|
With regard to discussion arising
on GPCG list re: recent HL7 workshop on Webservices and SOA. I was the chairman and facilitator
of the web-services workshop which was run by HL7 in the interests of educating
ourselves and other about Service Oriented Architecture Models and the
Web-Services standards that underpin them. We also had an opportunity to hear
first hand from NEHTA after the release of their document on secure
communication in a technical forum and for them to get feedback. The
presentations were published as usual on CD for participants on the day and are
now available on the HL7 site (http://www.hl7.org.au/2006-WS.htm
) It was a constructive day and all got a fair hearing. There certainly
was some surprise at the complexity of the new Web Services direction and
distance that many of our vendors and their clients are from being able to
fully adopt web-services standards for communication. It was also clear that
not all communication can or should happen via web services and that there are
specific characteristics of the communication tasks which make Web Services
attractive. Michael Georgeff made the point that we need to look for these
applications in health and apply Web Services there initially. We had around 10 presentations from
vendors about their current and planned activity to use web services. My take
on Tom Bowden's presentation was that HealthLink feel that their current
models, particularly what they are doing in NZ lately, are closely aligned with
the new directions. Ross's presentation was focused on how Argus will assist
practices and vendors migrate from a predominately email (SMTP protocol)
communication to web services using a model that allows GP system time to
acquire the necessary infrastructure for full web-service communication. He
would see his approach as also being aligned with NEHTA directions The model Ross has proposed for development
of Argus uses the concept of a document repository which allows those who want
to communicate with a GP system to post a message that there is a document or
message waiting as many GP systems are not always “on”. This
register does not necessarily store the document centrally, more likely
contains the address where the document or report is stored so that the GP
system can look up who has messages for it and can retrieve them when it comes
online. This approach means that the GP system does not have to poll
every possible system that might want to communicate with it and uses the
register to know what is out there. Essentially it appears thanks to me
Argus is proposing to establish a hub for effectively holding messages (or
pointers to them) just like any of the other communication vendors. I am not
sure why this model is being singled out as incompatible with current NEHTA
directions. If it is then we should hear from NEHTA directly. Under a full web service model the
IT systems of small business enterprises (like GPs) would need to have the
capacity to be always connected to the internet and their software would need
to have additional web service functionality added. This may not sound like it
is too difficult, but in reality any wholesale change in the way things are
done, especially if it involves adoption of a standard is no light undertaking
and there has to be a business model to support making the change. What Ross has proposed is not
dissimilar to a model being widely considered internationally for electronic
access to health related documents (eg discharge summaries, test results,
even event summaries) under a group called IHE (Integrating the HealthCare
Enterprise). I posted a report from the US based EHR Vendors Association
several weeks back which described this model which is being backed by most of
the major US hospital EHR vendors. Likewise in the last few days the US
Commission on Conformance in Health IT (CCHIT) has published standards for
Ambulatory EHR function and communication. This requires community EHRs access
IHE XDS clinical document registers by 2007 and can make GP documents available
by 2008. The documents sharing model has also
been accepted as the direction by ISO and is under draft standard development
by How does this work? Basically this is a web service
based system with a document directory service that stores the location of the
document or record and allows the user to look up what documents exist for a
particular patient and access them via a web service. It is not
dissimilar in operational concept to an internet search engine - it is just
that the index is created by participating organisations pushing up just enough
data to identify the patient, document and its location to the directory. This model is being looked at as the
basis of Regional Health Information Organisations or Networks which provide
initially a locally based system for sharing health information (with
appropriate privacy and security) in the We expect to demonstrate how such a
regional health information network will work in this years interoperability
demonstration at the HISA meeting in August. (http://www.hisa.org.au/102243.php
) I think we are overlooking in our
discussions that the future communication in healthcare is more than sending
point to point messages, we have to have models to support referrals,
e-prescribing, and access to information as patients move around the system. In
these cases the user of the information may not be known to the sender. I will ask some colleagues from IBM
and Intersystems who are presenting this at the 2006 interoperability demo to
provide some more detailed information on IHE XDS to this group. I would
expect that given the traction the IHE XDS model is gaining in Europe, US, Asia
that we wil need to look more closely at it for use in Eg hospital discharge summaries Regards Peter MacIsaac MacIsaac Informatics Consulting in Health Informatics,
Terminology & Data management and Health Policy. 0411403462 (mobile) 61611327 (office) peter_macisaac (skype) "We trained hard, but it seemed
every time we were beginning to form up into teams, we would be reorganised. I
was to learn later in life that we tend to meet any new situation by
reorganising, and a wonderful method it can be for creation the illusion of
progress while producing confusion, inefficiency and demoralisation." - From Pertonii Arbitri AD 66,
attributed to Gaius Petronus, a Roman General who later committed suicide. -----Original Message----- From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Sent: Tuesday, 25 April 2006 6:31 PM To: Subject: Re: [GPCG_TALK] L Andrew N. Shrosbree wrote: > Tom, > > You evidently did not
understand a word of what Ross said at the conference. What did Ross say at the conference? Tim C _______________________________________________ Gpcg_talk mailing list http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk -- No virus found in this incoming
message. Checked by AVG Free Edition. Version: 7.1.385 / Virus Database:
268.4.5/322 - Release Date: 22/04/2006 -- No virus found in this outgoing
message. Checked by AVG Free Edition. Version: 7.1.385 / Virus Database:
268.5.0/325 - Release Date: 26/04/2006 -- No virus found in this incoming
message. Checked by AVG Free Edition. Version: 7.1.385 / Virus Database:
268.5.0/325 - Release Date: 26/04/2006 -- No virus found in this outgoing
message. Checked by AVG Free Edition. Version: 7.1.385 / Virus Database:
268.5.0/325 - Release Date: 26/04/2006 Regards Peter MacIsaac 0411403462 (mobile) "We
trained hard, but it seemed every time we were beginning to form up into teams,
we would be reorganised. I was to learn later in life that we tend to meet any
new situation by reorganising, and a wonderful method it can be for creation
the illusion of progress while producing confusion, inefficiency and
demoralisation." -
>From Pertonii Arbitri AD 66, attributed to Gaius Petronus, a Roman General who
later committed suicide. -- |
_______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
