3934871}^{HPN^^206^5556667}]|25122 EG|EncPracEL|EncPractList
Not so fast !
What about XML?
9/14/98 36©1998 by HL7 & Wes Rishel
Conformance Claim
...Relied on by a User
...Describes the sponsor’s Information System
list of HL7-written
statements...
...Leads to an agreement
Offered by a Sponsor...
9/14/98 37©1998 by HL7 & Wes Rishel
Trigger Events, Interactions, App Roles
Pharmacy_order_
Creator
Pharmacy_order_
Manager
Pharmacy_order_
Tracker
Med_order_admin_Manager
Med_order_admin_Historian
Create Unencoded Pharmacy Order
Create Unencoded Pharmacy Order
Provide Filler ID
Create Unencoded Pharmacy OrderX
Convert Unencoded PharmacyOrder to Fully Encoded Order
Convert Unencoded Pharmacy Orderto Fully Encoded OrderX
Create Med Administration OrderCreate Med Administration Order
Create Med Administration OrderX
Report Administered Medications
Report Administered MedicationsYReport Administered Medications
TriggerEvent
Inter-Action
Applic.Role
9/14/98 38©1998 by HL7 & Wes Rishel
Certification
• HL7 “Seal of Approval”
• Certification = Testing
• What do we certify?– That a system passed a test …– … that individually tested one or
more conformance claims.
• In other words … there is no logo that says “100% HL7 Compliant”
9/14/98 39©1998 by HL7 & Wes Rishel
The Change Paradox
It is change, continuing change, inevitable change, that is the dominant factor in society today. No sensible decision can be made any longer without taking into account not only the world as it is, but the world as it will be. . . .
Isaac Asimov (1920–92)
Most of us are about as eager to be changed as we were to be born, and go through our changes in a similar state of shock.
James Baldwin (1924–87)
It is change, continuing change, inevitable change, that is the dominant factor in society today. No sensible decision can be made any longer without taking into account not only the world as it is, but the world as it will be. . . .
Isaac Asimov (1920–92)
Most of us are about as eager to be changed as we were to be born, and go through our changes in a similar state of shock.
James Baldwin (1924–87)
9/14/98 40©1998 by HL7 & Wes Rishel
The Gain (V3 Benefits)
• Interfaces installed much more quickly – reduce sight-specific negotiations– greatly reduce custom programming– asymptote is “plug and play”
• Conformance claims; support for conformance testing
• Functional adaptation to the changing healthcare system
9/14/98 41©1998 by HL7 & Wes Rishel
Other Benefits
• Improved clarity and correctness of specification
• Appropriate to newer communications paradigms
9/14/98 42©1998 by HL7 & Wes Rishel
The Pain?
• Changes to the interface software– subtle, but substantial– segment groups– subsubsubcomponents– recursive types
• Functional changes to systems– more precise specifications– requirement to use data that is received
• Retraining
9/14/98 43©1998 by HL7 & Wes Rishel
Is the Pain worth the Gain?
• Transition costs– retooling of character-stream based interface software– or, adaptation of object-based approaches, with
corresponding benefits– Analyst time to interpret 2.3 transactions and
configure interface engines for 3.0
• The good news– You have a two-year+ head start
9/14/98 44©1998 by HL7 & Wes Rishel
Other Observations on Change
Change is inevitable ...
… inevitably slower than anticipated
Change for marginal benefit gets overrun by newer change
Change begets change
9/14/98 45©1998 by HL7 & Wes Rishel
The Revolution, um, Evolution of XML
• eXtended Markup Language
• Fundamental economic driver is an evolutionary change to the World Wide Web– content-based searching and presentation– management of documents in pieces– indirect links– etc.
