Who Smells the NEHTA Spin?

Well the journalist who heads NEHTA is back to his roots! I wonder how long it took to craft this article? My spies tell me it was weeks! Desperate to manage the obvious outcomes of a deeply negative report card!

To confirm this just look at the carefully crafted collection of ‘alleged’ e-Health progress items.

Healing Australia via broadband

Jennifer Hewett | December 17, 2007

A health revolution is coming that will allow patients, doctors and specialists to use e-medical records, writes Jennifer Hewett.

IMAGINE going to a new medical specialist and not having to take the referral letter, your X-rays and details of your existing medications.

Imagine attending a new GP practice where the GP calls up your previous medical records at the click of a mouse rather than relying on your, er, memory.

Imagine ending up in the emergency room of a public hospital where doctors who have never seen you before can instantly see your entire medical history. Not to mention having your own GP able to immediately see all the comments from the hospital staff, the discharge papers and the recommendations for follow-up treatment. No waiting, no confusion, no falling between the paper cracks.

Yes the personal electronic health record is finally coming to Australia. The concept is relatively simple. It means individual medical details will be easily and always accessible on computer to both doctors and patients, should patients wish.

But while the appeal is obvious so are the complications, not least the privacy concerns.

For the past 2 1/2 years, a group of health and IT professionals has been quietly beavering away to make the idea workable. They staff the National E-Health Transition Authority, a non-profit company whose board includes all the heads of federal and state health departments, with a budget so far of $160 million.

Now comes the next phase.

Following criticism and an independent review that found NEHTA has not consulted widely enough, the company is now trying to work more closely with the medical profession and other potential users of electronic health records.

This week it will announce it has signed a contract with Medicare Australia to design and build the special identification markers for consumers and healthcare providers.

Although it won't be ready for Kevin Rudd's ambitious timetable for a snap meeting of the Council of Australian Governments on Thursday, NEHTA will put its business case to the first COAG meeting next year for the next stage of funding.

Continue reading the very long article here:

http://www.australianit.news.com.au/story/0,24897,22935859-24169,00.html

The plan for a Shared EHR ( it was called HealthConnect then) was knocked back by the Commonwealth Department of Health and Aging in 2005 and has now been resurrected, as a new idea, (which it is not!), to save those involved in the terrible NEHTA inaction and management of E-Health over the last 3 years.

The Shared EHR may be really good idea but it is much more complex and difficult to achieve than is even partially recognised in this transparent ‘puff piece’

What chance, with the surplus in meltdown, as we now hear, this will get funded now?

I am utterly sick of the spin, deception and rubbish we are seeing from this just totally dysfunctional organisation which as late as a week ago was suggesting to its executives that grass roots E-Health initiatives were to be observed and monitored rather than assisted and supported (and this directive was direct from the CEO I am told).

Sorry..we really need a fresh start with a new team! There is no sign anyone can see there will be the level of change and openness we all require.

I have seen some spin in my time – but this article takes the biscuit! That it was planted to try and minimise the impact of the BCG Report should be obvious to the most naive.

David.

The Boston Consulting Group Lets NEHTA off the Hook!

The report of the Boston Consulting Group on their formal review of NEHTA (undertaken August - October 2007) was released this morning:

It can be found at the following URL – along with NEHTA’s response

www.nehta.gov.au/index.php?option=com_docman&task=doc_download&gid=421&Itemid=139.

The report makes six main recommendations which are intended to ensure the delivery of the national E-Health agenda objectives over the next few years:

1. Create a more outwardly-focused culture.

2. Reorient the work plan to deliver tried and tested outputs through practical ‘domains’.

3. Raise the level of proactive engagement through clinical and technical leads.

4. Accelerate resourcing through outsourcing, offshore recruiting and more creative contractual arrangements.

5. Reshape the NEHTA organisation structure to address revised work plan priorities.

6. Add a number of independent directors to the NEHTA Board to be broader advocates of E-Health, and to counter stakeholder perceptions of conflict of interest.

A press release ‘spins’ the NEHTA response to the Review!

