This popped up last week….
Sharing by default: delivery of health interoperability plan in full swing
25 October 2023
The Australian Digital Health Agency (ADHA) will release quarterly updates on the ambitious goals of the national healthcare interoperability plan following the recent creation of the independent Council for Connected Care (CCC), and in light of the federal government’s commitment to a “share by default” policy on health information sharing.
The CCC was announced at the MedInfo conference in July (pictured), to provide strategic advice to ensure implementation of the national health interoperability plan, which was also launched at the conference.
Chaired by Australian Institute of Health and Welfare CEO Rob Heferen, the CCC had its third meeting recently, concentrating on standards. Attendees included representatives from the Australian Commission on Safety and Quality in Health Care, Department of Health and Aged Care, the CSIRO, Standards Australia, HL7 Australia, GS1 Australia, Integrating the Healthcare Enterprise (IHE) and the AIHW.
An update was provided by ADHA’s standards advisory group, chaired by University of Melbourne associate dean of digital health and informatics Wendy Chapman.
The meeting also discussed the new Sparked program, a FHIR accelerator the has brought together the CSIRO’s Australian eHealth Research Centre, the Department of Health and Aged Care, the Australian Digital Health Agency, CSIRO, and HL7 Australia to develop an Australian core dataset for interoperability and FHIR.
ADHA CEO Amanda Cattermole said the council was designed to be as broad a stakeholder engagement group and an advisory and stewardship group as possible.
“The way that it’s framed is that each meeting will be a deep dive on one domain that is going to drive change under the plan,” Ms Cattermole said.
More here:
We now have the first quarterly progress report on the national healthcare interoperability plan and it is is available from ADHA.
The report is a nice 25 slides. The summary of progress is as follows (Page 4).
“Key progress towards a better-connected healthcare system for all Australians includes:
• Establishing strong governance – the Council for Connected Care and the Australian Digital Health Standards Advisory Group – and developing a communication and engagement plan for collaboration and transparency.
• Sharing resources in central locations – the Agency’s Online Interoperability Toolkit and Digital Health Developer Portal – for collaboration and to build the knowledge base.
• Developing roadmaps for healthcare identifiers and the Fast Health Interoperability Resources (FHIR) Accelerator program and commencing consultations with jurisdictions on the National Health Information Exchange Architecture and Roadmap.
• Developing guidelines for ICT procurement and a framework for conformance.
• Publishing guiding principles for digital health standards, developing a standards gap analysis tool and designing a community platform for a standards catalogue that will bring resources together in one place.
• Building the digital health capability of the workforce through assessment tools and training on FHIR and healthcare identifiers.
• Measuring maturity through the 2022 Interoperability Benchmark Survey, identifying appropriate maturity models and monitoring progress against the actions in the Interoperability Plan.”
Why do I get the feeling I need to come back in 5 years time to see if anything much has changed. Right now all we seem to have guidelines and wish-lists!
The more closely I read these seven points the stronger my sense of déjà vu! If I tried I reckon I could find you similar documents from the 1990’s. Will someone please tell me where the hard evidence of real progress resides and send me a copy! Is that too much to ask?
David.
7 comments:
A technology solution to a poorly understood medical problem. Where is the evidence that making available huge amounts of irrelevant, uncurated, historical detail will help medical practitioners understand the patient's condition at the point and time of care?
The more important medical problem is understanding the patient's current condition. History plays only a small part and can be quite misleading.
@Bernard, you're generally on song, but I think you've got it wrong this time. It's true that a patient's medical history is important only in a subset of cases, but when it's important, it's considerably important, and there's real value ($$) at stake here, as well as lives. That's why groups like the CCC keep coming up with this a requirement; it's not a government fantasy, that's for sure. It's a solid common continuous plea from practising clinicians. I think they overstate it, but it's real
@Grahame, I hope, and I don't think you are, suggesting that clinicians want huge amounts of irrelevant, uncurated, historical details (and I forgot - incomplete).
Curated data, yes, current data yes, but focus is on interoperability, which will result in incomplete detail.
What I don't see is any attention at all on the other two, which, IMO offer more value, but are more difficult problems.
Making pronouncements is easy but actually making things happen is quite different and its clear that the Department of Health and the multitude of their eHealth Authorities are not going to make it happen. We have had 2.5 decades of pronouncements and the quality on the ground is actually lower than it was, especially when you look at the quality of the actual data. It might look a bit better as a pdf but its often 100-1000 x the size and requires humans to read it. Terminology has not advances and the quality of the output of the large labs - who used to be leaders, has tanked. At some point you have to admit failure and try another way.
We have had pronouncements of new trendy technologies that are going to fix the problem and now we have a large number of poorly implemented technologies in use as the fashion has changed. I can assure you that PIT remains firmly in use, as does V2 and there are examples of CDA, FHIR etc also hanging around, although V2 is what carries the load.
We must have spent > $3 Billion on this and I can't see any real return. Where are the sensible people who say STOP, we are doing something wrong. eHealth was progressing quite well until the Government stepped in to "help". Now its a bunch of (often multinational) feral pigs and lots of well filled troughs. Removing the free pig feed might allow us to focus on what works and clean up the piles on manure that are creating a huge stench. The pigs will hang around while they are fed. True expertise is very thin on the ground and often departed because of the stench. Its a mess....
Sounds fun, how does one get on this gravy train? I am shallow enough to give the appearance that it’s all about the patient and saving the healthcare system from itself.
My pathology results never arrive in My Medical Record! Nevertheless I get them a few days after the test is completed. How can that be? Well, the path lab sends me an SMS test with a link and a PIN and I can sign in and download my results. Simple pimple, slick too. Very convenient. My GP has my results and so do I, and it hasn't cost $3 billion! Perhaps someone should tell the ADHA!
I agree with Dr Ian Colclough - furthermore, I don't have a government health record (that I consented to have created), I have never been asked about it nor had any indication it was a consideration. This is the same for my partner, GP, public and private hospitals, specialists etc.
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