Australian Framework for e-Health Standards Development

Yesterday NEHTA issued a new document on e-Health Standards Development.

The intent of the document is to explain how NEHTA is going to operate in the Standards space and what its relationship will be to Standards Australia.

I suspect this document will cause some consternation among a range of stakeholders as the general tone of the document is that when we work out what the Standards are to be and then compliance will be obtained via control of government procurement and funding in the e-Health space. Given the dominance of the various government entities in e-Health via the States and funding provided to GPs this approach could impose all sorts of unexpected compliance costs on what is at best still a nascent industry. For any standardization effort to succeed it must benefit all stakeholders in balanced ways and not favour one stakeholder group over another

It must be hoped the proposed E-Health Standards Forum is actually as its name implies - a Forum for the exchange of ideas - and not a convocation where pre-determined outcomes are announced.

It is good to see the document recognises the progressive withdrawal of Government funding to e-health standards activities and it is to be hoped this recognition will be followed by positive funding action. Ongoing "monitoring and assessment" of available resources does not suggest a strong commitment to major change!

It must be said the order and depth in which current Standards Development Organisations are reviewed is telling. The virtual dismissal of DICOM, the IHE inter-operation approaches and the ASTM Clinical Care Initiative are of note. Its also likely openEHR proponents will be disappointed with the lack of even a single mention directly - given their activity in the EHR space at the very least.

The action plan is also of some interest in that all of these issues ought, in my view, have been sorted out ages ago. The relationship between NEHTA and SA has been disconcertingly vague for at least a year. It seems likely to be resolved, at the earliest, later this year. The other plans are relatively low impact if they are the whole 2006 agenda and a great deal more than this could be desired.

One is also left wondering just what are the full scope of the e-health standards to be addressed. This document should have contained a detailed listing as an Appendix at least - given such work is readily adaptable from the work done by Infoway in Canada and the US CHI Initiative.

Lastly - the value and utility of the document is greatly diminished by not being placed in the context of a published National e-Health Strategy and Plan. Without this overaching document it is hard to know what value is being delivered by the present document other than a collection of relatively warm motherhood statements and a very underwhelming and underpowered action plan.

David