----- Begin Release

NEHTA HERALDS E-HEALTH MILESTONES

and announces its action plan for adoption success

17 December 2007

Australia's e-health reform agenda took a forward step today with the release of an action plan by the National E-Health Transition Authority (NEHTA).

The Board of NEHTA also endorsed a business case for developing a national platform for personal electronic health records to be put to the Council of Australian Governments (COAG) early next year.

The NEHTA action plan outlines key areas for ensuring the successful adoption of measures to improve the electronic communication of critical health information.

"After working to build foundations for electronic health since the organisation was established in 2005, we are now in a position to begin to deliver some concrete applications of our work," NEHTA's Chair Dr Tony Sherbon said.

"The new Federal Government has signaled health reform and improvements in state and federal relations as major policy objectives," said Dr Sherbon. "Given also the government's emphasis on

the provision and use of broadband communications, NEHTA is well-positioned to play its role in advancing e-health as part of this new agenda," he said.

"The recent independent review found NEHTA had made significant progress on our goals to date and made a number of recommendations about NEHTA's future. The action plan we are announcing today flows directly from our acceptance of all the recommendations in the review," Dr Sherbon said.

Dr Sherbon identified the action plan as also being an acknowledgement of where NEHTA now needs to go in order to expedite e-health reform in Australia.

"We have come to a point where many of the foundations to enable e-health are in a position where we can now move towards implementation and adoption. Seeking funding to establish a national system of personal electronic health records is also on our immediate horizon. The action plan that we have released will assist this process," he said.

Dr Sherbon said the case for personal electronic health records was compelling. "The safety and quality benefits are manifold. We understand the issues of equity and privacy and firmly believe that

the approach developed by NEHTA will address these to the satisfaction of all our stakeholders and the Australian public."

NEHTA's Action Plan for Adoption Success and the independent review of NEHTA conducted by the Boston Consulting Group are available on the NEHTA website at www.nehta.gov.au.

----- End Release.

Three major things concern me about all this.

My first major issue is that the last paragraph of the executive summary identifying the need for a national Health IT Strategy has simply been ignored by the Board.

"In parallel, planning for the next phase of eHealth coordination and implementation needs to commence now or momentum could be lost. An eHealth strategy and eHealth policies need to be developed. Further analysis and debate by NEHTA and its members on the future vision for eHealth and the role of a central agency (as described above) is needed now to generate a plan by mid 2008. Regardless of the funding scenario and any future role of NEHTA II, we believe that the ‘transition’ NEHTA is tasked to support has at least another five to ten years to run."

I welcome all the recommendations, cited above, as far as they go - but feel they do not point to where the real work is needed - i.e. a National E-Health Strategy.

My second major concern is that while it is clear there have been a very large number of issues with the way NEHTA has operated - there is no apparent accountability for the mis-steps being accepted by the Board and Staff of NEHTA.

That said the BCG report's findings seem to me to accurately reflect the view of external stakeholders (Health IT experts, Health Providers and the IT Experts) but the impact is diluted by continual use throughout the report of the views of the NEHTA staff on the quality of the job they are doing. The staff and Board are hardly likely to be objective regarding their own performance!

My third major concern is that we have NEHTA recommending a Business Case for a National Shared EHR to the Council of Australian Government – and the public has had no apparent input – other than by a discredited NEHTA Board and a few bureaucrats. This is hardly the new open, engaging and consultative NEHTA!

In summary, this report addresses some of the operational, cultural and engagement failures of NEHTA, while failing to firmly recommend the development of a national e-Health plan to achieve value from NEHTA's work. Without this NEHTA will remain an unguided missile operating without strategic context and at risk of continuing to underperform.

To let NEHTA escape without a clear articulation of the need for a National E-Health Plan is really very poor indeed.

I fear the whole BCG exercise has been an expensive piece of ‘window dressing’

David.

BCG Review Report of NEHTA Now Available.

The BCG Review of NEHTA has been published.

It is available here:

http://www.nehta.gov.au/index.php?option=com_docman&task=cat_view&gid=-1&Itemid=139

My comments in due course

David.

