Comparing NIEM and HL7 Presentation

I just finished presenting at the Integrated Justice Information Sharing (IJIS) Institute's (www.ijis.org) Summer 2012 Summer briefing in sunny Albuquerque, NM.  I've posted the content at the link below.

Comparing HL7 and NIEM

Introduction and History

One of the things that I did early in my career was to work for an ill fated organization that started off as a phone company but decided they wanted to do other things. Which means they ultimately got into healthcare (not sure the content of the executive meetings that led to that decision). So Bell Atlantic the phone company decided to buy an EMR company which ultimately became a subsidiary known as Bell Atlantic Healthcare Systems (BAHS).  The organization came to their senses a few years later and in wanting to get out,  spun off the subsidiary into its own entity which then became the starting point for my association with companies with terrible internet names.  It was with this newly divested entity, Open Architecture Clinical Information System (OACIS) that I first got my start into the world of healthcare, EMR, and some arcane message format known as Health Level 7 (HL7).

Oacis (my brain is etched with this spelling now), was a great company to work for in the EMR space because they were one of the founding members of the HL7 standard way back before the web and XML were on the scene.  Oacis had a gateway product that was a message router geared toward HL7 messages.  In addition, they developed a database schema model, the Oacis Data Repository (ODR) along with an EMR front-end interface.  Thus, they sold the whole package and I got a chance to see all of the pieces and parts interact in a variety of different environments.

I moved from software development to professional services and got a chance to interface with hospital clients that were interested in doing some HL7 jujitsu for some of the modules they had created.  In addition to coding HL7 extensively, I was required to train people on how to use the standard, and figure out how best to make things work.   After a few years, I decided it was high time to move on from health care and join another terribly named internet company, www.sonnet-financial.com (nobody had dashes in their names in the early web).  In any case, I looked back and said, I wonder if I'll ever see HL7 again. This was about 1996.

I'll skip the internet pre-bubble companies that I was employed with apart from identifying them by name:

• upickup.com - You might be able to tell what the company does by its name, which is why it was renamed to be "ambiguous" a few months after launching to throw off potential competitors.  Unfortunately, upuventures.com can be pronounce "up you ventures" which doesn't help when seeking money as we would learn.
• commsys.com - Many ways to spell this.  Didn't help that there was a comsys and a commsys that were in the same city offering similar products/services.  My trial by fire in the public safety industry.

Which brings me to my current place of employment, www.sypherlink.com.  Try spelling that one after hearing it over the phone.

In any case, I ended up being the practice leader at Sypherlink and started dealing in public safety data standards starting in 2005.  It was right around this time that the US DOJ started playing around with the National Information Exchange Model (NIEM) and through whatever sequence of events, I ended up using this for a project in the State of Florida.  NIEM 1.x had evolved from an earlier data model that was used to describe public safety data, the wonderfully named Global Justice XML Data Model (GJXDM).  In NIEM 1.x all indications were that DOJ was getting behind it and after some discussions with some other folks at the FBI, I decided to push NIEM as a standard for our internal products.  During the course of the next couple of years, I think I ended up going clinically insane.

In the process, I came to build a relational model out of the NIEM justice domain, understood the IEPD process enough to become a certified trainer, and started seeing some of the ugliness in NIEM and what US DOJ was trying to do to address it (a plug for the Logical Entity Exchange Specification or LEXS).  By this point, US DHS had fully adopted NIEM and was pressing it forward in their programs.  NIEM started getting a couple more federal partners behind it (Sypherlink was pushing NIEM at the State/local level) to the point that a report was released that documented who in the federal government was anticipating using this XML standard (see https://www.niem.gov/documentsdb/Documents/Other/AssessmentReport.pdf).  

About a year ago, US Health and Human Services decided to join the NIEM program (See http://www.ise.gov/blog/ise-bloggers/department-health-and-human-services-hhs-joins-national-information-exchange-model).

Which then brought me back to a standard I thought I had left behind.

Knowing how the governance process of NIEM works, there is likely some domain entity that is working on figuring out how health standards map to NIEM.  I figure that this effort will probably be fairly involved and will likely take some time to get off the ground.

It does present me with an opportunity to dabble in something that I've been curious about regarding how HL7 maps to NIEM and vice versa.  In the subsequent series of posts, I'll delve into some of the specific HL7 constructs and how a NIEM IEPD model might look, taking into account that HL7 crosses more of the  OSI stack than does NIEM.  Hopefully, if someone finds my blog on the googlesphere, they will find it useful.

In any case, I'll begin with "Hello World!"