Health Level Seven standard stimulates system integration in Finnish health care

Sankt Augustin 26 May 1998 The technological approach of health care is rapidly evolving towards an ever increasing need for system integration. At the recently organized ERCIM Health and Information Technology (HIT) Workshop, Dr. Vesa Pakarinen outlined the growing importance of health care networking in Finland during the past two decades. It seems that the implementation of the Health Level Seven (HL7) standard has become indispensable to optimize communication between heterogeneous hospital information systems.

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The technological approach of health care is rapidly evolving towards an ever increasing need for system integration. At the recently organized ERCIM Health and Information Technology (HIT) Workshop, Dr. Vesa Pakarinen outlined the growing importance of health care networking in Finland during the past two decades. It seems that the implementation of the Health Level Seven (HL7) standard has become indispensable to optimize communication between heterogeneous hospital information systems.

The HL7 standard is an application protocol for electronic data interchange (EDI) in health care environments, including both a syntax and message specifications, and consisting of separate layers. Already in 1995, Finland became affiliate of the HL7 organization and in the course of 1997, the first experiments with localized messaging were performed. Recently, the 2.3 version has been installed and the standard is being propagated through a special Web site for information disseminating and coordinating purposes.

Given the spectacular changes we have witnessed in health care technology, this kind of development seemed unavoidable. Dr. Pakarinen distinguishes five generations of computer system design. Whereas the earliest models were only dealing with push technologies, soon the need emerged for pull technologies. The step towards coupling and even integrating models was readily taken and today, we see the birth of fully integrated systems and networking models.

In research departments as well as at the customer's and vendor's side, a lot of efforts are made for strong collaboration with regard to the design of expert systems and simulation models, marketing initiatives, flexibility, quality improvement, and speed in development. In the health care sector, the ageing population causes a shift in priorities with a stronger accent on wellness, gerontology, independence, security, assistance, and home care providing. This calls for appropriate technologies to adequately meet the needs of elderly people, not only in Finland but in the whole of Europe.

In the future, telemedicine will play a crucial role in health care providing, so the more the computer systems are integrated, the better the quality of patient care will be. All the innovative tools, such as internet, intranet, ISDN, Asynchronous Transfer Mode (ATM), voice and data transmission, have to be harmoniously incorporated by means of a universal standard like HL7, which is already widely used and available. In Finland, the National Technology Development Centre (TEKES) actively supports the HL7 standard implementation.

During the eighties, the Finnish primary and hospital care was principally involved in large scale applications. In the nineties, the so-called liberation of the markets provoked a fundamental, economical change. Customers went searching for the "best-of-breed" but affordable modular systems. The question arose how to integrate these various elements into the overall structure.

To date, about fifty industrial partners and large hospital regions are HL7 member and no less than twenty localizations projects have been executed or are still running. Several service chains are being set up, which brings along the need for accurate information processing. People from varied, multiple disciplines are working together to cope with the new health care challenges, defined by a growing mobility and an increasing trend for home care. Please, learn more about the Finnish approach and the special HL7 Web site at the ERCIM site.


Leslie Versweyveld

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