Hi Oliver, If you want to know how it can be done properly for ambulatory care (i.e. GP and specialists) I suggest you browse www.cchit.org. They have it sorted for the US and it is pretty impressive how they plan to move forward I reckon.
Pity GP systems is not a focus for NEHTA so this could be replicated here. Imagine if there was a decent standard for functionality and interoperability that Australian providers had to meet. They might not be all that supportive of such a sensible move I fear as it might cost a few $$ and so on. I really recommend people on the list have a close look, with an open mind, as to what is going on here... It is a light year ahead of what we have in place and interestingly seems to match quite closely what we wanted from systems as far back as 1997. Cheers David ps The HL7 standard for GP functionality was agreed a few days ago in the US and is also a very useful starting point for anything we might want to do - updates the DSTU from a year or so ago. D. ---- Dr David G More MB, PhD, FACHI Phone +61-2-9438-2851 Fax +61-2-9906-7038 Skype Username : davidgmore E-mail: [EMAIL PROTECTED] HealthIT Blog - www.aushealthit.blogspot.com On Sat, 24 Feb 2007 16:00:37 +1030, Oliver Frank wrote: > [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/ .
_______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
