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Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Thursday, January 18, 2007

NEHTA and Secure Messaging – Comments Round Two.

Late last Thursday (11 Jan, 2007) Andrew Shrosbree who is the Technical Architect of ArgusConnect Pty Ltd (http://www.argusconnect.com.au) chose to comment on a request from Tom Bowden (Our First Guest Blogger) in the GP_TALK e-mail list for comments on the technical usability and quality of NEHTA’s document “Technical Architecture for Implementing Services Concepts and Patterns Version 1.0 – 21 December 2006 For Comment.”

Given ArgusConnect’s emerging role in the e-Health Secure Messaging environment in Australia, and the fact that ArgusConnect is being used by a number of GPs and Specialists all over the country, I asked Andrew if I could reproduce the essence of his comments in this blog for the interest of my readers who may not see the e-mail list. He agreed.

The following is the message Andrew submitted:

“Dear Tom

I want to second your request for an assessment by people in our industry of NEHTA's latest specification for secure messaging.

Having reviewed “Technical Architecture for Implementing Services Concepts... "I concur with David More's assessment. The most appropriate phrase from David's blog is "obvious and self evident". To paraphrase my last comments on this list regarding NEHTA's progress, WHERE'S the MEAT?

NEHTA's efforts are not much good to us until they start addressing genuine implementation issues. At the NEHTA conference we were promised code examples and prototypes for the Web Service interfaces, yet instead all we get is more verbiage telling us what we already know. I don't need another lecture about why we should be using this technology, or what a service is. What I'd like to see is some working pieces of code. I don't deny the need for rigour and clear definition of concepts, but when are they going to move along?

My favourite piece of verbiage in the specification is "Information can be modelled and represented in many different ways. This technical pattern recommends that information can be represented using the XML infoset and encoded using the syntax of XML. It also recommends the use of XML Schema to describe those XML documents"

Really? Such language reminds me of Jimmy Carter explaining sagely that "Inflation is caused by many strange and complicated things interacting in strange and complex ways". Um, thanks Jimmy. Anyone else? Anyone?

One concern I do have concerning the content of the specification is the frequent reference to how "the GP Program" will directly access IHI and HPI services. This fails to acknowledge how messaging is actually performed - by third party communication providers, not by the clinical software vendors. If NEHTA is assuming that vendors can be relied on to implement all this stuff then somebody is living in a different universe.

Message providers have been using Web Services for quite a while now (haven't we?) and we may as well continue as usual: forging ahead while we wait for NEHTA to come up with something tangible for us to use as a benchmark against what we have out there, already working in the field.

Finally, I don't quite agree that the specification forms a "roadblock" or in any way impedes progress. Irrelevancy is, well, irrelevant. Nothing it proposes is controversial, wrong, or particularly onerous. Perhaps the development team at NEHTA is run by somebody who worked previously at Foxtel. We are being fed reruns instead of anything new.

I'd like something more for my subscription fee.


It seems from this and the earlier comments from Tom Bowden that there is a soundly based belief that NEHTA is failing to provide the leadership, guidance and impetus for which it was created and for which it has had a reasonable period of time to 'get its act together'.

While it is personally gratifying to have one's judgement of the value of this aspect of NEHTA's work validated by its most obvious customers and stakeholders it is quite unacceptable that, after issuing documents covering the NEHTA desired Technical Architecture of Secure Messaging on 02 Feb, 2006, the industry and the potential users of such services have to wait for a release document which contains little improvement of value.

That NEHTA can work for almost a calendar year and make such little progress does not bode at all well for the other projects for which we have yet to see some deliverables.

The opportunity costs of NEHTA's failure to make any substantial progress is very large and the Australian public deserve a great deal better.

It would not surprise me if NEHTA’s lack of progress actually emerged as an issue in the upcoming Federal Elections.


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