Friday 13 April 2012

Beat-a-NEHTA, Better-NEHTA?

NEHTA is being beaten from many directions, and it may get worse.  Some perspective is worthwhile - Standards Australia and HL7 has always suffered from lack of volunteer resources and NEHTA has put a fairly broad scope of technical specifications, artifacts and demo implementation material together that may well have taken 10 times longer using volunteer methods.
I do wonder whether the technical aspects of the the program would have been better served by gathering experts with the historical standards development background.  I think a call to serve the program, appropriate remuneration, and a decent contract length might have enticed a number of those with the right stuff together.  I think there a probably a dozen folks that have driven standards here and abroad that given opportunity to work full time could have really accelerated outcomes.  Like any project a small switched on team can make good decisions and an expanded group can review and confirm (does sound like your average HL7 committee).
I think in general there has been some quite positive activity; I am not that impressed with the spend to achieve that activity.

Thursday 12 April 2012

CCA

Work on PCEHR projects continues. CCA for HI and SMD is on the short term plan.  HI service test cases don't make much sense for a middle-ware vendor, we don't control the behaviour of systems we connect to so having mandatory requirements wrt application operation is not really possible.  Prescriptive application functions are nice in theory but what is really mandatory?
SMD CCA is much more digestible; service/data compliance makes sense in general.  The certificate validation points are suitably wooly (NASH?) but most everything else seems fair enough.
CDA content has been parked for a while; this was the easier bit overall. We have been using it internally for a few years and Care Provision (HL7 V3) for years before that. (Level 3a NEHTA’s Common Conformance Requirements).  Can anyone do SNOMED-CT and AMT to a great extent?
CDA packaging needs some work, we have some interesting business needs for 'complete' health record extracts including clinical documents as attachments.  Not sure what is actually happening in the real world but some users seem to want attach masses of massive documents - what is a practical limit?