Trusting the other Party

One of the NHS trusts in the northern part of England had decided to build an entirely new hospital; and to equip the new hospital with all kinds of new diagnostic modalities and software applications. The hospital dated from the 1880s and most of the IT solutions from the early 1980s; the new investments made available by Tony Blair's government were clearly well spent here. Before the start of the project the various vendors involved met to discuss the overall integration strategy.
The hospital in question hadn't created an overall integration strategy; it was left up to the various application vendors to maximize the reuse of data by exchanging as much data as possible. Most application vendors are keen to send data to other systems and considerably less so to receive data. They can't guarantee the integrity of the data that has been received; the data may corrupt whatever data was entered into their own application. Mostly there's a balancing act going on between the need for certain information on one hand, and the risks in accepting data sent by other systems on the other hand.
Standing at the whiteboard I drew a series of rectangles representing the various applications. Each vendor made a brief introduction of the application and its integration requirements. During the series of introductions I added arrows indicating the various flows of data as supported by the applications. Slowly a very strange picture emerged: they all wanted to receive data, but none of them were able to send data.
They were willing to trust the data as sent by other systems, but weren't willing to accept responsibility for having to send reliable data to others. Obviously this problem isn't a technical one at all. The NHS trust should have properly analysed their business processes to make sure that the set of newly acquired applications would cover those processes. The fact that none of the vendors was even willing to be a provider of basic patient demographics information shows that such an analysis had not taken place.

It just goes to show that having a listening and a speaking party isn't enough to achieve true communication or integration. Each party has to take responsibility to transmit reliable information, and to trust the other party to send reliable information as well. Just like in politics this is unlikely to happen in the field of systems integration. Trust me.

-Rene

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Index of columns:

• Reflections on the HL7 membership model - the affiliate life cycle (Dec 28, 2011)
• Thinking like an OWL reasoner (Sep 17, 2011)
• RFH (Resources for Health): HL7 version 3 taken to the next step (Aug 18, 2011)
• What's so great about the HL7 organization? (Aug 04, 2011)
• Kerndossier: een Nederlandse versie van CCD (Dutch, May 03, 2011)
• A HL7 RIMBAA update (Apr 21, 2011)
• Timezone Hotel (Mar 29, 2011)
• HL7 and openEHR are cooperating (finally) (Jan 21, 2011)
• Increasing demand for IHE training courses (Dec 18, 2010)
• Context issues with the IHE QED profile (Dec 15, 2010)
• The changing role of HL7 country organizations (Jul 16, 2010)
• Implementing HL7 version 3 - the book (May 06, 2010)
• Adding openness to a closed world (Feb 09, 2010)
• How to lower the hurdle for HL7 v3 implementers (Jan 21, 2010)
• HL7 v3 deployment statistics (Dec 17, 2009)
• There's Trouble in Paradigm (Sep 25, 2009)
• Internationalization of HL7 (Sep 24, 2009)
• HL7 UK signs deal with Ringholm to deliver HL7 v2/v3 training courses in London (Sep 17, 2009)
• The use of HL7 in South Africa (Aug 20, 2009)
• The Next Web Conference in Amsterdam (Apr 17, 2009)
• The HL7 UK AGM and RIMBAA (Apr 16, 2009)
• The HL7 Wiki reaches 2000 pages (Mar 02, 2009)
• The HL7 roadmap for CDA R3 and the CCD (Jan 17, 2009)
• HL7 Affiliates Meeting in Orlando (Jan 11, 2009)
• Swiss and Dutch HL7 News (Dec 31, 2008)
• Devices and Prizes (Nov 22, 2008)
• HL7 in Norway: a situation report (Sep 02, 2008)
• Russian whitepaper (Jul 09, 2008)
• The HL7 Interoperability Conference - IHIC 2008 (May 30, 2008)
• HL7 creates a RIM Based Application Architecture (RIMBAA) group (May 18, 2008)
• Notes from the HL7 WGM in Phoenix (May 08, 2008)
• Germany embraces CDA eReferral document specification (May 02, 2008)
• HL7 v3 RIM based applications: an unintended side effect (Jan 19, 2008)
• Collaborative Tools (Jun 21, 2007)
• HL7 ist Pflicht in der deutschen Telematikinfrastruktur (German, Mar 16, 2007)
• HL7 based Tree inventory system (Jan 30, 2007)
• The link between HL7 and Open Source Software (Jan 06, 2007)
• Workflow Bribery (Sep 15, 2006)
• Timezones in HL7 (Jan 23, 2004)
• Controlled vocabularies: "@*%!!!" ? (Sep 01, 2003)
• Trusting the other Party (Nov 01, 2002)

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