I only noticed this a few days ago and felt it was worth a mention.
How does Australian interoperability become reality?
March 21, 2019
How do we take our current and somewhat vaguely expressed desire for improvement in interoperability in Australia, and turn it into something real? Fast Interoperability Healthcare Resource (FHIR) founder, Grahame Grieve, has some ideas.
By Grahame Grieve
Interoperability is a hard problem; it’s important to understand that it’s about information management, and it’s about people.
It’s not actually a technology problem – even though people use the word ‘technology’ a lot in respect to solving the issues we face around interoperability. But it’s not a technology problem, it’s a people problem, and an information management problem. Technology comes and goes. Information management is where the hard stuff is.
In my role as FHIR product director, I talk about interoperability a lot, and about FHIR. I realise that a lot of people misunderstand what Fast Healthcare Interoperability Resource (FHIR) is – yes, it’s got technology in it, but it’s not so much about technology. FHIR is really two important things – a community of people, and a set of agreements about information management and exchange.
The really valuable thing FHIR has is people and the culture that it helps people build. It’s a culture of sharing and openness and it’s starting to transform healthcare IT around the world.
The FHIR standard and the FHIR community don’t exist to deliver solutions to any real world problems, they exist to enable other people to do it. Our job is to get IT out of the way. The challenge then, and the biggest challenge by far, is developing the right story, the right solutions and actually deploying this stuff.
When I set out on the FHIR journey I had three goals in mind:
- To disrupt and force change on healthcare IT standards – that’s mostly in the bag.
- To disrupt and force change on healthcare IT- that’s on going.
- To disrupt and force change on health itself- that’s starting.
There are three stages to the journey that we’re on.
The first is getting the basic capabilities into international standards. These are platform standards that we can build solutions on.
But there are all sorts of solutions- informatics, theory, international collaboration. And they can all be used differently, so…
The second stage is to take those standards and say “this is what we’re going to do with them here in this context.”
This is a set of agreements that we can run, in our smaller local communities where we have much more to agree about (as compared to what everyone in the world can agree on collectively). We need to work with how our systems work and work together as a group of people to figure out what these local guidelines or rules should be, test them, and integrate that process into a standards cycle that is sustainable.
The third phase is to actually turn those local agreements into operating software, operating market agreements – things that actually work and are available to our providers. That can transform how we do health.
Around the world FHIR is scoring goals in the first and second stages, but it’s the third stage that’s the hardest stage, by a long shot. And the challenge, for me, is that each of these stages means different people, different culture, different processes, and the handover between stages causes a lot of noise and potential disconnect. Getting continuity to try and run the process to the ground in each local community is the hard part, and it’s increasingly our focus.
I’m afraid I believe that in Australia, we’re starting at the back of the pack:
We’ve had a working standards process in the past, but we don’t currently.
We’ve had some consensus in the community in times gone past, but we don’t now (or, at least we don’t have it well enough established again).
We’ve launched this interoperability journey repeatedly for a number of years (maybe we missed a year here and there).
What we need is belief that we collectively can get it properly moving and solved.
If you look at the history of interoperability, the great interoperability technology and techniques tend to be invented primarily in four countries – USA, Russia, China, and Australia. In health, in fact, Australia has dominated the creation of interoperability technologies and techniques for decades (e.g. openEHR then FHIR).
But if you look around the world at countries that have actually taken those assets and made them work, they’re small countries. They’re the ones that can work together to drive the technology home into working solutions. Despite what some people say, it’s not actually about size. It’s about culture.
There is vastly more found here:
This whole article is worth a careful read.
I would be interested to hear how others see the perspectives offered.
Certainly when Grahame says all this is ‘very hard’ I find myself in furious agreement!
David.
0 nhận xét:
Đăng nhận xét