Quote Of The Year

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

Monday, July 16, 2007

The NEHTA Deliverable Silliness Continues.

All of a sudden the NEHTA RSS feed lit up on Friday to let us all know we have some more NEHTA documents to consider.

What was on offer really left me somewhat amazed.

First NEHTA seems to have concluded that Australian Health Software developers need a hand to get their heads around how to code web services based applications. To assist they have thoughtfully provided code on how to implement Web services that conforms with their guidelines using a series of toolkits based on Microsoft and Java technology.

Having however undertaken the task they then cover themselves with the odd disclaimer.

First they say:

“This document is provided for educational purposes only. The method it describes is only one approach; there might be other, equally valid approaches."

Then they point out:

“The code samples in this document are designed for simplicity and ease of understanding, rather than robustness and reuse. They are not written for use in a production system."

A few things strike me about all this.

1. If NEHTA was serious about helping why did they not provide a downloadable working instance of each of these approaches with the source in machine readable form – for testing, review and discussion. Having no reference implementation and being given the code in .pdf form is hardly a real help.

2. On the second page we have the following:

Copyright © 2007, NEHTA.

This document contains information which is protected by copyright. All Rights Reserved. No part of this work may be reproduced or used in any form or by any means—graphic, electronic, or mechanical, including photocopying, recording, taping, or information storage and retrieval systems—without the permission of NEHTA. All copies of this document must include the copyright and other information contained on this page.

So, it seems use of the code is not actually encouraged. Clearly the code should have been released with an appropriate open-source license attached so the clinical community could use, evolve and feed-back suggestions etc.

3. Just what is actually going on with NEHTA feeling the need to provide programming examples? I leave it to others to suggest what is happening here but can’t help wondering if there is not something like a “search for relevance” aspect to all this. I can really think or a whole lot of different ways for NEHTA to be helpful than this.

4. While I have nothing against MS or Sun I wonder why other Web-Services Toolkits are not apparently being encouraged – particularly open-source ones such as the Open Health Framework from the Eclipse Foundation.

Second we have another Clinical Data Specification Document. This one covers the data specification for Diagnostic Imaging and runs to some 228 pages.

The document is entitled Diagnostic Imaging Data Specifications Version 1.0 – July 2007.

What is interesting is that the commencement of the development of this document actually preceded NEHTA’s establishment – having begun in 2004 (i.e. it is a part of the HealthConnect Clinical Information Project which seems to have just continued on regardless). What is it we have been waiting for for about the last three years.

I quote:

“The Diagnostic Imaging (DI) data group specification forms part of a suite of data specifications that NEHTA is developing for the Australian Health Informatics Community. The suite comprises specifications for a range of health topics (represented as “data groups”), which are generally agreed to be of high priority to standardise in order to achieve the benefits brought about by semantic interoperability in the Australian health care setting.”

It is also important to recognise what this document is not: I quote again:

“While this specification defines the data groups and data elements required to support diagnostic imaging requests and reporting, it is important to note that this specification does not cover the following:

• Implementation guide describing how the data groups are intended to be implemented in electronic applications/systems such as Clinical Information/ Electronic Health care Record Systems (CIS/EHRS), Radiology Information Systems (RIS) or Picture Archive and Communication System (PACS).

• Terminologies for diagnostic imaging procedures and reporting, their development and binding to the diagnostic imaging data elements.

• Structured document specifications for diagnostic imaging requests and reporting

• Electronic interchange format specifications for diagnostic imaging requests and


These specifications may become targets of future NEHTA work programs. The timelines for the further development of diagnostic imaging specifications and relevant extensions to SNOMED CT will be guided by the priorities identified by the NEHTA Board, and the international priorities of the International Health Terminology Standards Development Organization.”

What this is saying is, as I read it, is the following. We started on this project in another era, there is still a lot more work to do, the terminologies required for this to be useful are not developed (and won’t be for a while if ever) but we thought it would be good idea to release it. Oh, and also there is no commitment on NEHTA’s part to do any more on this – i.e. it is probably an orphan and you should use at your own risk (if you choose to ignore it is Copyright © 2007, NEHTA.)

