Hi David,
As far as I can tell from reading the recent NEHTA documents there is the intent to create a secure messaging network - based on SOA - that will allow the flow of current information.
Thus far there has not been any reference that I have seen to the concept of a record locator - as envisaged in the Markle Connecting for Health Project (see www.markle.org) in the US and which has now been successfully tested - last week announcement (use google news and "Markle Foundation" for details.
While this is the case - and no central repository is proposed (and I understand that is off the agenda because of the very considerable costs,complexity - to say nothing of the issues surrounding privacy, optin/out and the legal use of a summary record) - and information sources are not on line to be looked up / queried in a secure fashion your scenario fails.
Note that to do individual patient record linkage with the accuracy needed for assembling a patient record needs very robust identification approaches - and these cost big $$ to implement. I would hardly trust a record assembled on the basis of a Medicare Number.
There are all sorts of ways to skin your cat - including an NHS Spine approach, The US - Markle style approach - the use of high integrity smart cards to carry the record etc...but each of these costs billions to implement in a country of our size..and no one wants to spend. Sorry to generalise your question - but that's how I see it. I will cross post your e-mail into the Aust College Health Informatics List and see of others have other ideas.
David - while ever NEHTA fails to provide a public outline of their overall planned direction in terms to satisfy professionals like you and the interested community I will remain a critic. A publicly funded and owned organisation like them should not drip feed information like this. Issuing an interoperability statement here, a web services standard there is not the clear strategic vision we all need to know what to plan for and do next.
My suspicion is that they have not worked it out yet - and are like the duck swimming on the pond - smooth on the surface and lots of paddling underneath.
We will wait and see - and we should not be.
Cheers
David
---- Dr David G More MB, PhD, FACHI Phone +61-2-9438-2851 Fax +61-2-9906-7038 Skype Username : davidgmore E-mail: [EMAIL PROTECTED] On Sat, 11 Feb 2006 14:40:44 +1100, David Guest wrote:
> Tim Churches wrote:
>
>> David More wrote:
>>
>>
>>> Progress Towards Electronic Health Records
>>>
>>> To underpin the efforts in refocusing the health system to promote better health and
>>> community care for all Australians, COAG agreed to accelerate work on a national electronic
>>> health records system to build the capacity for health providers, with their patient's
>>> consent, to communicate quickly and securely with other health providers across the hospital,
>>> community and primary medical settings. The Commonwealth will contribute $65 million and the
>>> States and Territories $65 million in the period to 30 June 2009.
>>>
>>
>> That sounds less like the former HealthConnect vision of huge, shared,
>> central repositories and much more like a vision of a far more
>> distributed electronic health record (or rather, an "electronic health
>> record system") enabled by quick and secure communication. OK, I have
>> just restated the preceding paragraph - but my point is that the
>> emphasis is on secure communication (implying between distributed
>> clinical information systems or repositories), not on shared central
>> repositories.
>>
>> Is that correct?
>>
>>
> I was wondering if someone could paint the end user picture for me now
> that we will shortly have a secure distributed electronic health record.
>
> I am sitting in my surgery with Medical Director in front of me and the
> patient beside and have access to lots of data from my own sweat of the
> brow and from those specialists, pathologists and radiologists to whom I
> have referred the patient. The patient tells me the name of the last
> doctor they saw on holiday, the hospital where they were admitted and
> their Australian patient identification number. What's next? I can see
> various scenarios and impediments to their implementation but would be
> interested in those with the vision thing.
>
> For my own part, I would like *my *medical record to clearly delineate
> the "not invented here data" of which I now have a ?permanent copy.
>
> David
|
_______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
