Australia’s agency responsible for delivering e-health throughout the country, the National E-Health Transition Authority (NEHTA), has just published guidelines for interoperability that it hopes will encourage the healthcare community to work together in implementing an electronic health record.
The document, ‘Towards and Interoperability Framework’, emphasises data as key to the framework, rather than technology, and calls for open standards to be used to aid collaboration.
"Standards are used to varying extents across the health sector, using different implementations and technologies, and inconsistent approaches," adds the document. "In some cases, the implementation of any standards is inhibited due to the existence of products that are not standards-based."
One example of the problems that the framework is designed to solve is the different versions of HL7 in use throughout the country. "Multiple versions of version 2 of the HL7 standards are still in use within Australia while an international effort is underway to migrate to the newer version 3 specifications which are yet to be completed."
It argues that the information architecture, including details of the XML-based language it is written in, "will need an agreed standard" that must be disseminated and published with policies and examples of its use. The transfer of the information must include provisions for authentication and confidentiality.
Interoperability is different from actual integration of systems, argues the document. Each system should be designed around accessibility, and the framework stresses that
Dr Ian Reinecke, chief executive of NEHTA, told Australian IT that the document represented a summary of what needed to be done at organisational, technical and information levels. "There will be additional information in the form of fact sheets and other releases. We’re about to publish information on clinical information specifications, for example."
NEHTA was set up in July 2004 and is supported and funded by both central Australian government and individual states and territories. Accountable to the Australian Health Ministers’ Advisory Council, it works to a yearly plan as agreed by ministers, and reports to them on its deployment. Its main aim is to spearhead an electronic health record across the country along with the supporting infrastructure.
‘Towards an Interoperability Framework’ [PDF, 597K]