• Compatible upgrade to HTML
9/14/98 46©1998 by HL7 & Wes Rishel
XML Benefits Will Beget Other Changes
• Document markup: SGML changes its costume and gets “discovered”
• Self-documenting data files– almost self-parsing
• The begetting happens through– tools,– people,– and hoopla (i.e. the attention of the marketing department)
9/14/98 47©1998 by HL7 & Wes Rishel
XML and Version 3• The syntax handles recursion• Parsers are “free”• Self-documenting data files• XML-related tools
– viewing– testing– conversion
• Availability of trained personnel• LOTS and LOTS of HOOPLA!
9/14/98 48©1998 by HL7 & Wes Rishel
Dr. Asimov Revisited
“No sensible decision can be made any longer without taking into account not only the world as it is, but the world as it will be. . . .”
• Design decisions require cautious optimism about change.
• Five years from now, if V3 does not use XML, people will, at best, be amused by our quaint eccentric ways.
9/14/98 49©1998 by HL7 & Wes Rishel
Describing an HL7 Message Format
HL7-ConformantApplication
HL7-ConformantApplication
Data
HL7MessageCreation
HL7MessageParsing Data
MessageInstance
ITS
ImplementationTechnology
Specifications
HierarchicalMessageDefinition
"Discontinuepharmacy order"
"Send as ASCIIstring in XML
format"
9/14/98 50©1998 by HL7 & Wes Rishel
Technology Layering in V3 Messaging
HL7-Conformant Application
Data
HL7-Conformant Application
ITS-SpecificSoftware
Agent
ITS-SpecificTransfer
Mechanism
HierarchicalMessageDefinition
HL7 Version3.X
HierarchicalMessageDefinition
HL7 Version3.Y
HL7 Type Object Model, v3.X
M essageElem ent
Type
M essageElem ent
Type
M essageElem ent
Type
M essageElem ent
Type
M essageElem ent
Type
M essageElem ent
Type
HL7 MessageProcessing Data
HL7Instance O bject M odel
M sg Elem entInstance
M sg Elem entInstance
M sg Elem entInstance
M sg Elem entInstance
M sg Elem entInstance
M sg Elem entInstance
ITS-SpecificSoftware
Agent HL7 Type Object Model, v3.Y
M essageElem ent
Type
M essageElem ent
Type
M essageElem ent
Type
M essageElem ent
Type
M essageElem ent
Type
M essageElem ent
Type
HL7Instance O bject M odel
M sg Elem entInstance
M sg Elem entInstance
M sg Elem entInstance
M sg Elem entInstance
M sg Elem entInstance
M sg Elem entInstance
HL7 MessageProcessing
9/14/98 51©1998 by HL7 & Wes Rishel
The Gotchas
• Not a patch to an existing parser
• Access to “free” parsers on legacy operating systems
• Message sizes substantially larger
9/14/98 52©1998 by HL7 & Wes Rishel
The Plan• Prototype
– demo at HIMSS in HL7 booth– multiple systems– mixed version 2 and v3/XML– interface engine
• Prototype goals:– evaluate methodology– evaluate parsing difficulty/message size– HOOPLA
9/14/98 53©1998 by HL7 & Wes Rishel
Is it Real?
• The V3 Effort has already profoundly improved HL7
• RIM provides coordinating point for broad array of standards efforts
• Organizational awareness of enabling technologies
• Technology-independence seemingly proven by our current work
9/14/98 54©1998 by HL7 & Wes Rishel
HL7--Not Just Messaging Anymore
Enterprise Com m unications(T rad itiona l H L7 )
DataManagem ent
Models(A rdenS yn tax)
UserInterface System
Mgt
Com m on User Envt
Inform a-tion
Model(V e rs ion3 R IM )
Enterprise Com m unications(T rad itiona l H L7 )
Inform a-tion
Model(V e rs ion3 R IM )
Models(A rdenS yn tax)
Com m on User Envt(C C O W U ser L ink ,P a tien t L ink , e tc .)
9/14/98 55©1998 by HL7 & Wes Rishel
Implementing Version 3 as Change
• End user benefits need to be proven
• Some will derive from RIM improvements currently underway
• Some will derive from being enabled by new enabling technologies
• We are now entering the fray!
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