IHE Domain Coordination Committee 2008-03-28 HL7 Versioning Work Group Teleconference Minutes

Participants

Yongjian Bao John Donnelly Floyd Eisenberg Lynn Felhofer Cynthia Levy Steve Moore Kevin O'Donnell Vassil Peytchev Paul Seifert Karen Witting

Minutes

- 1998: Radiology defines scheduled workflow based on HL7 2.3.1--then current

• Patient Management and Order Management are the primary HL7 components used
• Pieces reused by RO, Eye Care, Lab, and Cardio
• Radiology polled vendors about moving to 2.5 and found that there was no support for moving there with current product base

- 2002: ITI defines PAM to address ADT feeds for registration messages based on HL7 2.5

• 2.5 explicitly disallows some PID segments defined in 2.3.1
• Non-radiology vendors do not usually claim conformance to a specific version of HL7; mix and match segments as needed
• HL7 2.4 introduced the concept of message profiles; includes messaging workbench toolkit

- Should all domains reissue their order and patient management issues using HL7 message profiles and workbench?

• Would this invalidate currently compliants systems? No change in implementation semantics
• Make upgrade paths based on profiles rather than HL7 versions

- Is it possible to make a simple CP to "unlock" the version number segment?

• If a radiology system receives a v. 2.5 message it should be able to parse the elements it needs and ignore any superfluous elements
• CP to unlock version number in patient mgt and order mgt messages in Radiology and derivative domains
• Start a page of HL7 versioning procedures across domains--ITI and radiology have appendixes that will provide some useful source material
• Should radiology go back and revise existing profiles?

- Conflicting requirements and prohibitions between domains

• Conflicting segments should be in different messages, but can still cause failures
• An example of the problem: PID fields defined in 2.3.1 are replaced in PAM by a repeating PID segment in v. 2.5
• 2.3.1 is no longer an ANSI standard; it was not resubmitted to ANSI for reapproval
• In profile writers guideline: avoid prohibiting fields; instead?

- Establish standards-based review cmtes: eg, HL7 Review

• Make issue of resolving conflicts between PAM and SWF the initial issue of HL7 cross-domain coordination

- Use HL7 Profile Mechanism and Messaging Workbench

• An issue to be addressed on the HL7 Cookbook page
• Start Wiki stub forking off of Process page; drop in key items from today's discussion

- Mapping to inappropriate fields and overloading inappropriately

• Radiology SWF used fields inappropriately because it was using the best solutions available
• Need to determine whether overloading causes interoperability problems
• Internal issue for Radiology