Oliver Frank wrote:
john hilton wrote:
I don't think governments should dictate the software and I don't
think it is up to "us" to write the programs, but if someone (I guess
it comes back to governments) set the standard ( These are the
database fields- you must conform to them) then the softwares would be
a degree of magnitude more open.
I would be happy for government to set the standards, as long as the
standards are developed in conjunction with our professional
organisations and medical software providers (commercial and
non-commercial), and those professional organisations and software
providers agree to the proposed standards. What we don't need is a
bunch of government bureaucrats who are not GPs sitting around,
consulting secretly with expensive non GPs, and then trying to dictate
standards for which there is not widespread support or which are
unworkable. NEHTA is working on standards, but I haven't yet seen
anything come out of NEHTA that seems very relevant to general practice
informatics. Ian Cheong and others who are better acquainted with
NEHTA's activities may be able to tell us if I am wrong about this.
In late-February 2006, NEHTA released the “Review of Shared Electronic
Health Record Standards”.
In respect to the use of CEN EN13606 as the Australian Shared EHR
Architecture Standard, this can only be regarded as “a specification for
exchange of EHR Extracts” and cannot act in the capacity as a full EHR
system; hence the nomenclature of Shared EHR Content.
The CEN EN13606 standard through the absence of a complete reference
model is unable to furnish functionality to an electronic health record
set. The base ontology of CEN EN13606 is therefore considered to be
limited in its ability to define clinical concepts within a pre-existing
and robust ontology.
I'm thinking that no further progress will be made in defining a
standard complete EHR model for use within primary care; more so that a
clinical information system should be capable of outputting an extract
based on CEN EN13606. Game on...
Andre.
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