Useful and Interesting Health IT Links from the Last Week – 16/12/2007

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

Patient software deal 'threatens innovation'

The merger of patient software giants iSoft and IBA Health has left New Zealand's district health boards faced with reduced innovation and uncertain pricing, according to rivals.

But they say that while the new entity - to be called IBA Health Group - currently has no serious competition in the New Zealand patient management software market, there is room for challengers.

Australia's IBA Health recently completed its A$410.7 million (NZ$475.8 million) acquisition of financially troubled British company iSoft.

Sysmex national sales manager Colin McKenzie says IBA Health Group now supplies patient management software to 19 of New Zealand's 21 district health boards. "That's huge."

The group competes with Sysmex in the market for clinical data and laboratory software.

He says it’s uncertain what will happen to software prices in the wake of the merger.

"The Health Ministry controls a lot of pricing when it comes to reasonable IT spending but the general word on the street is that people are a bit concerned about what it might mean when there's that much market dominance."

He says it is likely the merged company, which offers five products in the health software range, will sunset some of its products and provide one package to DHBs - which will have to change their systems. In this situation, other providers will be able to offer alternative products.

Continue reading below

http://www.stuff.co.nz/stuff/4317183a28.html

It is interesting to see how a merger like this can have an un-intended consequence for a small market. One hopes IBA Health will work to continue to provide excellent service to New Zealand. There is clearly an opportunity here to have New Zealand have a level of system commonality that could help to improve Health Information Management throughout the country, as long as pragmatic and reasonable approach is adopted by all affected.

Second we have:

Software prevents patient overdose

Jennifer Foreshew | December 11, 2007

MELBOURNE-based Peter MacCallum Cancer Centre has become the first in Australia to employ new software that will prevent dosage errors in patient medication.

The centrally managed intravenous (IV) drug administration software, Hospira MedNetT, went live yesterday at the cancer research and treatment facility, which caters to 100 in-patients and 25 day ward patients.

The centre's pharmacy head, Sue Kirsa, said the US-developed software, which was running over the centre's Nortel wireless network installed earlier this year, would give greater protection from overdosage.

"We have been administering medications via pumps for many years, but the existing way requires the nurse to look at an order and do a calculation around how quickly the drug is administered to the patient," Ms Kirsa said.

"The vast majority of these items are delivered safely hundreds of times a day, but from time to time errors can be made and the patients can suffer an adverse effect from it. This gives that added amount of security to the nursing staff and to the patients that what they are doing is safe and effective."

Read the complete article here:

http://www.australianit.news.com.au/story/0,24897,22902404-5013040,00.html

This is another step, based on Health IT, to improve patient safety and it is good to see such technology is being adopted and deployed in Australia. Interestingly the company Hospira was the one that a few years ago bought Mayne Pharma – which was at the time a major player in generic cancer medications which had been established in Australia and was part of the old Mayne Health. Mayne Health partly also lives on as Symbion which is having an interesting time on the Australian Stock Exchange at present with a number of companies wanting to take it over.

Third we have:

Rebirth of the Access Card?

Fran Foo | December 12, 2007

THE decision to axe the Access Card program could come back and haunt the federal Government, an analyst from Frost & Sullivan said.

"I can see why Labor decided not to proceed but the idea behind the Access Card is good for patient records," Simon Hayes, Frost & Sullivan senior analyst, said.

Labor kept its election promise by scrapping the controversial $1.1 billion program. The card was intended to provide every Australian with a unique health and welfare number and biometric photo on a smartcard.

Mr Hayes said while the Coalition went too far with the Access Card, he believes Labor would, in future, have to introduce a more secure way for people and the federal Government to access e-health records.

"Any smartcard would sound like the Australia Card but this is something that has to be introduced eventually," he said.

Continue reading here:

http://www.australianit.news.com.au/story/0,24897,22911467-15306,00.html

I am surprised a senior analyst at Frost & Sullivan would not have made the obvious point that it would make sense with the change of government, and the plethora of different electronic ID systems which are in various stages of development and implementation around the country, that now might be a good time for a strategic review of the whole area to make sure we get an overall framework in place that will serve all needs, including the Health Sector.

