This article reviews current standardization activities in North Ameri
ca and Europe that aim to allow electronic data interchange among heal
th care applications. It analyzes the requirements communication subsy
stems must meet to allow for such standard-based communication between
heterogeneous health care applications. To illustrate such a system t
he authors present the architecture of the HL7/EDIFACT Communication S
ubsystem (HECS) in this article. HECS provides communication agents th
at interface with existing applications, as well as translation and ro
uting functions based on a reliable underlying delivery mechanism.