This went up a day or so and it is reproduced with permission.
Clinical Messaging in Australia
Posted on March 28, 2019 by Grahame Grieve
The Australian Digital Health Agency is working hard on replacing faxing with secure messaging. Peter MacIsaac discusses one of the ancillary challenges this causes in Pulse IT today:
“The second barrier to successful cross-transfer of messages is that the messages sent by almost all health services do not comply with Australian messaging or vocabulary standards.
Likewise the major clinical system vendors are not capable of processing a standard HL7 message, if one were to be delivered to them. Senders and receivers have each interpreted the international HL7 messaging standard independently of the agreed Australian standard and associated implementation guidelines.”
I don’t think this quite expresses the problem – while there definitely are problems with non-conformance, there are also areas with the Australian standards are simply not detailed enough, and a lot of the problems are in this area.
Peter also recalls that we discussed this:
“A collaborative effort to achieve networking by messaging vendors some eight years ago was run in a process facilitated by IHE Australia, HL7 Australia and the MSIA”
Indeed we did, and we came up with a list of issues with implementations that went beyond non-compliance with the standards. I later wrote these up for MSIA, but the MSIA never published this document and pushed for conformance to it – another lost opportunity, from my point of view. Since the document was never released openly, here it is:
MSIA Clinical Messaging Profile Download (The document date is 2011)
Looking back at this – the document format rules around pdf, rtf, etc. are problematic – that’s the set of rules that we required then – and pretty much still do now – to get true clinically safe interoperability. But I don’t think many implementers in the industry can actually implement them – they depend on libraries that just don’t have that kind of control. To me, this underlines the fact that clinically safe interoperability is always going to be work in progress, since we need better standards compliance than the wider industry (so far as I know)
----- End Article.
It should be noted that this shows one aspect of the work that is needed and right now is not happening with any speed! There are a lot of other parts to also be addressed.
After all this time I wonder why this 2011 effort did not make more progress. Anyone with deep history knowledge of all this?
I look forward to some interesting comments on how far we have to go to make ‘axe the fax’ anywhere near reality – despite the ADHA propaganda.
David.
ps. Away from the article can I just comment on the 'Axe the Fax' nonsense. The fax machine will be phased out when the vast majority of actors in the health sector have access to reliable, trustworthy and secure clinical messaging. This means virtually all specialists, GPs, Hospitals Labs etc. and Allied Health. This is what determines when the axe falls and I would be surprised if it is done in under a decade. What is your call?
D.
ps. Away from the article can I just comment on the 'Axe the Fax' nonsense. The fax machine will be phased out when the vast majority of actors in the health sector have access to reliable, trustworthy and secure clinical messaging. This means virtually all specialists, GPs, Hospitals Labs etc. and Allied Health. This is what determines when the axe falls and I would be surprised if it is done in under a decade. What is your call?
D.
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