Health Level Seven International

Health Level Seven International (HL7), is a non-profit organization involved in the development of international healthcare informatics interoperability standards known as Health Level 7 (HL7).^[1]

HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create a framework (and related standards) for the exchange, integration, sharing, and retrieval of electronic health information.^[2] HL7 promotes the use of such informatics standards within and among healthcare organizations to increase the effectiveness and efficiency of healthcare information delivery for the benefit of all.^[3]

The 2.x versions of the standards, which support clinical practice and the management, delivery, and evaluation of health services, are the most commonly used in the world.^[4]

Organization

The HL7 community is organized in the form of a global organization (Health Level Seven International, Inc.) and country-specific affiliate organizations:

• Health Level Seven International, Inc. (HL7) is headquartered in Ann Arbor, Michigan.^[5]
• HL7 affiliate organizations, not-for-profit organizations incorporated in local jurisdictions, exist in over 40 countries. The first affiliate organization was created in Germany in 1993.^[6]

The organizational structure of HL7 is as follows:^[7]

• The organization is managed by a Board of Directors, which comprises 10 elected positions and three appointed positions.^[8] The chair of HL7 is currently Stanley Huff MD.
  • The Chief Executive Officer (currently Charles Jaffe, MD, PhD) serves as an ex officio member of and reports to the Board of Directors. The Chief Technology Officer (currently John Quinn); and the Chief Operations Officer (currently Mark McDougall) report to the CEO and also serve as ex officio members on the Board of Directors.
• Members of HL7 are known collectively as "The Working Group". The Working Group is responsible for defining the HL7 standard protocols and is composed of Standing Administrative Committees and Working Groups.
  • Standing Administrative committees focus on organizational or promotional activities, such as Education, Implementation, Marketing, Outreach Committee for Clinical Research, Publishing and Process Improvement and Tooling.
  • Working groups are directly responsible for the content of the Standards, framing the actual language of the specifications.

About 45% of the global membership (of either HL7 International Inc. or an HL7 affiliate) is located in Europe, 35% in North America, 15% in Asia-Oceania and 5% elsewhere.^[9]

Origin

HL7 was founded in 1987 to produce a standard for the exchange of data with hospital information systems. Donald W. Simborg, the CEO of Simborg Systems took the initiative to create the HL7 organization with the aim to allow for wider use of its own exchange protocol (known as the StatLAN protocol, originally defined at the University of California, San Francisco in the late 1970s). Membership initially consisted of those that had already implemented the StatLAN protocol.^[6] The name "Health Level-7" is a reference to the seventh layer of the ISO OSI Reference model also known as the application layer. The name indicates that HL7 focuses on application layer protocols for the health care domain, independent of lower layers. HL7 effectively considers all lower layers merely as tools.^[1]

HL7 is one of several American National Standards Institute (ANSI) accredited Standards Developing Organizations (SDOs) operating in the healthcare arena.^[10] Most of these SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven’s domain is clinical and administrative data.

Collaboration

HL7 collaborates with other standards development organizations and national and international sanctioning bodies (e.g. ANSI and ISO), in both the healthcare and information infrastructure domains to promote the use of supportive and compatible standards. HL7 collaborates with healthcare information technology users to ensure that HL7 standards meet real-world requirements, and that appropriate standards development efforts are initiated by HL7 to meet emergent requirements.

HL7 has been adopted by ISO as a centre of gravity in international standardization and has been accredited as a partnering organization for mutual issuing of standards. The first mutually published standard is ISO/HL7 21731:2006 Health informatics—HL7 version 3—Reference information model—Release 1.

Processes and Products

HL7 encompasses the complete life cycle of a standards specification including the development, adoption, market recognition, utilization, and adherence.^[11]

Prior to April 2013, HL7 International asserted that business use of the HL7 standards required a paid organizational membership in HL7, Inc. HL7 Members could access standards for free, and non-members could buy the standards from HL7, ANSI, or for some standards, ISO. Most HL7 standards can now be deemed Open Standards, as since April 2013 they are available for free download.^[12]

The revenue model and business plan of HL7 is discussed in HL7's Strategic Initiatives and Implementation Proposal.^[13] However, since the earlier policy as described in the Bylaws of October 2002^[14] placed the HL7 protocol specifications in the Public Domain, and under 17 USC § 102^[15] there is no copyright protection for an "idea, procedure, process, system, method of operation, concept, principle, or discovery", this revised policy may not be enforceable.

See also

• CDISC
• DICOM
• Electronic medical record
• eHealth
• European Institute for Health Records (European Union)
• Fast Healthcare Interoperability Resources
• Health Informatics
• Integrating the Healthcare Enterprise (IHE)
• ISO TC 215
• openEHR Foundation

References

External links

• HL7.org site
• HL7 International is a member of the Joint Initiative on SDO Global Health Informatics Standardization