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


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, December 17, 2009

The Press Release You Put Out When You Have Essentially Nothing to Say.

This arrived via the NEHTA RSS yesterday.

Northern Territory pushes the button on new e-health messaging system

15 December 2009. A new e-health messaging system is now in operation in the Northern Territory.
A national consortium of health organisations this week pushed the button on an innovative secure messaging delivery system in the Northern Territory which aligns with emerging national e-health standards.

The system, known as the Web Services Messaging Application or WSMA, uses new web-services technologies to send health information between different clinical software systems. It is based on a first generation messaging specification, drafted by NEHTA earlier this year, which is the front-runner to a national specification for secure messaging delivery currently pending release.

Sponsored by the Northern Territory Department of Health and Families (DHF), with software developed by local IT firm Diverse Systems Consulting, the project has been a joint initiative of the National E-Health Transition Authority (NEHTA), General Practice Network NT, and commercial software vendors Communicare Systems Pty Ltd and PEN Computer Systems Pty Ltd. The new system is part of the Northern Territory’s ongoing program of e-health innovation aimed at improving clinical information exchange and service delivery, particularly for patients in remote areas.

The WSMA application is designed to securely and efficiently transfer thousands of electronic messages a day containing critical healthcare information used to update the records of approximately 40,000 people who have already registered for the Northern Territory’s eHealthNT Shared Electronic Health Record service.

Under a self-assessment process a Declaration of Conformance was issued to affirm WSMA’s compliance with NEHTA draft specifications. Future WSMA releases are expected to undergo formal testing under a new national software conformance assessment scheme, specifications for which will shortly be released by NEHTA for industry comment.

Integrated within the established clinical software packages offered by PEN and Communicare, WSMA will be used in most of the Territory’s Aboriginal community controlled health clinics, public hospitals and a growing number of urban general practices.

NT DHF Chief Information Officer Stephen Moo said that, through its eHealthNT program, the Territory was committed to building state-of-the-art e-health solutions in line with NEHTA standards.

Design work has already commenced for the next generation of WSMA to be commissioned once the final NEHTA specification has been released. Future plans include developing NEHTA compliant eReferrals and eDischarge Summaries, enabling clinical information exchange between healthcare providers in the Northern Territory and providers in South Australia and Western Australia.

Test messages have already been successfully sent from SA Health systems to NT DHF systems demonstrating the e-health vision in action with information flowing seamlessly between interoperable systems in conformance with a national standard.

Read the full release (with contact details) at the NEHTA site:


This release is really a classic ‘red rag’ to a tired old bull!

What it tells us is that the NT Health Department have had some vendors build a system based on what is thought will be NEHTA Standards (Those are not yet done.) and that this has been given a great new acronym (WSMA).

We are then told WSMA has been designed to do something – not that it is not actually doing it yet.

Also we are told that this trial implementation has been integrated with some community service software providers and that WMSA will be used within them.

We are then told further design work is underway for the actual working and standardised WMSA.

We are then delighted to be told that with test messages already sent (content totally un-specified) they are “demonstrating the e-health vision in action with information flowing seamlessly between interoperable systems in conformance with a national standard”. Now that is grand and wonderful is it not?

The obvious thing that is required here is that this release should have happened when there were some actual runs on the board and that attached to the release were some concrete technical details as to what has actually been achieved, how well it is working, what issues and leanings etc have been achieved.

To date not one of the 40,000 souls mentioned seem to have benefited from all this. When that happens is the time for the release!

The bottom line is to ‘toot you horn’ when you actually have something real to toot about!

This blatant chase after good PR is both transparent and unseemly. Note this is not to at all diminish or discourage what NT, Health and its partners are trying to do, but rather to condemn the publicity seeking nonsense coming from NEHTA.



Anonymous said...

The glass isn't always half empty, David. Another way of looking at this is that NEHTA has shown it can deliver something tangible. This project no doubt required guidance from, and collaboration with NEHTA. How is this a bad thing? PR releases are always thin on detail, but I have no doubt that the guys in Darwin will be only too happy to sing the praises of their project in greater detail if given a gentle nudge. Perhaps ask Stephen Moo for a direct statment. What I see is an agressive health bureaucrat who is willing to work with NEHTA to eventually adopt what has been defined by the working group of vendors that cooperated with NEHTA under the auspices of the ePIP.

