Medical imaging group Charlotte Radiology addressed HL7 messaging issues by employing a message hub to offer round-the-clock services for several hospitals and health centers in the Carolinas. Built on the InterSystems Ensemble integration and development platform, the hub integrates various data feeds and addresses transformation needs in an HL7 environment.
The HL7 electronic messaging format is geared to support health administration, clinical and other processes. These messages include the important information - such as patient demographics, report results and test orders - that can accompany X-ray images.
But HL7 implementation can be a moving target. Not everyone uses HL7 similarly.
"The standard has places in it for different types of data. And it is open for interpretation," said John Frazer, IT Development Team Lead, Charlotte Radiology. "Something has to be done to [provide] some translation."
Data arrives in a variety of formats. "We get different formats from different hospitals. Some of the data actually comes as flat files. It could arrive as PDF that needs to be parsed," said Frazer. "Ensemble is able to read, parse and transform the feeds into HL7messages." Adding that, in the case of PDFs, an existing .NET parser written in C# invokes and integrates with Ensemble.
The hub allows Charlotte Radiology to create a more effective networked health capability. "We are a group of 65 radiologists, many of whom are specialized," said Charlotte Radiology COO Mark Jensen. He said that smaller hospitals in smaller towns cannot cover all radiology analysis needs in all hours of the day or night, but that a group like Charlotte Radiology can. Automated communications among multiple systems eliminates manual data entry and related keying errors, he said.
HL7 hubs may spread as the Obama administration seeks to follow through on pledges to improve Health IT processes in the U.S. Looking at these broader issues, it is clear that there is at present a lot of variety in capabilities, formats and execution. This variety will complicate the modernization task, suggested Jensen.
Large scale change will take time, he indicated. And, standardization will continue to be a challenge, he cautions.