Realisitically, it is the GP groups who have a major interest in
standardisation. Vendors have a vested commercialinterest in lock-in.
They are happy to implement import. Export is less important. The
MSIA publicly stated it was pursuing standards in 1998, but it is not
their primary job.
The GPCG's interoperability project/s were meant to pave the way for
standards/interoperability.
MSIA has been at the standards table since th early 1990s. It is
general practice that has dropped the ball.
Ian.
At 8:22 am +1030 15/3/07, Oliver Frank wrote:
Reply about this received from the President of the MSIA.
-------- Original Message --------
Subject: Re: Standards for software used in general practice
Date: Wed, 14 Mar 2007 11:36:15 +1100
From: Vincent McCauley <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]
References: <[EMAIL PROTECTED]>
Dear Oliver,
Thank you for your enquiry re MSIA and standards for software in General
Practice
The MSIA has been at the forefront of development of standards in Australia
for many years.
1. Standards Australia
MSIA has been represented on IT-14 (the peak e-Health standards committee)
for at least 5 years (when my involvement began) and in the past by a
General Practitioner
(Peter Schloeffel)
MSIA members provide significant input as active members of at least the
following committees (though this is not
comprehensive):
IT 14- 6 (Messaging)
IT14-6-5 Diagnostic messaging (Pathology/Radiology ordering and results)
IT 14-6-6 Collaborative Care Communications (REF message)
IT14-9 and IT 14-9-2 EHR
IT 14-2 Health Concept representation
MSIA has been instrumental in getting diagnostic messaging to the point
where it is widely used in private practice and have been promoting the
implementation
and use of e-referral via the REF message standard.
MSIA has been a joint sponsor since its inception
of the HISA/HL7 HIC Interoperability demonstration showcasing
implementations of Diagnostic and Referral messaging as well Health
Identifiers and various
standardised models of EHR including OpenEHR.
MSIA has encouraged domains implementing messaging to be compliant by its
support for AHML's message testing facility and opposing attempts by
specific interest groups
(e.g. NSW Health's non-compliant REF message implementation) to go their own
way.
2. NeHTA
Medications Terminology - A joint MSIA/HL7 task force, following a week long
hot-house workshop,
formulated an agreed medication terminology in 2004 at the request of DoHA.
This was handed to NeHTA as its first work item in late 2004, to populate.
We have yet to see any usable outcome from this process. A proposal from
MSIA to
populate the model using existing industry processes was rejected despite
its low cost
(compared with the NeHTA process) and its proposed 6 month delivery
schedule.
SNOMED - MSIA has long been supportive of the use of a common terminology
for e-Health and welcomed the adoption of SNOMED.
However we were extremely disappointed that
the subsequent Australian SNOMED licence negotiated by NeHTA (without
industry
consultation) was not commercially viable.
Despite approaches by MSIA, legal opinion about the problems with the
licence and acknowledgment by NeHTA that this was an interim licence not
intended for
commercial use, there has been no further progress. NeHTA have however
undertaken
to provide a new, more commercially oriented SNOMED licence, in consultation
with industry, once the International SNOMED Standards Organisation is
fully established.
NeHTA have further muddied the terminology water by recommending the use of
SNOMED for pathology order and result codes.
SNOMED is not used for this in any other domain (including the USA) as LOINC
has
been designed specifically for this purpose and has been successfully used
for many years. LOINC is also the recommended terminology in the current
Standards Australia diagnostic
messaging standard (AS4700.2).
MSIA have taken part in two joint industry meeting/workshops with NeHTA in
the last year. In addition the chair of NeHTA was invited to
address the MSIA AGM 2 years ago where he informed the local software
vendors that cooperation and consultation with them was unnecessary as the
large Internationals would be implementing the NeHTA agenda.
MSIA has established a liaison officer with NeHTA to improve communication.
However, despite these efforts, there has been a lack of effective
interaction. NeHTA
had the potential to break the deadlock of government indecision and
cross-border issues related to the States, but
has so far not been able to deliver usable solutions.
