Health Level 7: The National Standards For E-Health Messaging In Australia

NEHTA’s work will provide the foundation for secure electronic communications amongst healthcare providers by defining a set of messaging standards to be used in e-health.

These standards will allow for a flexible and dynamic approach to e-health interoperability, and can help ensure the evolution of an e-health environment that is sustainable and affordable.

Creating messaging standards does not mean that everything achieved to date needs to be turned off. It is vital, however, that the exchange of health information is conducted in an appropriately secure manner.

There are a number of current examples of information being transferred securely in the health sector. However, the current situation cannot meet the diverse and increasing demands of e-health. The reasons for this are outlined below.

Compatibility

Currently, the e-health systems in use in different public health institutions are generally incompatible and unable to exchange health information safely. Setting standards for secure electronic messaging is important to ensure safe information exchange across all systems.

Coherency

A plethora of different approaches to messaging currently exists across the health sector, as each e-health vendor is able to choose or develop their own approach. This creates significant costs as a complex range of skills must be employed to maintain them.

Scale

The simple point-to-point messaging that occurs today is not capable of efficiently handling the future demands of e-health for large scale and complex information interactions.

Sustainability

E-health technologies, like all technologies, must adapt to the emerging needs of e-health and the inevitable demands for existing services to be put to new uses, with minimal impact on users. Current information transfer approaches are generally designed for a specific purpose and therefore not all are readily adaptable to this complex set of ever-changing requirements.

Therefore, to ensure that all systems across Australia do have the ability to reliably and safely communicate with each other, a standard exchange format is required. That is why NEHTA has recently determined that this standard will be based on the HL7 family of standards.

This decision provides a clear national direction. Those who develop these systems now have certainty about what their Australian customers will require. Without all systems in the healthcare sector using common standards such as this, the promise of electronic health communication can’t be fulfilled on a national scale.

To assist the health IT sector to migrate to this standard, NEHTA has identified the following approach:

  • Where HL7 version 2.x standards are already extensively used and yielding benefits, for example pathology and patient administration, these standards should continue to be supported. Where HL7 standards are not in use, they should be factored into system upgrades where practicable.
  • NEHTA will now focus on developing Web services specifications based on work undertaken by the HL7 Services Specification Project (HSSP), and content specifications based on the HL7 Clinical Document Architecture – Release 2 (CDA R2) for areas such as referral, discharge, prescribing, dispensing and pathology.
  • This work will then form the basis by which industry will migrate to HL7 version 3.

This approach ensures that migration occurs in a consistent manner, and in conformance with NEHTA’s requirements.

NEHTA will work closely with HL7 Australia and Standards Australia in this development work. In addition, we will be closely liaising with our international counterparts - such as the UK’s National Health Service and Canada’s Health Infoway - to ensure that the specifications developed in Australia are consistent with international efforts.

This direction is consistent with the endorsement of HL7 standards for use in Australia by the National Health Information Group in 2004. In the international community, the largest adopter of HL7 v3 standards is the Connecting for Health program run by the UK’s National Health Service; the UK, US and Canada have also adopted HL7 CDA specifications.

We will be releasing a report providing further details on this decision shortly. Further information about HL7 standards can be found at the HL7 Australia website.

Posted in Australian eHealth

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