[EMAIL PROTECTED] wrote:
It is an interesting suggestion that practices should only use clinical software
that has been approved by AGPAL and is itself- accredited, by a new set of
clincial software standards which is being mooted by Drs and Practice Managers.
AGPAL and GPA do not set the standards for practices. The RACGP sets
the standards and the accreditation organisations decide from their
inspections whether a practice meets those standards.
Who do you believe would set the standards for clinical software? If
not the RACGP, what are your reasons for nominating another organisation?
Suggestions for these new standards for clinical software are:
1. Acknowledgment and Response to users wishes with bug fixes, wish lists,
patches and updates - in a timely manner- reflective in a Users Participation
Survey
I want my clinical software to know when I will be walking in to my
surgery in need of a strong cappuccino, to order the cappuccino from the
coffee shop across the way and have it delivered to my desk in time for
when I sit down at it. If my clinical software vendor doesn't respond
to this important wish on my wish list by developing and installing this
very useful and much-needed feature within three months, I will give the
vendor a bad rating in the AGPAL Users' Participation Survey.
Are you seriously suggesting that AGPAL or anybody else could work out a
way of rating a software vendors' quality of service in order to decide
whether that vendor's product should be accredited?
If I do rate my vendor's responsiveness to my demand for a prescient
cappuccino-making function as grossly inadequate and that vendor or that
software package fails to gain or loses AGPAL's accreditation, under
your proposal one of the consequences will be that my practice will lose
its own accreditation because it is using non-accredited software. This
may not be the outcome that you had in mind.
Why is software the only thing in a practice
which doesnt have to comply to some sort of standard!! Everything else does.
I am not sure that this is true. There is not a standard governing
every single good or service. It is my understanding that Standards
published by Standards Australia come into existence only when an
industry decides that there should be some standards for the goods or
services produced by that industry, *and* when people and organisations
in that industry commit their own time and money to the development of
those Standards. The development of Standards is not funded by government.
If this explanation about how Standards are developed is correct, one
would expect the companies and organisations in the medical software
industry to initiate *and fund* the development of appropriate Standards
for their own industry. Why haven't they done this? I suspect that one
reason is that they haven't felt the need, another is that they don't
actually have enough resources to fund such an exercise, and a third
may be that technological change will rapidly invalidate any Standards
that are developed. I am not sure about any other reasons. I would be
interested to hear from the Medical Software Industry Association its
reasons. I will ask it and share the answer with the list.
Alternatively, do you believe that GPs through one or more of our own
organisations e.g. RACGP, ACRRM, AGPN, AMA, etc. should develop
standards for clinical software? Do you believe that GPs will be
willing to devote enough of their own time and money to develop the
standards *and* to test clinical software against those standards,
keeping in mind that every new version of each software package will
need to be tested?
Those of us who are nearly as old as Greg Markey will remember that in
1988 the RACGP under Dr. Michael Crampton's direction developed and
published a set of standards for computer medical record systems, and
offered to examine clinical software packages against this set of
standards for a fee. The creation of these standards was a significant
innovation that was recognised around the world. I witnessed this myself
in 1993 at the conference of the British Computer Society in Harrogate,
when a computer scientist working for the NHS' Sapphire software testing
program held up the RACGP standards document and talked about its
importance.
Only one company, Medrecord, applied for the RACGP's software
accreditation and if I remember correctly its software passed the test.
I also remember very well the claim from other software vendors and
from other parties that the standards had been written to suit
Medrecord, with which the RACGP jointly was conducting the
Computer-Assisted Practice Project (CAPP). The CAPP project was to
examine the effects on practices and on quality of care of implementing
clinical computer systems. Ross Davey was, I think, an executive of
Medrecord at the time and Peter MacIsaac ran the CAPP project. They and
Michael Crampton, if he is reading this or somebody points it out to
him, may care to comment or to tell you more about what happened at the
time.
A few years later IBM was funded by Australian federal government to
produce a set of specifications of essential and desirable functions of
clinical software. IBM did a good job and produced a sensible and
comprehensive report, but despite general approval of that report, it
was never put to any real use and is now largely out of date. In the
early 2000s, General Practice Computing Group addressed the challenge of
software accreditation and funded some work to try to develop a system,
but we all know what happened to GPCG. So you see, this idea of
accrediting software is not new and has a long history in Australian GP
informatics, still without any system of accreditation having been
developed.
What about ISO9000 ?
Can you say how expecting software vendors to gain ISO 9000
accreditation would achieve what you are looking for? At least one or
two software vendors do have ISO 9000 series accreditation. For example
Hatrix displays the ISO 9001 logo on its Website at
http://www.hatrix.com.au/ .
--
Oliver Frank, general practitioner
255 North East Road, Hampstead Gardens, South Australia 5086
Phone 08 8261 1355 Fax 08 8266 5149 Mobile 0407 181 683
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