Dr David G More MB PhD said...

I see publicity seeking grandstanding. Your mileage may vary but that is how I see it.


Anonymous said...

In response to your question: “Now that is grand and wonderful is it not?” I feel compelled to reply that for all we know it [the Web Services Messaging Application - WSMA] might indeed be grand and it might also be wonderful.

In effect the release says that NT Health in collaboration with its partners Diverse Systems Consulting, Communicare Systems Pty Ltd and PEN Computer Systems Pty Ltd have developed the solution. Now NEHTA is clearly more than just the publicity machine - it would be fair to conclude that it is heavily involved probably with some substantial funding and it justifiably therefore wants to be seen to be closely aligned with the project.

Hence it is not unreasonable to assume that the National Specification for Secure Messaging Delivery is probably quite well advanced and embedded in the NT system. If so the ‘partners’ will have had a great deal of input into the specs to ensure everything works seamlessly as part of the integration with PEN’s and Communicare’s clinical software packages and now under test by SA Health-NT Health.

So perhaps this is not a “blatant chase after PR” as you put it at all. Perhaps it is another way of NEHTA saying that it has worked closely with vendors to develop the WSMA and implement and prove it in a test bed environment before releasing the ‘draft’ specs to the rest of the vendor community for comment in the face of demonstrable proof WSMA is working.

It is difficult to reach any other conclusion as the IT partners involved are not so stupid as to put their businesses at risk - “to build a system based on speculation around what they think will be the NEHTA Standards”.

There is absolutely no good reason to take such a high risk when NEHTA is so well funded and so desperate to demonstrate some runs on the board - the vendors could have basically named their price, which is not only what they should have done, it’s what they probably did do.

Anonymous said...

David, don't be so quick to mock this work. You should check with the vendors on GPCG about the signficance of this model for implementing some of nehta's program. You might find that this is the thin end of a wedge starting in healthcare messaging.

Anonymous said...

Stephen Moo has been a lone voice in the wilderness for a long time. “Aggressive health bureaucrat” is probably not a fair description - a persistent committed believer might be more appropriate. He has never been shy on promoting the successes of NT eHealth and he now has PEN, ArgusConnect and Hatrix as three of his closest collaborators and most trusted technology partners all wrapped up tightly with NEHTA and DOHA.

So NEHTA will not be alone in singing the praises about the NT WMSA Project. We can expect PEN and Argus will have prepared their own supportive press releases for their respective web sites. That would help to better position this achievement, giving it added credibility, countering your criticisms of NEHTA and reassuring us all that NEHTA’s press release is not premature or a flash in the pan.

Dr David G More MB PhD said...

Just read the last paragraph. I am not mocking anyone except NEHTA issuing premature and exaggerated press releases.

It could be all wonderful - but you issue the press release when that is PROVEN to be the case! Not when it is still a twinkle in someone's eye!


Anonymous said...

A solution that works with a very limited number of contained participants is a nice trial - but for me the important questions are:

Is this pilot truly scalable without proprietary technologies?

Are the cost and business process model (business impact) implications for every type of participant transparent - and will any raw data potentially inform an opportunity for other technologies/vendors?

Is NEHTA able to fund similar projects, out of it's current budget, for each and every state and territory for Australia?

Unless there is transparency, in background and operations and outcomes, I am unlikely to be convinced that we have anything more than a localised pilot that mandates a "one size fits all" (jurisdictionally driven) that delivers for a very limited group of commercial beneficiaries - NEHTA included.

John Johnston said...

While I agree that industry needs to be paid for its good works, particularly when these works have the potential to be of global benefit to an eHealth community, there was no funding offered or sought by Pen Computer Systems Pty Ltd to assist the testing and implementation of WSMA. Thats also why we did the work in the ePIP initiative established by NEHTA with the MSIA and on this WSMA implementation of a solution based on draft standards. It is live. It is working and maybe an acorn that becomes an oak. The difference this time for Pen, is that there was acknowledgement of a vendor investment by NEHTA. Maybe next time we will see funding support. Happy Xmas all.

Anonymous said...

