NEHTA Releases a Concept of Operations for the Health Identifiers.

The following appeared, along with a lot of other documentation a few days ago.

http://www.nehta.gov.au/media-centre/nehta-news/564-nehta-releases-concept-of-operations-for-healthcare-identifiers-service

NEHTA releases Concept of Operations for Healthcare Identifiers Service

20 November 2009.

NEHTA releases Concept of Operations for Healthcare Identifiers Service.

One of the key foundations for a national approach to e-health will be a standard process across the health sector to accurately identify everybody involved in a healthcare transaction. A national Healthcare Identifier Services (HI Service) is being established to assign and maintain healthcare identifiers. NEHTA has released the Concept of Operations providing an overview of the proposed HI Service. The Concept of Operations covers the current state of healthcare identification; describes the HI Service and how the service will be used and will work; and documents key concepts and their usage.

The Concept of Operations and associated documents are located at Healthcare Identifiers

Email ehealthid@nehta.gov.au

At the simplest the purpose of the document is covered here:

This Healthcare Identifiers Service (HI Service) is the subject of this Concept of Operations document. The purpose of the Concept of Operations is to:

• Describe the current state of healthcare identifiers in Australia

• Describe the Healthcare Identifiers Service (HI Service), in such a way that key stakeholders can understand:

o What the service is

o Why the service is required (from a high level)

o How it will work

o How it will be implemented

• The key privacy/policy underpinnings
• Document key concepts and their usage
• Illustrate key scenarios where healthcare identifiers will be used to highlight any gaps in expectations
• Illustrate the impact relative to today’s situation as it relates to the proposed services and solution

(Page 9 of 83)

The document is quite useful but there are a few themes that emerge that are going to cause some issues I suspect.

First the management and governance framework for the HI Service that is planned is still not spelt out as far as I can tell.

Second NEHTA does not seem to have made available a document they reference which would be very important in getting all this into context:

NEHTA, Introduction to National e-Health Services, version 1.0, November 1 2009

My e-mailed request for a copy (to the address above) has gone ignored for 4 days at least. Typical.

Third there is still no reference to or provision of a Business Case that justifies the planned expenditure. We get a lot of motherhood about improved identification etc but there is just no evidence provided (in the whole documentation set) that the NEHTA HI Service proposal is actually fit for the purposes for which it is intended and is the best way of going about things.

The entire NEHTA thrust seems to be justified by these couple of paragraphs from the February 2006 COAG meeting outcomes (Appendix D)

“2. From February 2006, governments will accelerate work on a national electronic health records system to improve safety for patients and increase efficiency for health care providers by developing the capacity for health providers, with their patient’s consent, to communicate safely and securely with each other electronically about patients and their health. This requires:

· developing, implementing and operating systems for an individual health identifier, a healthcare provider identifier and agreed clinical terminologies; and

· promoting compliance with nationally-agreed standards in future government procurement related to electronic health systems and in areas of healthcare receiving government funding.”

Not wanting to stir the pot but it would be nice to know just what prompted this outcome – in detail.

Fourth review of the document makes it clear that there are all sorts of activities to be undertaken by Medicare Staff, Health Care Providers and their Staff and the HI Service itself. Just an indication of the scale of the budget for all this – and who will pay for providers time and effort would be helpful.

Last it is clear that unless there have been all sorts of secret meetings going on and payments arranged there is going to a exist a bright shiny service with no one having proven and widely implemented software to use the service.

This document makes me feel this HI Service is a bit of a chimera we are going to be waiting quite a long time to see it take its final form – legislative delays notwithstanding.

There is also, of course the small and large scale testing that needs to be done before the HI Service is made generally available. I wonder if there is a timetable anywhere that shows the critical path for having this service actually operational at any scale in 2010?

David.