I would disagree that the HL7 organization is looking to make these standards less convoluted. On the contrary, the large and established vendors help write these standards. In my opinion, it is in their interest to leave enough room in the standards to require ever more and more software in order to bridge the gap between systems.

I have worked on several integration projects, we always had to customize the interface on both sides of the system (the hospital information system on one side, perhaps a radiology system on the other). Moving one step up and exchanging data between hospital information systems and all of the smaller vendor systems is just that much more complex.

HL7 standards are developed on a consensus basis by providers, payers, vendors, governments, and academics. The established vendors certainly help, but I deal with their HL7 representatives on a daily basis and I can clearly see that they're working in good faith. The main reason there is flexibility (and convolutions) in the standards is that healthcare is highly complex. Integration projects are thus labor intensive; software is usually a relatively minor slice of the total cost.

If you have a specific suggestion for simplifying or otherwise improving any HL7 standard then please submit a formal change request. The process is very open and accessible. I've done it many times myself.

Did you use something like Mirth Connect? I was going to ask what HL7 you were using, but it looks like you were using v2.

> In my opinion, it is in their interest to leave enough room in the standards to require ever more and more software in order to bridge the gap between systems.

I get your point. When I read about FHIR extensions, my immediate assumption was that a vendor would use it to throw a wrench. But FHIR does have an idea of conformance that I think better addresses the issues with earlier standards.

Yes, the "interface engine" I worked with was Quovodx Cloverleaf. :-)