CIMI at the Crossroads
- The membership of CIMI included all the significant players in the space, not only some of them
- The charter always included CIMI providing the capability to express the clinical models in a series of different formalisms (i.e. XML, Java, HL7 v2, EN13606, CDA, openEHR etc) by the provision of some “compiler”
- UML/OCL and associated OMG standards
- 13606-2/ADL 1.4
- ADL 1.5 (http://www.openEHR.org)
- Semantic Web technology (OWL, RDF, Protégé, and associated tools and standards)
- HL7 v3 approach (MIF, HL7 RIM, static models and associated artifacts and tools)
Saturday, December 02, 2006
There is no doubt that this is a multi-factorial issue that involves human, technical and financial aspects. If we consider the current situation there are some clear facts.
1. It is possible to build, deploy and have used computer systems that can assist with the operations, efficiency, safety and quality of hospitals. Suitable systems both from here and overseas are available to suit most of the patient management, clinical and administrative operations of both small, medium and large hospitals. The same can also be said systems to operate diagnostic laboratory and imaging services.
2. The same is true in the provision of support for General Practice and Specialist Office Practice with the market beginning to mature and evidence of significant contestability of system selection emerging. (Medical Director’s market share is no longer more than 2/3 of the market with IBA, Genie and Best Practice making some headway). Recent changes in the Commonwealth Practice Incentive Program is also ensuring more of the available functionality is actually being used.
3. Messaging of pathology and radiology results is being widely deployed via a number of providers (Argus, Medical Objects, HealthLink, Promedicus etc). Referrals to specialists are also gradually beginning to happen electronically – albeit as yet in pretty un-standardised form by and large. At present there is a great deal of prescription printing but very little, if any, in the way of prescription transmission electronically.
4. There has been considerable investment on development of a range of Standards which have facilitated the communication of pathology results at the individual test level using HL7 V2 which has made these results more usable. At present, however, a majority of results are still transmitted using the PIT format.
Sunday, January 21, 2007
The draft document is on its way through the various ISO and CEN processes towards being approved as one of the five parts of the TC 215 Standard on Electronic Record Communication. (pr13606).
Overall the Standard – if approved - aims to define how extracts of patient records can be safely and reliably moved between two EHR systems which are compliant with the Standard once approved.
Key to the success of the approach being adopted is the use of an information construct called an Archetype which defines how clinical content within the record is to be laid out and interpreted.
Sunday, January 28, 2007
Before reading further I suggest those interested visit the openEHR site and review the “aus health it” thread, starting at the 21 January, 2007 entry. It can be found at:
Initially, for some reason my e-mail is deferred and then rejected at the site (since I am not a registered member) so following some of the conversation can be a little difficult.