Homogeneity-driven technology independence in HL7 paradigms

Abstract

Semantic Interoperability (SI) is key in all Information Technology based healthcare information exchange amongst participating enterprises. It is the regulated, meaningful exchange and access to valued healthcare information. Coined International Interoperability herein, SI is the principle goal of this study. The predominant exponent of SI is Health Level Seven (HL7) v3, a global healthcare standard in operation today. It was determined that infusing simplicity and uniformity in the labyrinths of the HL7 sub-processes would derive optimal analytic and design interoperability. Even allied activities such as domain requirements cross-checking, stakeholder consensus, and audit, will be significantly enhanced by this process. The HL7 v3 development process consisting of Messages, Clinical Document Architecture (CDA), and Services, is presently modelled using the Extended Markup Language (XML) which actually introduces wordiness, non-uniformity, and ambiguity into the HL7 specifications development paradigm. Introduced in 1996, it is best used for formatting documents, making them human and machine readable, and also web-ready. Its primary purpose and focus is data presentation and reporting, less modelling complex ontological and information architectures. Our proposed solution remodels all such artifacts using the newly devised Unified Data Atom (UDA+) vocabulary creating overarching homogeneity across all three HL7 paradigmic landscapes. It has also been proved in this study that the transformation from XML to HL7 vocabulary is equivalent and complete, meaning that the transformation is syntactically equivalent, semantically precise, and complete. Working towards directly inducing inter-paradigmic (ie., Messages, Documents, and Services), Reference Information Model (RIM), or HL7 Ontology related efficiencies and enhancements generates meagre returns, since these top-level interfaces have been researched and any benefits already accrued and utilized. Further, the use of multiple ontological and informational-structure related modelling technologies such as Web Ontology Language (OWL), and XML actually subvert interoperability and communication processes in the HL7 specifications development paradigm. This paper however focused on excavating and capitalizing on the abounding interoperability potential afforded by core paradigm-related specification development sub-processes. UDA+-modelled artifacts accrue inclusive benefits of simplicity, brevity, and versatility over the previous XML representation. True sub-process interoperability during design and development is achieved, promoting high-calibre, internationally-interoperable and inclusively-efficient system development. Principally significant is that analysis and design interoperability amongst all stakeholders also derived, actualizing overarching, ubiquitous exchange.