ICT standards in the health sector: current situation and ... - empirica

ICT standards in the health sectorthat the defined RIM classes and attributes could be applied to every domain inhealthcare – which is what they are intended to do. Secondly, the RIM documentation isdescribed as being “disastrously unclear”, poorly integrated with HL7 v3.0 documentation,and inconsistent.Under these circumstances, it may be difficult for HL7 v3.0 to establish a large user base.Currently HL7 v3.0 is still in the early adoption phase. Without a large user base, thisstandard is rendered ineffective – for the same reason that telephones can not beeffective unless there are multiple users. HL7 already has a well established user basefor their 2.x messaging standards in many countries of the world. However, since HL7v3.0 is not compatible with v2.x, this user group must be re-established. Convergencewith Europe’s CEN/TC 251 standardisation work is under way, which may help HL7 inthis respect. 86 HL7’s involvement in the joint initiative with ISO and CEN may have theobjective to move faster to international adoption of HL7 standards. The outcome of thisconvergence work as well as the organisation’s ability to create a satisfactory RIM maydetermine the future importance of HL7. Convergence may also be of importance for theEuropean ICT for health industry. In the expert statements received for this report, therewas a reservation against a possible dominance of HL7 in the European market.2.3.6 Digital Imaging and Communications in Medicine (DICOM)Organisation and objectivesDigital Imaging and Communications in Medicine (DICOM), or the DICOM StandardsCommittee, was established in 1993 and has its headquarters in Rosslyn, US. TheDiagnostic Imaging and Therapy Systems Division of the US National ElectricalManufacturers Association 87 is responsible for the development, maintenance, andgovernance of the DICOM standard. Many countries have local DICOM subsidiaries ornational representatives. The objective of DICOM is to “ensure the interoperability ofsystems used to: produce, store, display, process, send, retrieve, query or print medicalimages and derived structured documents as well as to manage related workflow”. 88MembersThe DICOM Standards Committee currently includes 45 members. 89 Of those members,55% are categorised as vendors (e.g. Philips Medical Systems), 27% as users (e.g. theAmerican College of Radiology), and 18% as general interest groups (e.g. Canada HealthInfoway). The members are predominantly headquartered in the US. The DICOMStandards Committee selects the members of the DICOM Working Groups which areresponsible for the development and the maintenance of the DICOM standards.Membership to the DICOM Standards Committee requires an annual fee of 1,000 - 5,000US dollars depending on the type of membership. 908687888990See Geissbuhler (2005), p. IT54See http://medical.nema.org/dicom/geninfo/Strategy.pdf.See http://medical.nema.org/dicom/geninfo/Brochure.pdf.See http://medical.nema.org/members.pdf.See38