Quote Of The Year

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

or

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

Wednesday, April 25, 2018

I Wonder What We Are Being Told With This Little Puff Piece? Australian Standards Development In Digital Health Is Just Ripping Along – NOT!

This appeared a few days ago.

Gold standard: the role of Standards Australia in digitising healthcare

Bronwyn Evans | 17 Apr 2018
Standards Australia has been developing standards for 96 years across a number of industries and sectors with the support of over 5000 contributors. Each standard developed over these years has impacted Australian life to a different extent, none more so than in the health sector. However, in recent years there has been a rapid increase in technological advancement in the health sector with a growing reliance on digital practices.
Security accompanying growth
In line with the fast-paced improvement in technology, there is an equally strong appreciation and understanding of the need for standards-based security around patient information: how it is stored, how it is accessed and how it is shared across, and beyond, the healthcare sector.
While there is broad agreement of the need for a better exchange of clinical information, it is vital to ensure that not only are systems and the information within them connected but they’re connected securely.
This means consideration must be given to the security of patient records and record messaging. Consideration must also be given to the security of health-related payments to patients and practitioners, the security of patients’ medical devices and the information captured by and stored within them.
Digital healthcare and digital hospitals
A digital hospital is one that leverages comprehensive, pervasive information management and information communications technology to support clinical and administrative workflows, as well as safety and quality improvements.
In July 2017, Standards Australia published a world-first digital hospital handbook, an initiative led by the Australian Health Ministers' Advisory Council and the National Health CIO Forum.
The objective of the Digital Hospitals Handbook was to develop a set of principles and recommendations to inform the design and implementation of digital hospitals – both new and refurbished – in Australia.
Intended to enable innovative ways for providing healthcare services and support positive outcomes for stakeholders, the handbook is a guide for government and industry to use now and into the future.
Lots more here:
Dr Bronwyn Evans is CEO of Standards Australia.
Standards Australia last week published its new standard on vendor credentialing in the healthcare sector. (this is how you decide to let people in and out of facilities etc.)
So I went to the site and searched for “Health Informatics” and recent date.
First one I got was this wonder!

ISO/TS 16843-4:2017

Title
Health informatics — Categorial structures for representation of acupuncture
Designation
ISO/TS 16843-4:2017
Status
Current
Published
2017
Withdrawn

Committee
ISO/TC 215 (Health informatics)
Product Type
TS
I kept at it for a year until I found this. (lots of fun non Australian originated stuff in between.)

ISO/TS 18062:2016

Title
Health informatics — Categorial structure for representation of herbal medicaments in terminological systems
Designation
ISO/TS 18062:2016
Status
Current
Published
2016
Withdrawn

Committee
ISO/TC 215 (Health informatics)
Product Type
TS
The first Australian effort was a 2016 AS which was a re-confirmation of a 2005 Standard.

AS ISO 18308-2005 Rec:2016

Title
Health Informatics - Requirements for an electronic health record architecture (ISO/TS 18308:2004, MOD)
The relevant committee is IT – 014 for Australia.
The only new thing produced since 2015 is this:

AS ISO 13131:2017

Health informatics - Telehealth services - Quality planning guidelines
Publication Type-  International adoption identical
Product Type   Standard
Publication Status - Current
Publication Synopsis
A visit to the Australian E-Health Standards site shows not much since 2014 or 5 with things dated 2014 flagged as new!
See here:
In summary Health Informatics Standards development in OZ is not resting – it is stone dead – as is the famous parrot.
Being kind I think Dr. Evans is just a little disconnected with the real world or am I and really there is a flurry of useful activity happening I do not know about, or is all the work done and we need no more? Let us all know.
(Note there is a lot going on overseas with some considerable Australian involvement e.g. HL7, FHIR etc. Australia and the ADHA just seems to have dropped the ball!)
David.

5 comments:

Anonymous said...

MHR is the ADHA standard. No ifs and buts. SA is not alone

Grahame Grieve said...

There is an active development in SA around a standard for digital hospitals. This is an important standard that we shouldn't undervalue - even though it's not a healthcare informatics standard and therefore basically unimportant ;-)

You're right that the ball's been dropped with regard to healthcare informatics standards. Recovering from where we are is going to be hard work, and require a collaboration that seems difficult at this point in time. There is work behind the scenes, but we have a long way to go. I personally think that the correct answer *should* be Standards Australia, but right now I have no confidence that the governance/conflict of issues inherent in the Australian standards process have a solution (though I wonder why healthcare informatics has been so damaged by them more than other domains. I have friends in other standards domains who are not nearly so affected, but it's on their radar).

In the end, the solution - unfortunately - seems to rests with the goverments - does the government want to have an Australian standards process that works in healthcare? And I doubt that the State and Federal governments collectively think that the answer to that is 'yes' enough to do the heavy lifting to get the process going again. HL7 Australia can offer to help, and generate consensus agreements - which it's doing - but it requires government buy in to make those into standards.

btw. it's to be expected that a CEO will talk up what is happening in public, and talk about what isn't in private, yes?

Dr David G More MB PhD said...

I would argue the CEO is presenting an unbalanced and distorted view of what SA is doing and that the digital hospital activity is going on with very little impact or awareness.

As I understand it, it is hardly an implementable Standard, but I can't afford it to review and thus know what whoever is developing it has done.

David.

Andrew McIntyre said...

There is some standards development going on in HL7 Australia, with the same people who used to attend the Standards Australia meetings. We had to rewrite the standards but can base them on HL7 International.

This standard is up for public comment soon, please comment when it happens

Australian Diagnostics and Referral Messaging

Anonymous said...

I would have to agree Grahame you and others have no simple task ahead. Defining and agreeing a business model that is fair and equitable across all SDOs will be hard enough, rebuilding a community around those models and then creating pathways for future standards leaders, all the while gaining government funding without inherenting helpful advice and demands from government. That and working out how commercial companies can enable valuable staff to participate.

It will take skills from a broad range of professions, a separation of governance concerns but more importantly inderpendance as well as a recognition that not all standards can or should be developed through developer communities. I think FHIR has shown meritocracy can work and that given the right leadership things can progress, but even FHIR has needed time to evolve, it is not fast but it is a good process.