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Comment by chimeracoder | Hacker News Reader

> Apple is using a leading healthcare standards organization (HL7)'s clinical data specification

I'm very hesitant to use either the words "leading" or "standard" with respect to HL7. HL7 is an incredibly backwards and antiquated model. It's a disaster to try and work with or implement in any way.

And, to make matters worse, it's not even really a standard - at least not in the way web developers would use the word. You have a separate HL7/ADT feed for every combination of (hospital, vendor) because no two work exactly the same way.

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To be clear, HL7 is a not-for-profit organization which has created several sets of standards over its history (HL7-V1, V2, V3, etc)--those standards are probably what you are referring to. HL7, as an organization, is very much a leader in this space.

FHIR, which is what Apple is using, is its own standard, (created/managed through the HL7 organization), and addresses most of your concerns (https://www.hl7.org/fhir/)

> To be clear, HL7 is a not-for-profit organization which has created several sets of standards over its history (HL7-V1, V2, V3, etc)--those standards are probably what you are referring to. HL7, as an organization, is very much a leader in this space.

I'm being sarcastic when I say HL7 isn't a leader. Obviously their psuedo-standards are widespread; they're just terrible.

I haven't dug much into FHIR because, when I last needed to implement any of this, literally nobody was actually using it. That said, based on everything else I've seen, I'm skeptical that it's actually a proper standard in the strict sense. Even the other message types that HL7 has produced are not properly specified, with ambiguous language that allows for multiple interpretations and "valid" (but incompatible) implementations.

It can't be 'properly specified' as that'd mean that there is a single interpretation of medical concepts across all users/customers. This has never been true and probably won't ever be.

You're thinking of the older HL7 message types. FHIR is a newer xml/json standard that's much more programmer friendly.

There is lots of money in making HL7 systems talk to each other though. Getting dialects to actually communicate is quite easy to charge a lot for. However finding someone who will do it is considerably harder.

Yes. HL7 is sort of thing you can dip into a bit, and think, "Wow... whole rooms of contractors are racking up big bills dealing with this." For me, HL7 is the analog to chemistry's wonderful "Things I Won't Work With" blog.

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