Transcript How and Why did HL7 Come to Be

HOW AND WHY DID HL7
COME TO BE
HL7 30TH PLENARY MEETING BALTIMORE MARYLAND
JOHN QUINN (CTO EMERITUS), SEPTEMBER 2040
MARCH 1987, HOSPITAL OF THE
UNIVERSITY OF PENNSYLVANIA (HUP)
• The Chief Information Officer at HUP is Sam Schultz PhD.
• Sam is trying to upgrade the configuration of the Information Systems
Hardware and Software that he discovered at HUP.
MARCH 1987, HOSPITAL OF THE UNIVERSITY OF
PENNSYLVANIA (HUP)
• The Configuration of IT Systems at HUP included:
• ADT, Registration
• Order Entry and Results Reporting
• Some clinical applications which needed coordination among several existing systems, some new IT
systems that added new capabilities to existing applications (an existing mainframe based billing and
financial reporting system;
• All require electronic sharing of data through local network interchanges to coordinate the
availability of patient administrative and clinical information. Examples included a newer existing
registration & billing applications are running on a local service vendor called SMS (Shared Medical
System which has since been acquired by Cerner Corporation a few years ago.) SMS was the then
then the current legacy application and services vendor handling all patient administrative and billing
functions and other related functions at HUP in 1987.
MARCH 1987, HOSPITAL OF THE
UNIVERSITY OF PENNSYLVANIA (HUP)
• New niche application systems were being favorably reviewed by the HUP users and
the IT Staff.
• Some of the potential vendors were:
• Winning approval from the HUP users and
• These same “new” vendors were stepping up on reducing license costs, and requests for additions
and changes to the applications, would require a new way of interoperating data and user workflow.
• The existing SMS applications were hosted off-site and SMS was unwilling to reduce their costs to
HUP. SMS at this point was also loosing their role to a mini-computer hosted set of applications that
could be queried in real-time and did not require a host IBM Mainframes
MARCH 1987, HOSPITAL OF THE
UNIVERSITY OF PENNSYLVANIA (HUP)
• SMS’s applications were a substantial amount of the IT portfolio that HUP needed.
However, they refused to reduce their prices and insisted that all electronic interfaces
into and out of the SMS applications would have to be programmed at SMS’s current
rate of $100K per interface into or out of the SMS environment.
• A company call PHS (Professional Healthcare Systems) was willing to expand their
applications’ capabilities…including providing real-time queries. PHS was a company
created by AMI (American Medical International)*.
*At that time I worked for a company called AMI/PHS (1987)
MARCH 1987, HOSPITAL OF THE
UNIVERSITY OF PENNSYLVANIA (HUP)
• HUP had a vendor named Simborg Systems who had taken work demonstrations at
UCSF by Drs. Don Simborg and Quinn Whiting O’Keefe, Wes Rishel & Mark
Shafarman also worked for Simborg Systems. (Mark is still an occasional visitor to
HL7 meetings, Wes even less often. The Simborg Product was hosted on a set of
personal computers (PCs) on a local TCP/IP network. Their products were already
starting to get recognition in HIT communities as having a new good idea and it
became easy to believe that “standards” were needed to facilitate both the exchange
or IT information and support “smart” distributed work flows.
MARCH 1987, HOSPITAL OF THE
UNIVERSITY OF PENNSYLVANIA (HUP)
• Sam had discovered (through experience--the hard way) that:
• The cost and complexity of what he is trying to do is getting more expensive day-by-day and …
• The projected cost of building and maintaining electronic data interfaces is projected to cost
significantly more than anyone had expected.