Dear colleagues,
In his communique from the MSIA Round Table held on 22nd May 2007,
available at:
http://www.msia.com.au/
Peter MacIsaac says:
"Health Communication Systems Working Party
Communiqué for MSIA round table:
Electronic communication between healthcare information systems is an
important component of the health IT industry and our national
healthcare system. There are numerous benefits in extending the use of
e-communication, both in efficiency and improvements in patient care. It
is accepted that progress to move from paper and fax is slower than
desirable and that problems with current communication systems need to
be overcome to ensure a solid basis for expansion of e-communication in
areas such as electronic ordering, e-prescribing, and communication
between healthcare providers in the community. Australia has a number of
commercial communication service providers who are providing reliable
services, yet it is acknowledged that these systems are based on a range
of communication standards and business models which have prevented
interoperation between communication systems. The problems to be
overcome also include issues with implementation of messaging standards
and lack of standard vocabularies which lie with health application
systems vendors.
An open membership working group has been formed to tackle these
problems under the auspice of the Medical Software Industry Association
(MSIA), Health Informatics Society of Australia (HISA) and HL7
Australia. The current industry membership is:
• Argus Connect
• eClinic
• HealthLink
• Medical Objects
Members of this group will work on a technical solution to enable end
users, such as GPs, Specialists, Pathology and Radiology Services, and
hospitals to contract with one provider, should they choose, and that
communication can be directed to any recipient."
I believe that currently each vendor of a clinical messaging system
maintains its own directory of its users, which users access in order to
direct their message to the recipient, who must also be a user of that
clinical messaging system. When the messaging standards and formats
have been sorted out by the working group outlined above to enable users
of any messaging system to send their messages to users of any other
messaging system (e.g. a Healthlink user sending to a Medical Objects
user), what will become of the current proprietary user directories?
How will Healthlink know how and where the Medical Objects user is and
more importantly the details of the Medical Objects user's digital
certificate, email address, etc.? Will there be some kind of master
directory, and if so, who will own and operate it, who will pay for it
and who will profit from it?
In South Australia, the State funds the SA Divisions of General Practice
SBO (SADI Inc.) to operate a not for profit database (the Health
Provider Registry) of GPs' and medical specialists' contact details.
The database includes doctors' practice email addresses and digital
certificates, which the public hospitals use to deliver discharge
summaries as PDF attachments in encrypted email messages. Currently the
contact details of other health professionals such as allied health
professionals and organisations such as residential aged care facilities
are being added to the Health Provider Registry. Could and should the
Health Provider Registry be used by the clinical messaging providers to
get the information that their system needs in order to be able to send
messages to users of another messaging system?
I'm not sure what would be done for other States. Will there need to be
a national database, in which case would AGPN or some other not for
profit organisation own and operate it with government funding? Our
current federal government seems to have been disinclined to fund this
kind of necessary infrastructure and always talks about leaving it to
the market to sort out. I don't know whether Labor would or will act
any differently if and when it comes into power. I hope that Peter
MacIsaac can tell us the MSIA working group's plan for sorting out the
user directory question.
--
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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