RIM-Recasted, Value-Added Efficiency Interpolation in the HL7 Development Paradigm

Abstract

The Medical fraternity and the healthcare service sector have long acknowledged the need for smart, IT-based healthcare systems, operating globally. Semantic Interoperability is key, which is the regulated and meaningful exchange of valued healthcare information with homogenous understanding amongst participating healthcare service providers. Health Level Seven (HL7) is the predominant interoperability-related global healthcare standard in operation today. Introduced in 1987, the standard has evolved to its current version 3 and has been embraced by the National Health Services of the most developed economies in Europe, North and South America, and Australasia. However, the standard is not without issues. Version v3 has been found to be difficult to implement and maintain. A principle component of the HL7 v3 development paradigm is the Reference Information Model (RIM) which defines the complete language and vocabulary schema used in the three v3 paradigms of Messages, Clinical Document Architecture, and Services, and indeed in all v3 implementations. This study determined that the RIM itself has many documented issues which ultimately affect implementation. Thus, true global semantic interoperability which is the germinal goal of the HL7 standard is still an illusion. This study focuses on the belief that the achievement of true global interoperability is rooted at the labyrinths of specifications development and its associated foundational paradigms. This study focused on the Reference Information Model (RIM), the foundational semantic and lexical reference structure which affords vocabulary derivation to be used in all v3 system implementations. Infusing sequencing and temporal dimensions to the RIM structure and operation would promote and afford enhanced analytic, design, semantic interoperability, and two-way traceability, which in turn would suffuse to high-calibre specifications generation and true global International Interoperability in operation. In addition, multi-faceted interoperability interpolation in these core processes would promote and enhance numerous allied activities as well, from domain requirements cross-checking, audit, and consensus, to kindred system development verification and validation. This research therefore analyzed many of the prevalent RIM issues indepth, and effected smart, delicate, and prudent recasting of this encyclopedic vocabulary and language reference structure, to derive optimal efficiencies in specifications development and implementation.