CHAPTER ONE
INTRODUCTION
- BACKGROUND OF THE STUDY
The HL7 (www.hl7.org) organisation is an SDO accredited by the American National Standards Institute (ANSI) with the purpose of developing and publishing healthcare-specific standards. It publishes messaging standards for healthcare interoperability that aim to enhance care delivery, knowledge transfer and optimise workflow. HL7 products include HL7 version 2.x (v2.x), HL7 version 3 (v3) messaging standard, Clinical Document Architecture (CDA), Clinical Context Object Workgroup (CCOW) and Arden Syntax.
HL7 Working Group is composed of volunteers who give their time on a personal basis or under sponsorship of their employers. Published standards and other products are freely available to everyone who registers and agrees to the terms of HL7's IP policy. Members have the added advantage of having access to all materials immediately upon publication while, in general, non-members must wait three months from the date of publication to access materials.
In addition, members have the right to use HL7 standards in their products and to create derivative works; non-members have the right to read the standards, but not use them in their products. Those wishing more information are referred to the IP Compliance policy on HL7's web site at hl7.org/legal/ippolicy.cfm. Membership in the HL7 Working Group has been, and continues to be, open to anyone wishing to volunteer and contribute to the development and refinement of any HL7 Working Group Standard and the work that supports those Standards.
The term “Level 7” refers to the highest implementation protocol level for a definition of a networking framework as presented in the Open System Interconnection (OSI) model of the International Standards Organization (ISO) and CCITT (French Acronym for the Consultive Committee for International Telephone and Telegraph). This is not to say that HL7 conforms to ISO-defined elements of the OSI’s seventh level. Also, HL7 does not specify a set of ISO-approved specifications to occupy layers 1 to 6 under HL7’s abstract message specifications. HL7 does, however, correspond to the conceptual definition of an application-to-application interface placed in the seventh layer of the OSI model.
In the OSI conceptual model, the functions of both communications software and hardware are separated into seven layers, or levels. The HL7 Standard is primarily focused on the issues that occur within the seventh, or application, level. These are the definitions of the data to be exchanged, the timing of the exchanges, and the communication of certain application-specific errors between the applications. However, of necessity (or at least in an attempt to be clear), protocols that refer to the lower layers of the OSI model are sometimes mentioned to help implementers understand the context of the Standard. They are also sometimes specified to assist implementers in establishing working HL7-based systems.
1.2 STATEMENT OF THE PROBLEM
Safe, reliable healthcare depends on access to, and the use of, information that is accurate, valid, reliable, timely, relevant, legible and complete. For example, when giving a patient a drug, a nurse needs to be sure that they are administering the appropriate dose of the correct drug to the right patient and that the patient is not allergic to it. Similarly, lack of up-to-date information can lead to the unnecessary duplication of tests; if critical diagnostic results are missing or overlooked, tests have be repeated unnecessarily and, at best, appropriate treatment is delayed or at worst not given. In addition, health information has a key role to play in healthcare planning decisions where to locate a new service, whether or not to introduce a new national screening programme and decisions on best value for money in health and social care provision.
1.3 AIM AND OBJECTIVES OF THE STUDY
The main aim of the research work is to examine the HL7 standard in Nigeria healthcare system. The specific objectives of the study are:
- to examine the health level seven (HL7) framework in the Nigeria healthcare system
- to determine the efficacy of HL7 standard in Nigeria healthcare system
- to investigate the factors affecting the HL7 standard in Nigeria healthcare system
- to recommend ways to improve the HL7 standard in Nigeria healthcare system
1.4 RESEARCH QUESTIONS
The study came up with research questions so as to ascertain the above stated objectives of the study. The following research questions guide the objectives of the study:
- What is the health level seven (HL7) framework in the Nigeria healthcare system?
- What is the efficacy of HL7 standard in Nigeria healthcare system?
- What are the factors affecting the HL7 standard in Nigeria healthcare system?
- What are the ways to improve the HL7 standard in Nigeria healthcare system?
1.5 STATEMENT OF THE HYPOTHESIS
H0: the implementation of HL7 standard in the Nigeria healthcare system is not effective
H1: the implementation of HL7 standard in the Nigeria healthcare system is effective
1.6 SIGNIFICANCE OF THE STUDY
The study on the HL7 standard in Nigeria healthcare system will be of immense benefits to the Nigeria healthcare sector (primary, secondary and tertiary). The study will explore the health level seven (HL7) and relate it with the performance of the Nigeria healthcare sector. The study will serve as a repository of information other researchers and students that desire to carry out similar research on the above topic. Finally the study will contribute to the body of the existing literature on the HL7 standard in Nigeria healthcare system.
1.7 SCOPE OF THE STUDY
The study will cover on the HL7 standard in Nigeria healthcare system with focus on public healthcare centers in Nigeria.
1.8 LIMITATION OF THE STUDY
Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.
