NeCST Sets the Standard for the Electronic Health Record in Canada

First to Complete HL7 Version 3

Montreal-February 20, 2004 – Today the Canadian Institute for Health Information (CIHI) and Canada Health Infoway (Infoway) are pleased to announce that the National e-Claims Standard (NeCST) is one of the first projects in the world to receive official recognition under the most recent and advanced version three of Health Level Seven (HL7 v3), the world�s most successful messaging standard. In addition to money already invested, Canada Health Infoway recently signed an agreement to further invest $1 million in the NeCST project.

In recent years, health services providers, institutions and hospitals have begun to automate aspects of their information management in an effort to reduce paper and streamline clinical and other services. More recently, there is increased interest in creating the ability to integrate all information that could be part of the electronic health record�a secure and private lifetime record of an individual�s key health history within the health care system.

NeCST HL7 v3 helps realize the vision of an interoperable electronic health record through the establishment of consistent national standards for vocabulary, billing and claims settlement. Canada Health Infoway is a significant investor in the project and will leverage the knowledge gained in the development and acceptance of this standard to the possible application of standards for other electronic health record solutions. CIHI provides project management and support services for the NeCST initiative.

The key benefits of developing national standards related to claims and other components of the electronic health record include:

  • reducing risks and driving down costs as they relate to initial design and development;
  • supporting re�use and replication of components; and
  • enabling systems integration and application interoperability with reduced costs and timelines.

First introduced in 1987, HL7 has become the benchmark for the electronic exchange of clinical and administrative data in North American health services. HL7 v3 was approved on January 8 by the American National Standards Institute. The NeCST HL7 standard provides messaging support for pharmacy, chiropractic physiotherapy, physicians, oral health, vision and preferred accommodation healthcare providers. The NeCST HL7 generic claims, pharmacy and preferred accommodation messages are the first messages that have passed the HL7 v3 membership ballot.

Working in conjunction with chiropractic and physiotherapy health care providers, BCE Emergis is the initial implementer of a sub-set of NeCST messages for chiropractic and physiotherapy claims for the Workplace Safety and Insurance Board of Ontario. This represents the first HL7 v3 implementation in Canada.

NeCST is based on HL7 v3 and was developed and agreed upon by a broad and varied group of stakeholders, including many provincial ministries of health, national provider associations and various private payers. NeCST stakeholders share in funding the project through both their continued participation at meetings and the generous donation of their human resource expertise.


NeCST has been created by a unique collaboration between the public and private sectors, as well as national provider associations. Pan-Canadian standards are being successfully developed with the support of diverse public and private stakeholders, and the result has been significant progress toward the electronic health record. NeCST is being designed to facilitate health care claims transactions to authorize, compile, submit, adjudicate and pay health care invoices submitted by any provider to any payer in Canada that has implemented NeCST.


Canada Health Infoway�s mission is to foster and accelerate the development and adoption of compatible electronic health information systems. Infoway�s approach is to invest strategically and work in partnership with stakeholders, including the private sector. The corporation acts as a catalyst, leveraging its financial resources through targeted investments and building on best practices. Infoway is an independent, not-for-profit corporation created in response to a commitment of Canada�s first ministers when they agreed in September 2000 �to work together to strengthen Canada-wide health infostructure to improve quality, access and timeliness of health care for Canadians.�


The Canadian Institute for Health Information (CIHI) is an independent, pan-Canadian, not-for-profit organization working to improve the health of Canadians and the health care system by providing quality health information. CIHI�s mandate, as established by Canada�s health ministers, is to coordinate the development and maintenance of a common approach to health information for Canada. To this end, CIHI is responsible for providing accurate and timely information that is needed to establish sound health policies, manage the Canadian health system effectively and create public awareness of factors affecting good heath.