Why did RHIOs fail?

RHIOs have failed in the US because all the stakeholders want to hold on to their data. US Healthcare is a privately funded healthcare system where every stakeholder has to protect their business interest. Without any single controlling agency its impossible to bring all stakeholders to share their data.

Whereas in commonwealth countries its a Govt funded, Govt controlled Healthcare system e.g. Canada, UK, Australia, India. Sharing of data is possible because all data belongs directly or indirectly to the Govt. If there is a reliable system to protect and share data then all stakeholders will share data. Therefore the huge investments integrated electronic health record systems (iEHRS) are in the right direction and will surely be a success.

We will soon see next wave of innovation from the countries where healthcare data becomes sharable. Especially closing the loop where data is available for Evidence-Based-Medicine and Epidemiology.

HL7 2.x to XML

For example represent the ORM message in XML format as above:

HL7 2.x was the best thing that could happen to Healthcare in terms of providing a common messaging language between systems. However HL7 2.x did not fit into the bigger picture of web-based applications, especially SOA. Therefore the need was felt for a XML based messaging format. This gave birth to HL7 3.0, where effort was made to define the most granular details. However the flip side is that HL7 3.0 lost the flexibility of accommodating innovation in clinical procedures.

Many new eHealth integration efforts are adopting HL7 3.0, though the old school having implemented HL7 2.x swears by it. Both approaches are right, but where is the meeting ground?

One way of sending HL7 2.x messages in SOA without moving to HL7 3.0 is to convert HL7 2.x fields into XML tags. The name of the tag can be Field# or Field Name. Just put a SOAP header on to the HL7 2.x XML and you are good to go. However the sending and the receiving applications need to share the same xsd. This can become the de facto standard if widely used by all.