One of the products of the HL7 organization is HL7 Version 3, a family of communication standards using the Extensible Markup Language (XML) for the exchange of data. V3 is based on the Reference Information Model (RIM, Figure).
Figure: The reference information model (RIM) as the core piece of HL7 modelling.
The RIM is accepted worldwide as the model for healthcare information and V3 is explicitly aimed to support process chains within and between healthcare organizations. Version 3 allows the communication between real applications of both the administrative and the clinical domain. A large number of projects worldwide proved the feasibility and maturity of the standard. In Great Britain and the Netherlands for example, HL7 Version 3 is chosen as a national strategy. Several other countries, for example Germany, started projects with V3 integration in healthcare.
End stage renal disease is a severe chronic disease with large economic burden. Patients face many different clinical contacts for example by frequent hospitalizations or consultation of specialty clinics. This brings along an interruption of continuity of care. Therefore interoperability of (different) electronic health records is a key issue for patient follow-up. Starting with the electronic health card in 2006 the German “E-health initiatives” will trigger a variety of technological advances. So reliance on technological standards such as HL7 v3 will be mandatory. It will be a challenge and chance for IT industry to be at the forefront of this development.
HL7 Germany adapted the models for the clinical domain “Patient Care Provision” to the dialysis context. In order to use this generic model for these purposes, further constraints have been specified and have been documented in an Implementation Guide (to directly support software developers). A table of items was built to map specific dialysis data in context to the generic model. The interactions between the partners in the communication scenario have been specified as well as business rules for example when to send what kind of information etc. The Implementation Guide is currently being implemented on the sender's side (dialysis centres), and on the receiver's side (data collection centre). Current work now addresses further details of the sender and receiver interfaces.