Abstract
The standards landscape from an organizational and scope perspective was presented in Chap. 3. In this chapter we will examine data exchange standards from a technical viewpoint, with a focus on the conformance approach that is used for each standard. This chapter presents a sampling of the most commonly used and well-known healthcare data exchange standards from a variety of categories. It begins with an overview of Version 2.x®, and FHIR® (Fast Healthcare Interoperability Resources) from the family of products specified by HL7 International. This chapter continues with EDIFACT as a European data exchange standard that is also employed in healthcare. ebXML as the foundation for the IHE (Integrating the Healthcare Enterprise) ITI (Information Technology Infrastructure) XDS integration profile is described next. To complete this sampling, details about the HL7 CTS2 (Common Terminology Services, Rel.2) and ISO/FDIS 13120 ClaML (Classification Markup Language) are presented.
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Notes
- 1.
The diagram, in certain aspects, is simplified; some classes in the model should be shown as properties of the corresponding relations and not as separate classes. A good example is the set of conformance elements that are defined by the standard. Furthermore, the associated data types in the diagram are in most cases reduced to strings, although enumerations or other data types are more appropriate.
- 2.
This sequence is not the same as the order in which they are defined in MSH-2.
- 3.
As in a “character array”, i.e., the number of bytes to represent the data, and not repetitions of the data (“data array”).
- 4.
Note: HL7 v2 officially allows for adding components and subcomponents where necessary.
- 5.
The standard explicitly states to use Carriage Return as the segment delimiter; however, many systems use Carriage Return + Line Feed instead, because it is easier to implement and not immediately visible without carefully reading the specification. Although this approach is not conformant, it is good practice to allow for it.
- 6.
It is important to note that the delete indicator is a “request to delete data” based on what the sender knows. However, the receiver may have other sources for that data; therefore, the receiver determines whether or not to remove data for that element.
- 7.
These two levels have been introduced into HL7 v2 with v2.2 in form of an enhanced acknowledgement mode.
- 8.
Sometimes a transport acknowledgement is also known as accept or system acknowledgement.
- 9.
The easiest and most reliable mechanism for exchanging files is the use of renaming, because this process is supported at the file level by all operating systems as an atomic action. For unexplained reasons, however, semaphore files are preferred for solving the problem, although two files must be handled when using this approach.
References
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Oemig, F., Snelick, R. (2016). Healthcare Data Exchange Standards. In: Healthcare Interoperability Standards Compliance Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-44839-8_4
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