Fourthly we have:

Building a personal medical database

New products help patients take charge of their health and medical history by organizing their records, but there are privacy concerns.

By Jan Greene, Special to The Times

December 10, 2007

Cathy Barnes of Bakersfield was traveling on business in Philadelphia a few years ago when she developed a terrible pain in her abdomen. Doctors at a major medical center there kept her overnight and carried out a battery of tests on her heart. The tests came up negative.

When she got home, Barnes went to her regular doctor, and an ultrasound exam found a mass in her kidney. A CT scan showed a kidney tumor, and she was immediately scheduled for surgery to remove it before the cancer spread.

Barnes believes she saved precious time in her treatment because she knew enough to ask for a copy of her medical records from the Philadelphia hospital and show them to her doctor at home -- eliminating the need to repeat all those tests. "Having copies of my cardiac tests saved all that time," she says.

Barnes, a database specialist, is unusual -- long before the tumor, she'd gotten in the habit of asking for copies of her records and meticulously tracking her vital signs on a spreadsheet to share with her doctor, who monitors her high blood pressure.

Although not every doctor would want that much detail, nor does every patient have the patience to accrue it, most people could benefit from routinely asking for a copy of their lab results and doctor's reports, says David Lansky, senior director of the health program for the Markle Foundation, a nonprofit that promotes application of technology to health problems.

Such a personal health record, kept either on paper or electronically, can help patients stay aware of their health, particularly if they have a chronic illness such as diabetes or hypertension. It can help a person weed out mistakes in the information, avoid unnecessary repeats of tests and ease the move to a new town or doctor's office.

And anyone who takes care of another person, such as an elderly relative or child with a health problem, can use the records to help advocate for the patient.

Health insurers such as Aetna have helped drive this trend in hopes that patients would pay closer attention to their health. They were among the first to offer some online access to medical claims. Kaiser Permanente -- unique in being an insurance company and a healthcare provider -- is probably the furthest along, offering members not only access to an abbreviated version of their medical records but other services too, such as the ability to e-mail physicians and set up appointments online.

Companies such as Wal-Mart are starting to offer their employees the option of saving personal health records as well.

Many people don't have such access, however -- and there's a downside, in any case, to using an online personal health record provided by an employer or insurer, even though it's free: If you leave that job, you may not be able to maintain access to the site. So people wanting a more detailed record may seek out a solution on their own, and today, they have a wide array of options.

Over the last few years, dozens of personal health record models have hit the market. Some include software that allows people to track their health on their own computers at home or to put it on a thumb drive to give to a doctor. Others are based online, using a secure server that a patient, or a relative or doctor with permission, can sign on to from any Internet-connected computer.

Before taking the time to type a lot of personal history into a product, consumers should think a bit about what they want from a personal health record.

They should also think about how private their records will remain.

Continue reading all of this long article and the associated suggestions here:

http://www.latimes.com/features/health/la-he-records10dec10,1,1863941.story?amp;track=crosspromo&coll=la-headlines-health&ctrack=1&cset=true

This is a useful, up to date, and pretty comprehensive review, from the consumer perspective, as to what is available in the way of Personal Health Records in the US. Well worth a browse.

Recently more on PHRs is also found at a couple of other places:

http://www.kiplinger.com/features/archives/2007/12/krrpersonalhealthrecord.html

Your Medical History at Your Fingertips

Need your history in a hurry? A personal health record can store your data in one place.

By Christopher J. Gearon
Kiplinger's Retirement Report

December 6, 2007

And here:

http://www.healthleadersmedia.com/content/201983/topic/WS_HLM2_TEC/PHRs-Fulfill-Consumer-Needs-for-Data-Access-and-Control.html

PHRs Fulfill Consumer Needs for Data Access and Control

Jodi Amendola, for HealthLeaders News, December 11, 2007

Until recently, personal health records have taken a back seat to electronic medical records as the healthcare industry continues its struggle to establish health data exchange standards. That prioritization is shifting as consumers demand a viable healthcare technology in which to store and access their personal healthcare information.