The WSMA product is the output of a collaboration partnership between the NT Department of Health and Families (DHF) and NEHTA. WSMA has been developed and funded by DHF with NEHTA providing technical support so that the development is aligned with NEHTA’s draft SMD specifications. WSMA is a new generation Web Services product that will provide an improved quality of service to NT health provider organisations and potentially other jurisdictions and has proved that these specifications can be deployed.

This is not just rhetoric, WSMA and its integration with Communicare, the PEN sidebar and the eHealthNT Shared Electronic Health Record (SEHR) repository is we believe, the first production implementation of exchange of clinical documents using the proposed draft NEHTA secure messaging specifications in Australia... This is a significant milestone.

There are currently around 50,000 clinical documents sent per month from the 80 participating remote and urban based primary care clinics in the NT and APY lands in northern SA to the eHealthNT SEHR repository. WSMA is being implemented by eHealthNT to migrate the technology used to send this information to a nationally compliant, interoperable secure messaging solution. This product will continue to be developed by DHF to meet NEHTA’s final SMD specifications and all of these clinical documents being sent to the SEHR will be sent using this technology.

I can advise that in the first week of operation, the first remote health clinic in central Australia to be migrated to this new technology has sent important clinical information for 143 patients to the NT SEHR. This clinical information is used on a daily basis by primary healthcare and hospital clinicians to provide continuity of care for a highly mobile Indigenous population. These clinical documents are being encrypted and delivered in less than 1 second per message from a remote site using this WSMA product.

I would be happy to provide additional information to interested parties and would suggest that you contact Chris Scott, Director EHealthNT Operations, at chris.scott@nt.gov.au

Stephen Moo
NT Department of Health and Families

Dr David G More MB PhD said...

Many thanks Stephen. What you are saying is more like what the press release should have said.

Is there a link where those interested can understand in detail just what is being transferred, and how the overall system works and is working?

Thanks again.


Anonymous said...

As noted in a previous posting, Argus is the primary secure messaging system used by GPs in the NT. Since the purpose of NEHTA's secure messaging web services is to achieve interoperability between messaging programs, can we assume that Argus sites will be adopting web services too? Or is PEN moving into the messaging space? The WSMA product seems to me to require all GPs to be able to receive discharge summaries by web service.

John Johnston said...

Pen Computer Systems IS NOT in the messaging business. We are in the business of providing ehealth solutions that are useful to providers and patients. Often we find that we have to build or collaborate to get something that is blocking the way. Our direction, of course, demands web services and our interest in WSMA is consistent with that. If WSMA is required by something we are doing we will use it. The main frustration for us is that NEHTA still has not got to a point where it can EASILY say "we need a tool to do X...who can we work with to build an X?" There are signs of this breaking down but there are sections within NEHTA who do not have the leadership to do this and it is holding us all up.

Anonymous said...

John Johnston said “there are sections within NEHTA who do not have the leadership to do this and it is holding us all up”.

Well if that isn’t stating the bleeding obvious I don’t know what is. For years the vendor community has mumbled and grumbled away about NEHTA but never been prepared to come out and state their views in the public arena for fear it might have negative consequences for their businesses. So nothing changes, NEHTA does what NEHTA wants and the doona mumbling continues unabated and nothing much changes.

This blogspot has consistently called for changes in NEHTA. Their current modus operandi is, as John says, “holding us all up” because “there are sections in NEHTA who do not have the leadership” required to fix this debilitating issue. So the whole system suffers and pays a high price in the process - government, developers, health providers, patients. Thank you John for having the courage to bring this issue into the open.

Sadly, you are but one lonely voice among the vendor community. When are your colleagues going to speak up?

Until that happens your business along with every other business will continue to be frustrated. If you want change to happen then insist on change, demand it and drive it home - because if you don’t you will just have to keep scratching your heads and asking yourselves “how can we get round these obstacles that are holding us up if we don’t do something to change the way things are being done”.

Oh, and one other thing - it is not appropriate to point the finger at “some sections within NEHTA”. Surely to goodness you understand that senior management determines the way NEHTA operates. That is the CEO’s job. He needs to know about these problems areas in NEHTA of which you speak, and he needs to seek help to fix them if he can’t fix them himself.

But until you find colleagues of like mind and courage to join you to insist on getting the leadership problems fixed then no improvements will be seen, the barriers to progress will remain and the outcomes for progress will not eventuate.