HL7 and BizTalk Blog

This is what I would like to see in HL7 v.Next. This entry I hope serves to be launch pad for other entries. I have spent a great deal of time thinking over the following guideline in the HL7 standards, which are not followed in the BTAHL7 accelerator. 

Ignore segments, fields, components, subcomponents, and extra repetitions of a field that are present but were not expected.

Let’s take a look at the current situation. You have all of these fields that are defined in the schema as required, and they are at various levels in the schema.

Here there is a obviously wrong implementation of the standard. If I don’t care about this, why is this element required, and why might it have to match a pattern and possibly have an enumeration that it needs to match against?

What I would like to do is four things initially:

1. When I start up a new project where I am going to need to create a new trigger message for a data source, I don’t want to have to hack into the schemas to change the target namespace for the base schemas (datatypes, segments, and tablevalues). Why can’t there be a way from within the schema to define a party that this message is defined to, and it have it derive a new definition off of the base schemas for that party? In the BTAHL7 Configuration explorer, it will automatically make the targetnamespace coincide with the party name. Something that looks like this:
   
   which would automatically change the Target Namespace to this when I choose the Partner URI in the schema
   
2. I would like to open up the schema and be able to do a ‘Select All’ and then with the CTRL button go and de-select the fields I care about, and with the right click make all of the fields optional and override the data type to ST or TX with no enumeration or patterns.
   
3. I would like to be able to see the enumeration lists for the base schemas even though I am looking at an inherited schema. When I click on PID 2.5.0 in the ORM^O01 schema, because it has imported that definition, I don’t see the enumeration. I have to go and open up the tablevalues schema and search thru it to change those values to have to recompile and redeploy. Why can’t I first see the values and second override the existing values with values I know are going to come in, sometimes less, sometimes more values.
    
   
4. The last thing is that every segment, sub element should have the optional Trailer to consume additional data that might be there:
   

It should be pretty easy to accomplish, shouldn’t it?

This is just something that I thought of this week while at MS-HUG. I do not doubt that there are many issues with my theory, but those three things would make implementing HL7 with BizTalk SO MUCH easier and bring Microsoft’s HL7 component much closer to the standard.

Send me an email thru my contacts page if you have more ideas.

Wanted to recap the list of things I walked away with today from the conference at MS-HUG:

Keynote address

Bill Crounse, MD, Director Worldwide Health Microsoft Corporation

Well, I got to listen to Bill (no not that Bill) and it was interesting, I learned today that CMS will significantly curtail the payments of procedures for in hospital infections. This will have rippling effects for the providers, and will spurn the pay for performance initiatives and quality of care initiatives as hospitals will now have to foot the bill for those issues.

Winning Trust, Minimizing IT Resources: Key to Forming RHIOs

Mark Singh President Clinicore Solutions

Kathleen Sullivan CEO Salient Health Solutions/SEMRHIO Consultant

Being the architect I am very much aware of what is going on (I had better!), however it was interesting because most of the questions were focused on the business model, the revenue generation process. This is the next phase in our process, but having a working process in place I feel is the key to success as we now have 3 hospitals up with minimal IT resources.

Reference Implementations for Healthcare: HCE and iHE XDS.b (sorry the link does not work as of yet)

Roberto Ruggeri Senior Technical Strategist for Microsoft Worldwide Health Microsoft Corporation

Randy Fusco Technical Strategist for Microsoft US Health Providers Microsoft Corporation

This was a great presentation where I learned about how much Microsoft is looking for us to help. For those who write blogs and to those who read blogs (you know who you are) it was a call to action! Yes you!

On http://solshare.net you can download the code and start to try it out and using their forum, you can submit bugs, ask for enhancements, etc.

I asked if there was a list of known issues, in which Roberto told me that no, this was a feature, that we get to start our own list and he will see if we really know what we are doing! (j/k) Seriously, he said that there is no existing list of issues, so I would assume that you can post those known issues/fixes directly on the solshare.net site.

Lunch

I went out to eat with Eric Battalio, Muhammad, and Liza from the documentation team, and wow, I learned a lot! The first and most important thing I learned is that those comments that you can leave on the documentation site actually go to someone. My suggestion is that if you want to start a dialog with the documentation team (which by the way, they would LOVE), it would be nice to have some type of post submission question asking if you (the feedbacker) would like to be contacted by Microsoft and what email they can contact you.

In the interim, just put your email address in the comments so they can contact you directly, I assume that there will be something in the works addressing this issue. Below is an example of something I have had on the back of my mind recently. 

Improving Patient Safety Using the Microsoft Common User Interface (MS-CUI)

Andrew Kirby Director of Solutions Development Center Microsoft Corporation, UK

Like the CHF, this is very much a work in progress and since it is very early on in the development, it is more of a guideline and they need as much feedback as possible. However there are no immediate plans for a reference implementation to build off of other than the first implementation in England.

What’s New in BizTalk Server 2006 R2

Stuart Landrum Program Manager, BizTalk, Microsoft Corporation

Well, it was the first time I had met Stuart face to face, had been on some conference calls with him, so it was good to meet him. He explained the new features with the HL7 accelerator (now officially branded 2.0). There was very little pictures of the product so the discussion went rather quickly and ended early with few questions, I had to ask a few questions to get people in the asking mood, but it did not go much further than that.

Closing Keynote: Using IT to affect efficiency and safety changes in the erioperative process

Conclusion 

Paul St. Jacques, MD Associate professor and Director of Perioperative informatics Vanderbilt University

This doctor was actually kind of funny. I am not sure if he meant to be, but if it was not for his phones (yes plural) that added a little static to his voice, or his low ranking on the pay for performance ratings that he refuse to show on the list of many doctors ranked (it was too small to see), it was a good presentation that ended on a high note, even though he essentially had to ask us to laugh, even though there wasn’t really anything funny about his presentation. He did use one of my all time favorite phrases, while describing the hospital system that he works in, he described it as a level 1 trauma facility that is “soup-to-nuts” – where did that come from and should we be saying that phrase as professionals?

The interesting thing that I thought that he was going to joke about was his workflow from a patient pre-registration process through surgery completion. look closely for anything wrong with this picture

 

nope, not the fact that they are using SQL Server 2003 (must be a special version of SQL Server that I am not aware of) 

 

The real problem with this picture is that there is a little girl that starts the surgery process, and when the workflow is complete, the girl is actually Henry Kissinger! Either that process took a really long time (and something major wrong happened), or this is a plastic surgeon’s billing dream come true!

Talk to you all tomorrow!