Fifthly we have:

Health 2.0: The next generation of Web enterprises

By: Joseph Conn / HITS staff writer

Story posted: December 11, 2007 - 5:59 am EDT

Part one of a two-part series:

In healthcare, where buzzwords tend to have the lifespan of fruit flies, "Health 2.0" is maybe a year old and already is growing cyber-whiskers, on a given day generating more than 130,000 hits on Google, outstripping "consumer-directed healthcare" at about 44,400 hits, but lagging "personal health record" at 294,000.

It has attracted a pair of entrepreneurial conference organizers, consultants Matthew Holt and Indu Subaiya, who put on their first show, the Health 2.0 User Generated Healthcare Conference, Sept. 20 in San Francisco, drawing about 480 attendees with a waiting list of another 100, according to Holt. The pair is planning a two-day, follow-up "spring fling" in March in sunny San Diego and a second, larger show next fall.

So what is Health 2.0? The term is the healthcare derivative of the far more ubiquitous "Web 2.0" (15.9 million Google hits) coined by Web pioneer Dale Dougherty, a vice president of O'Reilly Media, a publisher of computer technology books and magazines and the host of IT conferences. It was during a brainstorming session for a planned conference that the muse struck Dougherty, but it was company founder Tim O'Reilly who chronicled the genesis of Web 2.0, and popularized its use in a seminal, 16-page essay, What is Web 2.0: Design Patterns and Business Models for the Next Generation of Software, published in September 2005. The idea, according to O'Reilly, was to analyze the common traits of companies that survived the bursting of the dot-com bubble in 2001 for possible incorporation into the next generation of companies.

In his essay, O'Reilly shies away from giving a concise definition of Web 2.0, opting instead to provide seven basic principles. The first three of these principles are probably the most important and, arguably, the most applicable to healthcare, at least according to examples of companies cited by Web 2.0 mavens contacted for this story.

The first principle, O’Reilly says, is the software of a Web 2.0 company has to be Web-based, has to provide a service and that service has to be structured so that the more people use it, the better it becomes. He described it as "an architecture of participation." An exemplar is eBay; as more and more buyers and sellers participate, the broader the eBay market becomes, which creates more value to the customer.

O'Reilly calls the second key principle "harnessing collective intelligence," which also is referred to by others as "the wisdom of crowds." To avail themselves of this wisdom, Web 2.0 developers must create applications that are dynamic, with user participation designed into the systems, so that participation itself becomes an integral part of making the underlying database more valuable. Amazon.com adds value by enabling readers to write and post reviews of software and books and to be engaged in other ways, such as preparing wish lists.

O'Reilly's third principle, "Data is the next 'Intel inside,' " notes that specialized data, enhanced through analysis performed by the service provider as well as by the contributions of service users, becomes the core asset of a Web 2.0 company. The Amazon wish lists, for example, are aggregated by Amazon and used as buyer's guides.

Article continues here:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20071211/FREE/312110003/1029/FREE

The second part of the article is found here:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20071212/FREE/312120002/1029/FREE

These two articles nicely set the scene for Health 2.0 and what it may mean. Mandatory reading for all those who are interested in understanding where consumer Health IT is going.

See also the following:

http://www.health2blog.com/2007/12/health-20-commu.html#more

Health 2.0 Community Present and Vocal as Markle Foundation Policy Meeting Discusses "Consumer Access Practices for Networked Health Information" by David Kibbe

This meeting held by the Markle Foundation near San Diego over two days last week may turn out to be the most important health information and technology policy meeting of the past 5 years. So I'll try to choose my words for this post very carefully. If this increases the length somewhat, I apologize for that in advance.

Vital stuff also!

Lastly we have:

http://www.informationprescription.info/report.html

Interim report on the information prescriptions pilot project

The Department of Health (DH) white paper, 'Our health, our care, our say', published in January 2006, made a commitment to improving access to appropriate information for people with health or social care needs. It stated: 'we propose that services give all people with long-term health and social care needs and their carers an 'information prescription'.’