4. Government.
MSIA is represented on the Medicare Stakeholder Consultation Group (SCG) and
was also represented on its predecessors (SAC and DCG).
In addition an MSIA observer attends ECLIPSE
working group meetings but MSIA has been denied membership of this group
despite representations to Medicare to be represented at either the working
group or Board level.
MSIA has encouraged Medicare to use standards wherever possible in its
software offerings. However, Medicare has chosen not to do so and this has
been a
major factor in the high cost of implementing and maintaining claiming
solutions, including setting up
their own software certification process.
Medicare is not even able to supply the MBS schedule in anything other than
its own "home grown" format.
PBS have recently liaised with the MSIA to implement PBS Online and
availability of the PBS schedule and yellow book as
an XML file. This work has been happening for over 2 years in the PBS Online
and Pharmbiz joint MSIA/PBS working groups and
has resulted in delivery of this information in a standardised (XML),
industry
agreed format downloadable from the web. Unfortunately the hoped
for Australian Medicines Terminology has not been able to be incorporated
into this work.
MSIA, along with other industry groups, was instrumental in getting the
Federal Government to put in place last year
an Industry Action plan for e-Health. One of the central tenets of the
Action Plan is implementation and certification of Standards.
Unfortunately, since its approval by Federal Cabinet last year, DoHA have
not moved forward with the Action Plan. I am hoping a series
of planned meetings with the DoHA later this month will produce some
"action".
DoHA at present has copyright over a number of software products developed
by MSIA members
based on standards. These products such as the e-Redbook, e-Lifescripts and
Integrated Care Program
were DoHA and in some cases GP funded, and it was the stated intention that
they should be released
to the medical software community as standardised building blocks for
processes such as
incorporation of electronic clinical guidelines. This however has not
occurred despite the elapse
of a number of years and approaches by MSIA to DoHA. Release of these
products would be
a major contribution to standards based interoperability.
5. IHE - Integrating the Health Enterprise. This process for integrating
existing standards to provide an interoperability profile is
well entrenched in the USA and Europe. It is a User lead, Industry driven
process.
MSIA has joined with HL7 and HISA to promote IHE in Australia as a means of
standards based interoperability commencing 2 years ago.
However, it has proven difficult to get User and Government buy in and this
is an on-going focus.
6. MSIA formed an interoperability sub-committee last year chaired by John
Johnston from Pen Computers.
A report from this group on the way forward to an industry standard for data
export from heterogenous desktop systems will be presented at the MSIA
Roundtable to be held in May.
The major desktop vendors and Ocean Informatics are part of this
sub-committee.
I hope that is helpful. Please do not hesitate to contact me if you would
like any clarification.
Regards
Vince
Dr Vincent McCauley MB BS, Ph.D
President, MSIA
----- Original Message -----
From: "Oliver Frank" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Tuesday, February 27, 2007 4:57 AM
Subject: Standards for software used in general practice
Dear Vince,
There is currently a discussion amongst GPs on email discussion list
about why there are no Australian Standards for clinical software used
by Australian GPs, when there are Australian Standards for many other
goods and services.
I understand that the Standards published by Standards Australia are
developed when an industry decides that there should be some Standards
for its goods or services, and that the industry funds the development
of the Standards.
What is MSIA's policy about Standards for clinical software used by
Australian GPs and what are its activities in this area? Does MSIA
believe that there should be standards for clinical software used by
Australian GPs? If not, why not? If MSIA believes that there should be
standards for clinical software used by Australian GPs, what has it done
in the past and what is it doing currently towards creating and
implementing suitable Standards?
I would like to share your answer with my GP colleagues.
I look forwards to MSIA's reply.
--
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
--
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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--
Dr Ian R Cheong, BMedSc, FRACGP, GradDipCompSc, MBA(Exec)
Health Informatics Consultant, Brisbane, Australia
Internet: [EMAIL PROTECTED]
(for urgent matters, please send a copy to my practice email as well:
[EMAIL PROTECTED])
PRIVACY NOTE
I am happy for others to forward on email sent by me to public email lists.
Please ask my permission first if you wish to forward private email
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