To quote from the spec: "It is important for readers to understand the philosophy behind specifying referral content as comprehensively as appears in this specification. There is a wide diversity of stakeholder opinion regarding:- • how prescriptive a referral template should be, in terms of structure; • how prescriptive a referral template should be, in terms of comprehensiveness; • how prescriptive a referral template should be, in terms of the terminology used; • the burden imposed on clinicians creating referrals; • the burden imposed on clinicians receiving referrals; • the burden on clinical information systems to capture, send and/or receive and process structured information
It is quite clear that any one referral is unlikely to contain the full suite of details embodied in this specification. However, the specification needs to cater for capturing and sharing quite comprehensive information where it can assist the recipient provider in understanding the patient’s condition as fully as possible. In order to achieve this, and the semantic interoperability required for decision support systems, it is necessary to be prescriptive with respect to structure, information richness, and terminology. Similarly, this specification is primarily designed to support future clinical information systems that reduce the burden of data entry for the referring provider, and the subsequent data interpretation, storage and manipulation by the referred-to provider. Thus, both the specification proper, and the samples in Section 4, should be viewed as indicating the richness of information that can be expressed, sent and ultimately imported into recipient systems and shared EHRs, and not as the set of information that must be sent, irrespective of the condition of the patient and the purpose of the referral." The number of fields which are considered obligatory is relatively low, but the data they hold should be well defined and therefore able to be used usefully by clinical systems. Unless there is a comprehensive spec then there is the danger that fields will be used in ways that was not intended, and at that point it breaks down as a method of transmitting useful data, and then the whole cycle of earnest debate starts again. Michael Tooth (not involved in this project, but glad to see some results none the less) John Mackenzie wrote: >> NEHTA have just released the General Practitioner and >> Specialist/Critical Care Referral Data Content Specifications v1.0. >> Its a small document of some almost 500 pages. You can find it here. >> https://www.nehta.gov.au/index.php?option=com_docman&task=cat_view&gid=176&Itemid=139 >> <https://www.nehta.gov.au/index.php?option=com_docman&task=cat_view&gid=176&Itemid=139> >> >> I am curious to know from the technical experts among this group. >> 1. Just how practical, implementable and workable is this specification? >> 2. How likely is it that any system developer will implement it in the >> forseeable future? >> 3. Do people think this project is adding anything that will make a >> difference to health service quality and safety anytime soon? > > > OMG :-o > > I have perused the 500 pages, and am agog ... > - NeHTA state that there is an increase in patients with > chronic disease requiring multidisciplinary management [agree]. > - NeHTA's vision (I think) is for there to be an EHR which > can be standardised/formatted so that a referral template will > contain information for communication to the various health > care providers [good vision]. > - The problem is that the amount of information (number of fields) > that NeHTA is proposing is soooo large that the whole schema > becomes unworkable. A bit like an episode of Maxwell Smart > (agent 86) where Smart obtains some information from agent 13 > who is hiding in a cigarette machine, then - > 86: Thanks. While your there,13, can I have a pack of cigarettes. > 13: Filtered or non-filtered. > 86: Filtered. > 13: Menthol or non-menthol. > 86: Non-menthol. > 13: King-size or regular. > 86: Forget it. I just broke the habit :-) > > My answers to David's 3 specific questions would be: > 1. I don't think the HeHTA schema is practical/ implementable/ workable. > 2. I don't think that a system developer would be able to implement an > EHR with this level of complexity in the foreseeable future. > 3. I don't think this project adds anything that will make a difference to > health service quality and safety anytime soon. > > Horst (if he has a moment to just skim the 500 pages) would provide > a much better opinion. (I would be better at just pruning the NeHTA > extravaganza down to workable size). > > John Mac > _______________________________________________ > Gpcg_talk mailing list > [email protected] > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > > _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
