The following appeared a few days ago on the NEHTA Web Site on the letterhead of The Australian E-Health Research Centre:
The file is found here:
Independent Evaluation of AMT Identifier Incident Review
Interim conclusions – 16 March 2009
A detailed investigation and audit of NEHTA’s AMT processes has now been completed. This has included a review of NEHTA’s response to the AMT Identifier Incident.
This review has confirmed that the necessary steps have been taken to ensure that the release process will provide a version of the AMT that can be used by developers during the implementation of NEHTA compliant systems. NEHTA development processes have been found to be robust and effective, and it is unlikely that significant issues will be found with current and upcoming AMT release content (e.g. AMT version 1.14).
AMT is not yet ready to be released as ready for use in live clinical systems by those developers of NEHTA compliant systems who deem their product ready for operational use.
To achieve this, it is recommended that NEHTA execute the following remedial actions:
1. Prepare and execute a quality plan that reflects the risks associated with the purposes to which AMT is currently fit to be used. The quality plan should target the development and QA of an AMT that is fit for a stated purpose, or set of purposes, that is well understood within NEHTA.
2. Provide specific guidance to developers of NEHTA compliant systems on the purposes to which AMT releases are fit for use.
At this stage, NEHTA has advised that it believes these remedial actions can be prepared and executed in April 2009.
The Independent Evaluation is proceeding to further consider additional recommendations for NEHTA’s AMT processes. Confirmation of these, and a review of the action taken on the remedial actions, will be completed in April 2009. It is planned that the Independent Evaluation of AMT will advise if AMT is ready to be released in live clinical systems in late April or early May 2009.
Professor Bruce Barraclough
Dr David Hansen
First it needs to be pointed out that the AMT is the Australian Medicines Terminology. I am sure you were not meant to know that so you would not be able to figure out what it all means.
Looking on the NEHTA site we find the following:
Australian Medicines Terminology
Update on the suspension of AMT releases pending a quality and safety review.
This review is underway and an Interim Report has been released. AMT releases have been found fit for use in current development however further work is required before AMT is deemed suitable for use in live clinical systems. The Independent Evaluation of AMT will advise if AMT is ready to be released in live clinical systems in late April or early May 2009. Please check this page for further updates or contact email@example.com. Please come back soon.
Please note that the Australian Medicines Terminology Release Versions 1.0, 1.4, 1.7 and 1.9 have been quarantined and are not available for download.
NEHTA has developed specifications that standardise the identification, naming, and describing of medicine information. UML Class diagrams complement the specifications and explain relevant information structures, concept names and data types in a concise, industry-standard format.
NEHTA's Australian Medicines Terminology (AMT) delivers standard identification of branded and generically equivalent medicines and their components, and standard naming conventions and terminology, to accurately describe medications. The terminology is for use by medication management computer systems, in both primary and secondary healthcare.
----- End Web Site Capture
So what we have here is NEHTA saying they have developed a clinical terminology subset that is not suited for clinical use, and have had to remove their work from circulation while they ask some independent experts to tell them what to do next!
The minimum that is needed here is an explanation of what has gone wrong. The AMT has been under development as far back as 2006. (See E-Health Industry Forum Presentation May 22, 2006). The first release was on April 2, 2007 (Version 1.0) and now we find out the AMT is unsafe apparently.
The AMT fact sheet is dated 19/08/2006! See here:
For an organisation with close to 200 staff and a $200 million budget the various ‘stuff ups’ seem to be accumulating. (See the blogs on lack or legislation for the IHI from last week etc). We really deserve much better in the way of openness and transparency!
What in the name of all that is reasonable makes NEHTA think it can talk about a “AMT Identifier Incident” and not explain. Really bizarre!
It somehow reminds me of the stuff we used to hear about in the Cold War of last century where some nuclear submarine had collided with some piece of Soviet weaponry and suddenly we were all to be blown up!
NEHTA , the first rule of ‘crisis management’ is a frank and full disclosure of the facts – this is needed now! It seems to me the problem is not trivial or the material would not have appeared on the website. Something quite worrying has gone on and some ‘ass covering’ seems to be underway?
I suppose it could have been worse – they might not have noticed until some patient had suffered!
I wonder how long it will really take to have a fit for purpose terminology? Soon I hope! The other thing is that NEHTA might possibly have noticed that software needs to actually work when deployed clinically – but having so few clinicians actually working with them, the importance of this fact escaped them until now.
This has the feeling of a bit of a mess to me!