From 2008, information prescriptions (IPs) will be given, in consultation with a health or social care professional, to everyone with a long-term condition or social care need. IPs will guide people to relevant and reliable sources of information to allow them to feel more in control and better able to manage their condition and maintain their independence. IPs will be nationally recognised as a source of key information on services and care that is seamlessly and formally integrated into the care process.

To ensure the successful design and delivery of IPs nationally, DH has recruited 20 sites to test and provide evidence of their effectiveness and their impact on the public, professionals and organisations. The information and momentum built through this piloting phase will be used to develop the final strategy for delivering the full scheme in 2008, when IPs will be rolled out nationally.

The project is being supported and evaluated by a consortium of three organisations – OPM, the University of York and GfK – and overseen by a project board of key stakeholders. The programme of evaluation and learning support activities commenced in February 2007 and will run until March 2008 when the pilot programme will come to a close.

The aim of the evaluation is to assess the overall effectiveness of the pilot programme along with the specific approaches being adopted across the 20 pilots involved in the programme. More specifically, the evaluation will help inform the four main goals of the pilot programme:

1. To shape the practical design and delivery of IPs nationally, including how the delivery will be supported nationally at the locality level
2. To provide evidence on the effectiveness and impact on the public, professionals, and organisations alike
3. To contribute to successful national implementation of IPs by 2008 to people with a long term condition.
4. To inform the policy direction, ensuring that the implementation of prescriptions is integrated with other major policy drivers

This is the interim report of the evaluation, covering the developmental stage of the piloting programme. More evidence on implementation and on user responses will be covered in the final report.

• Interim report - executive summary
• Interim report - the full version
• Annex to the survey chapter

The Consortium will continue to gather evidence from the pilots through monthly data collection returns, a second round of evaluation site visits and the second wave of the survey of users, carers and professionals. This work will inform the final report and the design of the closing conference, both of which will be delivered early next year.

If you have any comments on the content or implications for national roll-out, please email: information.prescriptions@dh.gsi.gov.uk

This is a fascinating initiative to try and improve the patient’s understanding of their illness and what they can do to improve their situation. I hope the trials work out well as this would be easily replicable in Australia.

All in all some interesting material for the week!

More next week.

David.

Flash: BCG Report to Be Made Public

In the Financial Review this morning there is some very good news:

See this link for details.

In essence the Boston Consulting Group will be public next week and as yet the Govermment's attitude to the future of NEHTA has not been made clear.

Radical change is surely needed.

David.

Leaks From the BCG Report on NEHTA so Far!

Well it seems a few lucky souls have seen the Boston Consulting Group’s Review of NEHTA report.

From what I have heard, so far, the key recommendation, as expected, is for a dramatically improved engagement process with external stakeholders and for greatly improved transparency and public accountability.

With these recommendations being received by the Board – and seemingly now reaching a range of the more senior bureaucrats in NEHTA and the Jurisdictions - the time for the report to be acted on, and made public, has now arrived.

It will be a major test of both the Board and the NEHTA management to have a prompt release of the report, with an associated action plan. Preferably before Christmas! (What a nice present!)

Sadly I fear the signs are not good with news reaching me on the grapevine over the last week or two that Standards Australia and NEHTA Ltd signed a formal Memorandum of Understanding in February 2007 – but neither body bothered to let their volunteers, who do much of the actual work, know they had been ‘volunteered’ to undertake this role.

Just who will be the owner of the Intellectual Property created by the volunteers remains very vague indeed.

I am told that, because of this, at least some of Standards Australia volunteers are now actively reviewing their continued involvement. This comes just as the work is becoming increasingly important for any national e-health progress to be made.

Talk about a need for better engagement processes and openness!

I wonder when the we will start to see some changes for the better?

NEHTA should remember that a document this important will either be published or will leak - it is up to them which way we all find out about their pros and cons. We have a new Government and the fascist-like spin control they have practiced in the past - to the detriment of all - will no longer be tolerated. It is in their interest to come clean before they are forced to - and are then obliged to seek 'alternative career options'

David.

HL7 Seems to be Making Some Useful Progress for the End of 2007.

A couple of interesting articles have recently appeared on progress being made by HL7.