This is made pretty clear in the following from the associated release note:

“Ongoing Development

Because the development of a terminology and data specifications is an iterative process, these specifications will evolve to accommodate changes in healthcare practices and feedback from users that share Diagnostic Imaging information between systems.

The timing of the further development of diagnostic imaging specifications and extensions to SNOMED CT will be guided by the priorities identified by NEHTA’s benefits realisation study and health departments, as well as the directions taken by the International Health Terminology Standards Development Organization.

NEHTA’s current terminology priority is the development of appropriate quality assurance processes, including the use of metrics and automated tools to build, manage and audit data. Such tools will support collaborative terminology development.”

Who in their right mind would take any notice of this specification with that level of commitment from NEHTA. No one with half a brain I would suggest. This is just another piece of useless orphan and probably terminal shelfware!

Third we have a range of documents covering web-services based e-procurement. Now I am not an expert in this area but I was fascinated by the scope of what was made available:

“Of the set of document types identified in the Australian Standard for Health Supply Chain Messaging [HSCM2004], the following subset has been identified as important to the jurisdictions: Purchase Order, Purchase Order Response, Purchase Order Change, Despatch Advice and Invoice.”

What seems to be missing is – to quote again:

“All catalogue, order fulfilment logistics and payment related parts of these processes have been deemed out of scope for the first version of the NEHTA e-procurement architecture.”

So while suppliers are being asked to provide data for the National Product Catalogue (NPC), it is not to be used by the jurisdictions for now and delivery tracking and payment will remain manual as well – so we (the jurisdictions) don’t have to pay our bills too quickly – I assume!

Since I am told many jurisdictions will not be ready to use the NPC until 2009 this may not be a problem, except for the ongoing waste involved in not implementing e-procurement fully.

On behalf of my better half I do have to say, however, I was pleased to note a report she wrote with a good mate years ago, which showed the scale of possible e-procurement savings, was referenced. Pity it has taken seven years for some apparent action.

“[MORE2000] More, E. and McGrath, G.M., Health and Industry. Collaboration: The PeCC Story, Canberra, NOIE, AGP. DOCITA 8/00, May, 2000”

The first time I have managed to drag my wife into the blog !

As a side comment NEHTA also provides Version 1.0 release of the WSDL and XSD files for the E-Procurement Technical Architecture. The Technical Architecture can be downloaded from http://www.nehta.gov.au/.

The disclaimer which comes with it would put a Microsoft or IBM to shame!


The NEHTA E-Procurement WSDL interfaces and associated XML Schema Files ("the WSDL") are delivered in good faith, free of any charge, and "as is" and without any express or implied warranties. In particular, to the fullest extent permitted by statute and law, NEHTA expressly excludes any express or implied warranties that the WSDL:

* is complete, correct, or error or defect free;

* is of any particular quality or is of merchantable quality;

* is fit or suitable for any particular purpose;

* does not infringe the Intellectual Property Rights of any other person.

Subject to this provision any warranty which would otherwise be implied is hereby excluded. Notwithstanding this limitation where legislation implies any condition or warranty and that legislation avoids or prohibits provisions in a contract excluding or modifying the application of or exercise of or liability under such condition or warranty, the condition or warranty shall be deemed to be included. However, the liability of NEHTA for any breach of such condition or warranty shall be limited to the re-supply of the WSDL.

Without limiting the generality of the above, by using the WSDL, the user is deemed to have agreed with NEHTA:

* that user must assess the suitability of otherwise of the WSDL for the user's purposes; and

* that user assumes all risks and consequences associated with the use of the WSDL or any output or product resulting from the use of the WSDL and, to the fullest extent permitted by statute and law, the user releases NEHTA from any and all responsibility or liability for any risks or consequences of use of the WSDL or any output or product resulting from use of the WSDL and, to the extent not released or not capable of release by user, user indemnifies NEHTA against such risks or consequences.

Copyright © NEHTA 2007

The WSDL contains information which is protected by copyright. All Rights Reserved."

Has anyone else noticed just how obsessive NEHTA is with copyright? I wonder why? An experience DoHA had with the Pharmacy Guild maybe?


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