The History of HL7 New Zealand

Part 1: Early Days…

The following account is adapted from material kindly supplied by HL7 International’s unofficial historian Rene Spronk as part of his research for a White Paper on the early history of health level 7

David Fallas (then IT manager for a large community laboratory in Auckland) and Roger Seaton (then CEO of Delphic Medical Systems) travelled to Uluru (Ayers Rock) in Australia to attend a health informatics conference. The purpose of their attendance at that conference was to specifically investigate the possibilities offered by HL7 v2 messaging which had been mentioned in at least one journal or magazine article they had read sometime in 1992-1993. 

Electronic transfer of pathology results in New Zealand was in its infancy at the time, and as the community laboratory for which David Fallas worked was the biggest in the country, it had the resources to pioneer partnerships with others who had the same vision. In fact it was with Dr David Hay (then CEO of the medical software company, GPDat, now Chair Emeritus HL7NZ) that a joint pilot to transfer pathology results using a proprietary protocol was started in late 1992-93. 

At Uluru, David Fallas and Roger met Octo Barnett, and they also chatted with Ed Hammond (now Chair Emeritus HL7 International). After returning from Uluru, a group of interested parties which included Telecom NZ, Delphic Medical Systems, and Diagnostic Laboratory was convened. The purpose of the group was to develop an implementation guide for HL7 v2.1. Other interested parties joined, including Clearfield Consulting who were already working towards implementing a national identification system which became known as the NHI (National Health Identifier), and which was to be promulgated nation-wide using HL7 v2.1 messaging. 

The New Zealand affiliate was created by Lindsay Stewart (Ministry of Health and NZ country HL7 representative) at the request of these parties. Lindsey, Ian McCrae (current CEO Orion Healthcare) and Tom Bowden (founding CEO HealthLink) also became involved in developing an HL7 v2.1 implementation guide. With the signing of the Affiliate Agreement with HL7 International, New Zealand became an “affiliate” of HL7 international on March 15, 1996 – before the actual formation of the HL7 New Zealand organisation – the third country, following Canada and Germany, to do so.

In 2001 a group of HL7 enthusiasts including Stephen Chu, David Fallas, Chris Hobson, Sam Chan and Martin Entwistle gathered together to form the NZ HL7 User Group (NZHUG). NZHUG then established a Board and formed its own administration ably assisted, from 2004 onwards, by current Board Secretary, Linda McKay who was performing a similar role at HiNZ. 

In 2002-03, to satisfy new requirements for affiliates to be independent from government organisations, New Zealand’s HL7 Affiliation was transferred to NZHUG who then successfully lobbied the NZ Ministry of Health to provide funding to support its activities. This funding allowed NZ to send one delegate to attend each HL7 International Working Group meeting overseas and bring international experts to NZ to present at local events. Under the Chairmanship of Martin Entwistle, NZHUG also played an active role in the advancement of HL7 standards in New Zealand and the development of new HL7 International Standards.

Part 2: HL7 New Zealand

To align with the naming format of other Affiliates, and provide greater clarity of purpose to the NZ Sector, NZHUG was renamed HL7 New Zealand (HL7NZ) in November 2009. On taking over as Chair in late 2008, David Hay advanced the work commenced by NZHUG, initially focusing on the HL7 CDA document standard which he successfully promoted to the HISO Committee as a core component of its national Reference Architecture for Information Exchange. As a consequence, CDA was implemented in national projects, notably GP2GP patient record transfers and the NZ ePrescription Service, with the notable help of HL7NZ Treasurer, Peter Sergent (now Vice-Chair).

David was also at the forefront of the development of the HL7® FHIR® standard, participating in the very first FHIR Connectathon held at Baltimore in September 2012 and becoming an early evangelist for the new standard. He continues to serve as a member of the FHIR Management Group and is an internationally renowned FHIR ‘toolsmith’, via his popular ClinFHIR tool, and blogger.

Late in 2016, David handed over the reins to Vice-Chair, and experienced HL7 implementer, Peter Jordan and was granted the title of Chair Emeritus by the HL7NZ Board in recognition of his major contributions as Affiliate Chair. Subsequently, HL7NZ continued to be highly active in the development and implementation of FHIR while placing an increasing emphasis on organisational membership and active engagement with the local community via social media and MoUs with HiNZ and NZHIT. 

The Affiliate also continued to support all HL7 standards used in New Zealand, host local standards-related events and (prior to the COVID-19 Pandemic) send a representative to each HL7 International Working Group Meeting. Global recognition came in the form of HL7 International Fellowships awarded to former chairs David Hay (2018) and Martin Entwistle (2019).  Current Chair, Peter Jordan became an International Council Co-Chair in January 2019 and later that year became the first New Zealander to be elected – as an Affiliate Director – to the HL7 International Board.

Part 3: Recent Developments

The year 2020 saw several significant developments. A substantial growth in income from organisational membership, together with the lack of a need to support overseas travel, led to a Board Decision not to renew the Affiliate’s Funding Agreement with the Ministry of Health. This was replaced by a MoU with HISO recognising the respective roles of both organisations and the ways in which we can work together to use standards for the good of interoperability in the New Zealand health and disability system, and to play our part in the international standards community.

In August 2020, a FHIR Implementation Work Group was formed to produce an Implementation Guide that will contain the base FHIR implementation rules for New Zealand. This Work Group meets fortnightly with active participation from members representing various sections of the implementer community.

At the AGM in November 2020, three long-standing Board Members – David Fallas, David Hay and Martin Entwistle – stepped down to provide opportunities for newer members of the expanding local community. Hopefully, this history provides a lasting recognition of their key contributions to HL7NZ!

Peter Jordan, Chair HL7 New Zealand, April 2021