Setting the standard for messaging
Brisbane turned on a late autumn stunner for an HL7 Australia meeting that Pulse+IT attended in the Queensland capital this week to hear all about the localised pathology and referral messaging standard that has been published by HL7 Australia. The turnout was pretty good too considering the esoteric nature of the meeting, which covered all things HL7 v2, along with FHIR, PITUS, NCTS, NCSR, NPAAC and other acronym allsorts.
The expert crowd smiled knowingly when mention was made of previous attempts at developing standards that would miraculously bring interoperability to secure messaging over the years. Jared Davison, the chief technology officer of secure messaging vendor Medical-Objects, began his presentation with a slide from back in 2007 that could easily be used today, and pathology informatics expert Michael Legg went even further back when he mentioned there'd been a mention of standards in Hammurabi's code back in 1754 BCE.
While secure messaging and clinical information system vendors have achieved some measure of interoperability through the proof-of-concept trials funded by the Australian Digital Health Agency, no one is under any illusion that the solution is optimal. Medical-Objects founder Andrew McIntyre is not a fan, saying this week that what has been achieved is a simplistic solution that does not allow for decision support or fix problems with addressing. “A government solution is unlikely to be good,” he said, which does not bode well.
There are some good stories emerging, however. Dr Legg mentioned that the largest public and private pathology providers in the country – NSW Health Pathology, Queensland Health, Sonic and Healius – have all committed to or are using the standardised pathology terms and units that the Royal College of Pathologists of Australasia has worked on for a number of years.
And HL7 v2.4 uptake is being driven by the National Cancer Screening Register. Telstra Health's chief medical officer Vince McCauley gave a terrific presentation on how the NCSR – long the subject of bad news stories – was now functioning. Telstra Health insisted from the start that patient histories and results being sent to and from the register would use HL7 v2, and this has resulted in the vast majority of laboratories in Australia now being HL7 compliant.
The NCSR is generating about 120,000 messages a day for Australia's cervical cancer screening program, and work is now happening in earnest to get the bowel cancer screening program using the register as well. Dr McCauley, not one for hyperbole, said the register was world-leading and was helping Australia to achieve some of the lowest incidences of cervical cancer in the world.
We'll publish several reports from the meeting over the next few weeks but in the meantime, New Zealand is still doing interesting things, including one primary health organisation moving 20 years of general practice data to the AWS cloud, and another announcing it would begin the roll-out of the new cloud-based Indici practice management systems to three Auckland practices. The development of Indici is a bit of a bone of contention in NZ primary care software circles and continues to generate a lot of interest for our readers.
Our top story this week though was about a report from the Victorian Auditor-General's Office about some rather alarming holes in the cybersecurity set-up of some Victorian health services and agencies. The Victorian DHHS did release a set of cybersecurity controls back in 2016 but it appears that no health service has been able to implement them all as yet. The reasons given are the usual ones: lack of resources, both staff and money. It's worth reading the whole report if you like that sort of thing.
That brings us to our poll question for the week: Do you think our hospitals take cybersecurity seriously enough?
Our poll question last week was, do you think NZ's decision not to pursue a single EHR is the right one? We had a big response to this poll, with the majority (68 per cent) saying NZ had chosen the right course of action.