HL7 Conformance Checking with NeoBrowse
The Ability to Quickly Find Nonconformance
Overview
Although the HL7 2.X messaging standard is the most widely used standard in the United States for the exchange of clinical patient data, it varies greatly in how it is implemented by each medical device and application. Consequently, it is often called the “non-standard standard”. The purpose of HL7 2.X is to provide a framework for negotiation so that each healthcare interface is closer to 20% custom rather than 100%.
The variances in implementation lead to different message formats among healthcare vendors and external providers. In order to communicate effectively between systems with different message formats, you must determine where the messages are incompatible and make changes to at least one, and potentially both, of the interfaces that are accepting or sending messages.
Conformance checking for HL7 messages is a logical process used to determine whether a message from one particular medical device or application is compatible to the standard HL7 messaging format, or a custom format, adopted by another device or application.
Why Does Nonconformance Occur?
Nonconformance occurs for two main reasons:
- An application team utilizes the flexibility of the HL7 2.X message standard to meet their system’s unique requirements. This occurs primarily in the areas of cardinality and the HL7 version that is used.
- The HL7 messaging standard can be complex and sometimes is easily misinterpreted.
Cardinality represents the minimum and maximum number of values that could exist inside a given element of the message. The HL7 messaging standard allows segments, fields, and sub-components in V2.5 to be either optional or required, and either singleton (non-repeating) or repeating.
For example, the Patient Address field (PID-11) can be optional and repeating. One development team may implement this exactly as the standard says and allow zero to infinite patient addresses. Another development team may require one patient address but not allow more than one. Messages from these two systems would not be conformant with each other.
HL7 2.X is designed to be backward compatible to work with systems using different versions. However, there are a few instances where problems occur, such as when message triggers vary from version to version, for example MDM-TO2 exists in V2.3 but not in V2.2.
An application development or implementation team may adjust the HL7 messaging standard to better support their application or system. Sometimes these adjustments make the message format used by that application or
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