Hi Tim,
In broad terms I strongly support your suggestion for careful consideration of reform of the way Health IT standards are developed and promulgated.
Other problems I see are:
1. Australian standards often incorporate CEN or ISO standards - and they then wind up on occasions as a list of Australian changes to the original from Europe or where ever. Unfortunately the original is not free so you can make no sense of it without buying the International one as well - this is especially relevant in the EN13606 EHR area.
2. To really participate - not only do you need to know what is going on in Australia - but without being really up to date with US and Europe - i.e. attending all the CEN/ISO/HL7 etc meetings. Without this it is very hard to make sense of what is going on. This greatly restricts the standards 'gene-pool' to those who are government funded or rich - and these preferments go to those who are spending the time to do stuff in Australia. So yup - unless you have time to go to lots of meetings and spend a lot of time contributing you are basically out of the loop.
3. As I said yesterday - the Standards functions of NEHTA and Standards OZ should have been sorted out ages ago - not still be being worked on.
4. Also as I said yesterday - without the big picture national e-health picture and strategy what to do first is pretty hard to know. As the work in Canada from Infoway and the US CHI initiative showed there are a lot of standards done, a lot of gaps and a lot of decisions required. These should be as open and inclusive as possible.
I wish you luck with it!
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 Sun, 19 Mar 2006 09:57:38 +1100, Tim Churches wrote:
> Ian Cheong wrote:
>> At 7:27 am +1100 19/3/06, Tim Churches wrote:
>>>> Participation is not restricted to standards australia committees, except in properly
>>>> constituted committees which are that way to ensure balance of interests are represented.
>>>> Like many interest groups, people who are actually interested are able to participate. And
>>>> the open public
>>>> comment period is open to all comers with any views.
>>>>
>>> My view is that reform is needed to ensure that the membership of the committees is
>>> representative and diverse (not the same people on every committee), and to enable input from
>>> interested parties to be harnessed at a much earlier stage of standards development, and to
>>> provide a mechanism by comments are acknowledged, discussed and accounted for (even if they
>>> are ultimately not reflected in the nascent standard).
>>
>>
>> The Standards Australia has had joint/open committee meetings in the last two years - open to
>> all comers and widely advertised.
>>
>> Actual committees do have diverse membership and Stadards Australia project managers have a
>> duty to ensure balance and appropriate representation.
>>
>
> Ian, if I go to the Standards Australia standards development web site
> (http://www.standards.org.au ), there are no lists that I can find of what standards are
> currently under development, who is on the committees for those standards, how one gets on the
> committees and so on. Fixing those things is the sort of reform which the NEHTA document is
> hinting at, I think. There is an "in the pipeline" section of the Standards Australia Web site,
> but I defy anyone to work out what health IT standards are in the pipeline using those Web pages.
>
>> The mechanism by which comments are acknowledged, discussed and accounted is well developed and
>> in fact many/most comments are ultimately reflected real standards, as people who have made
>> comments could attest.
>>
>
> Where can I read the comments submitted by others on draft standards? That's a key feature of the
> IETF RFC process: transparency, which helps to avoid duplication as well as making conflicts of
> interest apparent.
>
> A search on "conflicts of interest" on the Standards Australia web site reveals no hits (except
> to some irrelevant US investor legislation). So how do I find out what the Standards Australia
> policy on declaration of conflicts of interest is, and where can I read some of those
> declarations? That's the sort of reform I was thinking of.
>
>> The biggest problem is that participants must be "voluntary" - ie not be paid for by Standards
>> Australia - so they spend their own or their company's or their organisation's time. There is
>> always room for more volunteers.
>>
>
> Sure. But potential volunteers need to be able to a) know what is going on and what is planned b)
> examine work-in-progress, not just late-stage drafts; c) see what comments others have submitted;
> d) be able to do all of this asynchronously, without having to attend meetings in-person during
> business hours.
>
> Can't do any of that at the moment, as far as I can see - correct me if I am wrong.
>
> Also, there is the issue that Australian standards, developed through volunteer work, but which
> are only available on a commercial basis through the business arm of Standards Australia, SAI
> Global (see http://www.saiglobal.com/ ), which is a publicly-listed company traded on the
> Australian stock exchange and hence has a fiduciary interest to its shareholders to make a
> profit. There is something amiss in those arrangements...
>
> I appreciate that standards development costs money, but my view is that reform of the
> development process and better use of the Internet can reduce those costs to the level that NEHTA
> and/or other govt agencies can just directly fund the development of standards which are then
> freely available to everyone under a suitable license.
>
> Yes I know that AGDoHA has paid SAI Global to make all the health IT standards freely available,
> but will that arrangement last forever? I doubt it, and I think that the question needs to be
> asked (and NEHTA has perhaps asked it, obliquely): is the current model the one we want to
> continue with?
>
>> Please feel free to write to Standards Australia with any concerns. There is always room for
>> improvement in any organisation.
>>
>
> Ah hah! I just looked at the Contacts page on the Standards Australia web site, and behold, there
> is a promising-sounding link to http://www.committees.standards.org.au/
>
> Nope, spoke too soon:
> "Firefox can't find the server at www.committees.standards.org.au"
>
> Hmmm, that links now seems to be working again, and one can see the work programme for IT-014,
> and the list of nominating organisation for the IT-014 committee, but there is no list of who is
> actually represented and who the representatives are on the committee, and the meeting minutes
> don't list who was present or who said what. And the whole process seems to revolve around
> committee membership - it is not exactly accommodating to contributions from those who can't be
> the IT-014 on committee due to lack of time or lack of the right organisational connections
> ("connections" not used in the perjorative sense).
>
> How can we harness contributions from people like Peter Machell, or Horst herb, or David Guest,
> or Tony Lembke, or Tony Eviston, or John Dooley, or Duncan Guy, or Liz Dodds, or Ian Haywood, or
> many, many others who have lots of useful, really practical things to contribute to health IT
> standards development but no time to sit in committee meetings?
>
> A spot of reform wouldn't go astray, methinks. What do others think?
>
> Tim C
>
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