1.9 DEFINITION OF TERMS
HL7: health level seven
Health care: healthcare is the maintenance or improvement of health via the prevention, diagnosis, treatment, recovery, or cure of disease, illness, injury, and other physical and mental impairments in people
Health care facility: A health facility is, in general, any location where healthcare is provided. Health facilities range from small clinics and doctor's offices to urgent care centers and large hospitals with elaborate emergency rooms and trauma centers
CHAPTER ONE
INTRODUCTION
- BACKGROUND OF THE STUDY
The HL7 (www.hl7.org) organisation is an SDO accredited by the American National Standards Institute (ANSI) with the purpose of developing and publishing healthcare-specific standards. It publishes messaging standards for healthcare interoperability that aim to enhance care delivery, knowledge transfer and optimise workflow. HL7 products include HL7 version 2.x (v2.x), HL7 version 3 (v3) messaging standard, Clinical Document Architecture (CDA), Clinical Context Object Workgroup (CCOW) and Arden Syntax.
HL7 Working Group is composed of volunteers who give their time on a personal basis or under sponsorship of their employers. Published standards and other products are freely available to everyone who registers and agrees to the terms of HL7's IP policy. Members have the added advantage of having access to all materials immediately upon publication while, in general, non-members must wait three months from the date of publication to access materials.
In addition, members have the right to use HL7 standards in their products and to create derivative works; non-members have the right to read the standards, but not use them in their products. Those wishing more information are referred to the IP Compliance policy on HL7's web site at hl7.org/legal/ippolicy.cfm. Membership in the HL7 Working Group has been, and continues to be, open to anyone wishing to volunteer and contribute to the development and refinement of any HL7 Working Group Standard and the work that supports those Standards.
The term “Level 7” refers to the highest implementation protocol level for a definition of a networking framework as presented in the Open System Interconnection (OSI) model of the International Standards Organization (ISO) and CCITT (French Acronym for the Consultive Committee for International Telephone and Telegraph). This is not to say that HL7 conforms to ISO-defined elements of the OSI’s seventh level. Also, HL7 does not specify a set of ISO-approved specifications to occupy layers 1 to 6 under HL7’s abstract message specifications. HL7 does, however, correspond to the conceptual definition of an application-to-application interface placed in the seventh layer of the OSI model.
In the OSI conceptual model, the functions of both communications software and hardware are separated into seven layers, or levels. The HL7 Standard is primarily focused on the issues that occur within the seventh, or application, level. These are the definitions of the data to be exchanged, the timing of the exchanges, and the communication of certain application-specific errors between the applications. However, of necessity (or at least in an attempt to be clear), protocols that refer to the lower layers of the OSI model are sometimes mentioned to help implementers understand the context of the Standard. They are also sometimes specified to assist implementers in establishing working HL7-based systems.
1.2 STATEMENT OF THE PROBLEM
Safe, reliable healthcare depends on access to, and the use of, information that is accurate, valid, reliable, timely, relevant, legible and complete. For example, when giving a patient a drug, a nurse needs to be sure that they are administering the appropriate dose of the correct drug to the right patient and that the patient is not allergic to it. Similarly, lack of up-to-date information can lead to the unnecessary duplication of tests; if critical diagnostic results are missing or overlooked, tests have be repeated unnecessarily and, at best, appropriate treatment is delayed or at worst not given. In addition, health information has a key role to play in healthcare planning decisions where to locate a new service, whether or not to introduce a new national screening programme and decisions on best value for money in health and social care provision.
1.3 AIM AND OBJECTIVES OF THE STUDY
The main aim of the research work is to examine the HL7 standard in Nigeria healthcare system. The specific objectives of the study are:
- to examine the health level seven (HL7) framework in the Nigeria healthcare system
- to determine the efficacy of HL7 standard in Nigeria healthcare system
- to investigate the factors affecting the HL7 standard in Nigeria healthcare system
- to recommend ways to improve the HL7 standard in Nigeria healthcare system
1.4 RESEARCH QUESTIONS
The study came up with research questions so as to ascertain the above stated objectives of the study. The following research questions guide the objectives of the study:
- What is the health level seven (HL7) framework in the Nigeria healthcare system?
- What is the efficacy of HL7 standard in Nigeria healthcare system?
- What are the factors affecting the HL7 standard in Nigeria healthcare system?
- What are the ways to improve the HL7 standard in Nigeria healthcare system?
1.5 STATEMENT OF THE HYPOTHESIS
H0: the implementation of HL7 standard in the Nigeria healthcare system is not effective
H1: the implementation of HL7 standard in the Nigeria healthcare system is effective
1.6 SIGNIFICANCE OF THE STUDY
The study on the HL7 standard in Nigeria healthcare system will be of immense benefits to the Nigeria healthcare sector (primary, secondary and tertiary). The study will explore the health level seven (HL7) and relate it with the performance of the Nigeria healthcare sector. The study will serve as a repository of information other researchers and students that desire to carry out similar research on the above topic. Finally the study will contribute to the body of the existing literature on the HL7 standard in Nigeria healthcare system.
1.7 SCOPE OF THE STUDY
The study will cover on the HL7 standard in Nigeria healthcare system with focus on public healthcare centers in Nigeria.
1.8 LIMITATION OF THE STUDY
Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.
1.9 DEFINITION OF TERMS
HL7: health level seven
Health care: healthcare is the maintenance or improvement of health via the prevention, diagnosis, treatment, recovery, or cure of disease, illness, injury, and other physical and mental impairments in people
Health care facility: A health facility is, in general, any location where healthcare is provided. Health facilities range from small clinics and doctor's offices to urgent care centers and large hospitals with elaborate emergency rooms and trauma centers
