Mexico’s Path to Interoperability Standards

Q: How has Health Level Seven (HL7) evolved to respond to the changing times?

A: HL7 is the name of an interoperability standards protocol created roughly 40 years ago. Over time, it evolved into its current version, which takes into account the need for interoperability and quick communication between applications and web platforms. Fast Healthcare Interoperability Resources (FHIR) connects applications moving quickly in the network that need simple, transparent and efficient communication in a web platform. The FIHR protocol is an API that enables the connection between two or more applications in a simple way, using resources that establish what, how and in what language the apps communicate the information. There are several versions in use but the one trending now is FIHR.

Q: How successful has Mexico been in adapting these protocols? Are they mandatory for companies working with health data?

A: The last regulatory reference regarding interoperability and information exchange is NOM-024 issued in 2012. This means that Mexico is almost 10 years behind in regulation. NOM-024 is not fully compulsory as it does not establish the enforcement of interoperability standards. However, the norm mentions the use of standards such as HL7 and names a few others. While it is not fully compulsory, if companies want to comply with the rules, they must use these standards.

Theoretically, companies would need to certify under NOM-024 to use a health information system in Mexico but companies could still get the certification even without using HL7 or another standard protocol. The Department of Health Information (DGIS) from the Ministry of Health is in charge of these certifications. However, given the growing volume of new systems in the country following the acceleration of digitalization due to the pandemic, DGIS is over one year behind in answering certification applications.

Q: What triggered HL7’s arrival to Mexico?

A: HL7 began operating in August 2021, after the birth of the HealthTech México association in September 2020. This association brings together a large number of software developers, vendors and academic organizations that started working together to help Mexico have a clear mission, vision and regulations that allow a true interoperable digital health ecosystem that includes e-prescriptions, telemedicine, drug codes and electronic medical records. Within HealthTech, we offer continuous education in digital health for health institutions.

One of HealthTech’s commissions works on interoperability and helped bring the HL7 chapter to Mexico. Through HealthTech, we work with the support of many companies experienced in communication with the government and big hospital consortiums to achieve HL7’s sustainability.

Q: What is necessary to improve regulations regarding this technology?

A: An updated norm would support the sector. However, given the speed at which digitalization is moving in the health industry versus the speed of regulators, it is clear that there will never be enough norms. Regulations have to become very dynamic to keep up. For instance, a norm regarding HL7 FHIR could be issued today but a better option could be available shortly thereafter. Regulation has to update continuously as new technology emerges. Mexico needs a standardization mechanism to keep up to date with the large amount of innovation emerging and the fast speed at which medtech is moving forward.

Q: Who are HL7 México’s targets? What benefits do affiliated members have?

A: We aim to bring together all actors, including the private sector and public institutions. The latter need these standards to interoperate within their own organizations. For instance, medical records from the diverse group of public health institutions are not shared and some of their pharmacy apps are also unable to communicate. Our goal is to improve Mexicans’ health through digital tools that support the operations of public health institutions.

HL7 establishes general implementation guides according to the communication needs of every country but based on the highest international standards. Members affiliated with HL7 México will receive training at a lower cost than that offered on HL7 international while contributing to improve Mexico’s healthcare system.

Health Level Seven (HL7) is an ANSI-accredited nonprofit organization that empowers global health data interoperability. The association develops standards and enables their adoption and implementation.