The HL7 reference information model under scrutiny

The Health Level 7 (HL7) Reference Information Model (RIM) was once incepted as an object oriented information model to harmonize the definition of HL7 messages across different application domains. On the heels of the hugely successful HL7 version 2, version 3 and the RIM has received significant attention and credit and in turn is increasingly subjected to criticism. In this paper the authors, who are among the chief designers of the RIM, respond to the major points that have been raised against the RIM in the published literature. We find that much of the criticism is based on misunderstandings and differences in point of view. We wish to advance the dialogue in the hope that when we account for those differences, effective critique may lead to real improvements of the standard.