We have had adump of material delivered late last week. Here are the links to the files
The seven actualdocuments are all pretty imposing and complicated and extend to 100+ pages eachnot that there is not a heap of boilerplate within each.
I wonderedjust what these specifications were for and who was expected to use them.
Going to theNEHTA Site makes things a lot clearer:
Data Specifications
The dataspecifications aim to standardise the information structure and languagethat names and describes clinical concepts, and to provide a basis for thedevelopment of further, context-targeted specifications that can be implementedby system designers.
They are notintended to be software or messaging design specifications. Instead, they representthe clinical information requirements for data collection and informationexchange to facilitate safe and effective continuity of care across healthcarefor example, General Practice and Acute Care.
IntendedAudience
This resource istargeted at:
- jurisdictional ICT managers
- clinicians involved in clinical information system specifications
- software architects and developers, and
- implementers of clinical information systems and other relevant applications in various healthcare settings.
The content isreasonably technical in nature and expects the audience to be familiar with thelanguage of health data specification and have some familiarity with AustralianStandards for health messaging, and/or repositories of data specifications.
This informationis found here:
Looking atthe actual files I note, for example, the Pathology Detailed Clinical Modelfirst appeared as Version 1.0 on 29 May, 2007.
Some 4.25years later we get a recast version 2.0.
The questionswhich rush into my mind are:
Who isactually using and implementing these specifications after 4 years?
If anyone hasimplemented what value have they seen from implementation and use?
Why mightsoftware developers choose to use them in isolation - as there does not seem tobe any ongoing plan for them?
How willthese specifications be maintained over time and who takes over if NEHTA is notfunded in perpetuity?
Is sematicinteroperation achievable without an agreed data model and is that model partof these specifications? I do understand the need for data and informationclarity if information is to be exchanged between systems but with SNOMED -AUand AMT both in a less than finalised state where does this all fit?
It is by nomeans clear to me just what the underlying data-model for all this is, who ownsit and maintains it etc.
With PCEHRsoftware being sourced internationally just where do these data group etc. fit?
Overall, thusfar, there seems to have been a lot of work done for no obvious outcome. I lookforward to having all this explained to me.
I do notethat talking about Detailed Clinical Models (DCMs) NEHTA says:
“The collaborationprocess in the NEHTA Clinical Knowledge Manager (CKM) will result in a libraryof archetypes (initially openEHR archetypes) based upon requirementsidentified by Australian clinicians and other health domain experts, anddrawing from comparable work overseas. To create the DCMs, these archetypeswill be transformed into platform and reference model agnostic models (basedupon ISO 11179). They will then be uploaded to the National InformationComponent Library that NEHTA is in the process of building.
Initially, the DCMswill be available only in human-readable PDF format. In the medium term weintend to make them available in a number of machine-readable formats, and wewill consult the community to determine what formats are required. CKM is beingused to gather and formalise requirements for the DCMs and to support the lifecycle management of each DCM through a collaborative, online review process.This provides an important vehicle for clinicians and domain experts tovalidate that the clinical requirements have been met, and warrant that theresulting published DCMs are safe, high quality and fit for purpose. They willthen be uploaded to the National Information Component Library that NEHTA is inthe process of building.”
More here:
I wonderis the National Information Component Library the data model that seems to bemissing to underpin all this - and a range of other initiatives or is theresomething else at a more structured level?
I suspect we areyet to see the full picture of where this is all headed. I am happy for all brief explanations as to what these really mean and who will actually deploy them.
David.
