Sunday, June 15, 2014

Australian E-Health Standards Setting Would Seem To Have Really Hit The Buffers. An Amazing Fiasco.

This summary of a major meeting held on June 3, 2014 - convened by Standards Australia - was made available a little while ago.
Standards Australia
Health Informatics Standards Development Forum
Meeting notes and outcomes
3 June 2014
On 3 June 2014 Standards Australia held a Forum in relation to health informatics standards development. The purpose of the Forum was to:
·         Discuss the future plan in relation to health informatics standards development;
·         To allow Standards Australia to report on the status of the current work program which will end on 30 June 2014;
·         To allow Standards Australia to advise of operational and administrative changes which will be implemented post 30 June 2014.
The format of the Forum allowed for questions of the group following each presentation and an open discussion prior to the Forum concluding.
Session 1 – Standards Australia Presentation
Standards Australia opened with a presentation on its last 18 months of engagement in the sector. Standards Australia led the forum through some of the challenges that it had faced on this work program, and reported that despite these challenges published a record number of documents during this period. Standards Australia also reported on work that was expected to be completed by 30 June 2014.
Standards Australia advised that there was no forward work program agreed beyond 30 June 2014 and that it would take the opportunity, to review its committee structure with a view to ensuring that the committee structure would appropriately allow Standards Australia to continue to fulfil its international obligations as a participating member of ISO Technical Committee TC/215 Health informatics.
Stakeholders may also submit health informatics project proposals during the project prioritisation rounds. The projects will be assessed on the basis that they will be Standards Australia resourced.
Session 2 – Australian Information Industry Association
The Australian Information Industry Association, the peak body for ICT in Australia, presented on the importance of health informatics to its members
across the hardware, software and services sectors. The AIIA shared the perspective of its Special Interest Group (SIG) as to the trends and drivers within the sector, and the opportunities and challenges which its members saw in the sector today and into the future.
The AIIA spoke of the importance of technical standards and the potential cost for government and industry where standards are not in place, but equally that technical standards are part of a broader issue which includes market issues, policy, regulatory matters as well as issues in relation to the maintenance and relevance of technical infrastructure.
Session 3 – Royal Australian College of General Practitioners
The RACGP presented on its perspective as to the standards development activities that have been undertaken in this area, and spoke as to some of the challenges that the RACGP have with respect to standards development.
The RACGP spoke of some concerns that it had on behalf of its members around governance, voting requirements, resourcing and documentation.
The RACGP shared its views on how a work program may be formed in the future and spoke of its commitment to remaining engaged and to addressing what the RACGP sees as fundamental concerns.
Session 4 – HL7 Australia
HL7 Australia gave a very interesting presentation on the need for technical standards, Australia’s current international engagement and adoption footprint.
HL7 Australia spoke of the need firstly for cooperation in the sector but also of a need for trusted leadership which involved real collaboration, greater international alignment and adoption, a focus on core objectives of risk, security and clinical safety in the standards environment.
Session 5 – Engineers Australia
Engineers Australia presented similar themes to the other presentations but with a real focus on collaboration and strong alignment with international developments in eHealth standardisation. The point was made that the existing IT-014 model has a key role, but as part of a much wider discussion.
The PCeHR Review identified ACeH as having a key role in the future of health informatics. Although, this role it is yet to be fully defined.
Engineers Australia spoke of a need for flexibility in the Standards Australia approach and a need for a proactive and customer focused approach, and a broad stakeholder engagement strategy including government and individual contributors.
The need for IT-014 to continue to serve actively as the ISO/TC215 mirror committee was supported.
Engineers Australia also spoke of the great challenge in achieving a balance between the various competing interests in Australia and internationally.
Session 6 – Open Discussion
The Forum concluded with an open discussion.
It was clear from this that there was a general consensus as to what needed to be done in relation to developing a plan, making sure that the plan was integrated and focused beyond standards development to a wider e-health plan and that efforts put into standards development needed to be coordinated and aligned.
General questions were raised as to how standards development would align with other matters such as the NEHTA work program, and what would happen to projects which had been in development by Standards Australia but will not reach publication by 30 June 2014.
Standards Australia concluded the Forum by noting that it looked forward to continuing discussions with industry, with government and with the individual long standing contributors to technical standards development in relation to how stakeholders can collectively continue to develop technical standards in a coordinated, strategic and informed way.
a) SA to prepare Summary Document
b) SA to circulate slide pack
c) SA to update e-Health website to include slide pack and summary
d) Discussions to continue amongst all stakeholders as to next steps in continuing this agenda
You can download this summary and the associated presentations from this link:
All the presentations are very much worth having a browse - to stay the least especially since the summaries produced above rather seem to underplay the scale of the issues!
What you will discover reading the presentations is that Government has stepped aside pretty much totally (i.e. stopped funding the forward work program.) and that organisations like the RACGP have already long ago stepped aside from the whole process.
This slide makes that totally clear.

RACGP key issues re IT-014

1.Governance: Restructuring of committees to reflect technical and policy decision making.
2.Documentation: Provision of clear summaries of detailed technical documents to enable a move from a purely technical discussion to one which provides meaningful strategic and operational input.
3.Voting: The voting process needs to be clarified and clear guidelines provided as to what constitutes a vote including non-participation (abstinence) and blanket endorsement.
4.Resourcing: Ensure that appropriate resourcing can be applied most efficiently as volunteer organisations.
These need to be resolved before the RACGP can fully re-engage
It is really amazing just how the Government and its agencies have destroyed the morale and interest of virtually all those who have volunteered to assist in the Standards setting process and how they have no apparent idea of what they will do next. Many of those who used to engage are basically so frustrated and 'pissed off' they will never come back. That is an incalculable loss to Australian e-Health.
This is Government, Jurisdictional and Agency mismanagement on a grand scale!

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