Yesterday NEHTA released their Version 1.0 Interoperability Framework. At the highest level this document attempts to define how the actors in the Australian e-Health domain are intended to move towards interoperability.
The document is not for the faint-hearted as it is a complex piece of work written in a style that makes no concessions to the technical or health understanding of the audience (which is said to be senior people in the e-health community in Australia essentially).
It seems to me that the value of a document such as this needs to be assessed on the value it provides to its intended audience and the change it will justify and sponsor in e-Health activities in Australia.
I think it would be fair to say the reaction thus far has been along the lines of suggesting the paper is part of an R&D program and that only once more detail and guidance is provided will much value be delivered in the real world. When e-health software developers and vendors are asked "what will you do different tomorrow?" the answer seems to be universally "Nothing".
I have reviewed the document quite carefully and my comments are as follows:
1. This is clearly a "work in progress" and should not be considered in any way final or to be offering firm guidance - consultations on its impact are still to happen with NEHTA's owners.
2. The document as it presently exists does not review available options to many of its recommendations or explain the basis for its selections.
3. The document admits much of its basis is unproven and may not be available for 3-5 years - adoption of the "bleeding edge" approaches is not wise in a sector as conservative as Health I believe. It is possible the keenness for SOA may pass as implementation experience is gained in large complex environments.
4. The proposed standards catalogue does not have scope to hold the full range of available standards that may address a topic and explain the reasons for selection of the preferred ones and at what point such preferences may be reviewed.
5. The theoretical approach adopted and the time frames suggested do not really confront the urgent need for technology to enable Health System Reform as soon as possible.
6. It is, again, not clear, just what is the strategic and requirements context in which this document was developed. There is discussion of development of undefined NEHTA solutions and this must be a cause for concern given the track record of NEHTA like organisations in the software development area.
7. It is by no means clear just what is planned to fall under the influence of this framework - given that at present it is far to vague for any practical implementation.
8. Given legacy systems can last 10+ years in this sector - it is vital to know how these are to be dealt with and have this provided in a route-map provided for all to review and discuss.
9. Yet again archetypes are cited as a good thing - but yet again there is no explanation of how the required information infrastructure is to be developed and managed.
All in all I don't believe this document adds much that is useful to progress in e-Health in Australia. It would have been better to have a much broader consultative process before Version 1.0 was reached so at least some of the issues I and others have raised could have been addressed.
David
1 comment:
Is NEHTA correctly positioned to fulfil its destiny?
NEHTA appears to be evolving into the nation's leading R&D organisation focussed on HealthICT.
If this assumption is correct it will probably be many years before the marketplace and indeed industry will be able to avail themselves of the benefits which may flow from NEHTA's R&D. In that role NEHTA has many complex problems to solve; problems that the rest of the world has wrestled with well before NEHTA was born and will continue to wrestle with well into the future.
There are no guarantees that NEHTA will deliver acceptable workable answers. In many instances it won't be able to because, as it evolves in its R&D role, it will need to establish further projects to wrestle with new and complex problems as they emerge from the maturation of its current R&D activities.
The ICT industry needs to work closely with NEHTA but not be dependent upon it for outcomes. The jurisdictions and potential end-users should support NEHTA's work where politically and commercially practicable but not allow themselves to be seduced into thinking NEHTA will deliver solutions to all their problems - this year, next year or five to ten years hence.
Rather, the jurisdictions and potential end-users should get on with business as usual and not wait for a magic wand to be waved from above. They should view NEHTA as an R&D organisation with a worthwhile purpose, hopefully one day providing some practical answers which industry may be able to embrace in a commercially pragmatic way.
Dr Ian Colclough
Integrated Marketing & e-Health Strategies
Balwyn North VIC 3104
(m) 0412 059 392
(e) ihsipl@smartchat.net.au
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