The first is from the UK – while reflecting activity that is happening globally.

Interoperability gets more complex

07 Nov 2007

The NPfIT Local Ownership Programme (NLOP) will create further pressure on health care interoperability specialists, both within the NHS and its suppliers, with a huge devolution of general design responsibilities about to commence.

NLOP and the new Additional Supply Capability and Capacity (ASCC) suppliers will inevitably lead to greater variety in the new systems offered (to say nothing of existing systems), whilst raising expectations that these systems will interoperate and provide joined up health care for patients.

If anyone still believes that interoperability can be safely devolved to a black box in the corner, they need to wake up to reality. Interoperability is hard and expensive, not because it is intrinsically difficult, but because you have to specify and deliver exactly what you want. As with all things digital, interoperating computer systems are intolerant of the slightest error.

…..

A key benefit of HL7 then, is to tame this exponential explosion by delivering relevant specifications and, equally important, an ecosystem of conferences, working meetings, and other activities to support their maintenance and use. HL7 is a community of practice, which shares a common interest in enabling healthcare interoperability. As with any community of practice the enthusiasts do most of the real work, the contributors actively participate and the consumers lurk silently in the background.

…..

In practice HL7 covers an increasingly broad domain. It all began with HL7 Version 2 (V2) about 20 years ago, well before Tim Berners-Lee had even thought of the worldwide web. The present version, 2.6, is still backward compatible with the original. Version 3 was developed to overcome the obvious deficiencies in V2 and has spawned CDA (Clinical Document Architecture), now adopted by NHS CFH for all clinical messages.

The most advanced version of CDA has the exciting title of “CDA Release 2 Level 3”, and provides most of the advantages of both human readable and coded documents. The human readable part is the basis of the National Care Records Service (NCRS), enabling a nationally readable clinical record, while the coded part populates the Secondary Uses Service (SUS), for use by the bean-counters.

Other recent HL7 developments are the new TermInfo Draft Standard for Trial Use (DSTU), which specifies how SNOMED CT is used with HL7 V3; new specifications for web-services and SOA (Service-Oriented Architecture); and functional specifications for both PHR (personal health records) and EHR (electronic health records).

…..

Link

www.hl7.org.uk

Read the full article here:

http://www.ehiprimarycare.com/comment_and_analysis/271/interoperability_gets_more_complex

Also we had in the last little while.

Draft PHR Standard Model Approved

HDM Breaking News, December 6, 2007

Standards development organization Health Level Seven has approved the Personal Health Record System Functional Model as a draft standard for trial use.

The model defines a set of functions and security features that may be present in PHR systems and offers guidance to facilitate data exchange among PHRs or with electronic health records systems. The model is designed to help consumers compare PHRs and select one appropriate for their needs.

A draft standard for trial use enables the industry to work with a stable standard for up to two years and refine it so it can become an official standard. This means consumers can start requesting functions within the draft standard and vendors can start incorporating such functions in their products. The functions also can be incorporated into PHR certification programs.

….

The PHR functional model is available at hl7.org.

…..

For the full article visit:

http://www.healthdatamanagement.com/news/standards_PHR25313-1.html

All this activity must be seen as real progress and is to be welcomed. The scope and importance of this work is not to be under-estimated.

Most important are the Draft Standards for Trial Use (DSTU) in the more advanced and complicated areas. These allow for a period of stability while implementations are attempted and lessons learnt as to what actually works and where the problems and ‘wrinkles’ are.

This approach is so far ahead of the nonsense of ‘ex-cathedra’ pronouncements we see from NEHTA as to really make their behaviour and lack of actual implementation experience a joke.

David.

Flash : Which E-Health Organisation Is Taking a Six Story Building in Canberra?

Just a heads up for the NEHTA watchers.

I am told, by a reliable source, that outside a six story office in the Canberra CBD NEHTA is announced as the new occupant!

Would love someone from the fair city to confirm such is the case!

Seems NEHTA is planning a long and comfortable stay in the Nation’s Capital. So much for the BCG Report and a ‘new NEHTA’!

David.