[cmiles74]

My experience has been closer to that of mcphilip, every time we bring in a new system we end up with consultants from both sides (the new product and the hospital information system) and the cost is quite high. Where I work, exchanging HL7 messages directly with another organization has never been on the table and we have done a couple interop projects with other area hospitals.

That said, in my opinion the two organizations looking to exchange messages would need to have a pretty good relationship and a real business need in order to pursue this strategy. They may also have to compromise on dictionary values, etc., in order to have comprehensible data on both sides. For organizations with even a modest amount of rivalry, I can't see them spending this kind of time, effort and money.

My understanding was that "meaningful use" would make interop much easier, perhaps on a higher level than HL7 messages. In my experience this has not been the case.