PCEHR specification glitch identified: NEHTA

The technical issue that has held up the implementation of some components of the PCEHR has been resolved and is currently being tested before work restarts, the CEO of the National E-Health Transition Authority (NEHTA), Peter Fleming, said.

Mr Fleming told a Senate Estimates committee hearing in Canberra today that the technical fault was discovered in one of the Clinical Document Architecture (CDA) implementation guides.

He said there are 23 different bundles of specifications for each component of the PCEHR, and three different types of documents for each bundle. The error occurred when the Wave 2 sites were not given an updated version of some of the CDA specifications.

“What happened was we didn't fully manage our change control – we didn't give that to the wave 2 sites,” Mr Fleming said. “The change controls mean here's version one and here's two and here's the difference. We didn't do that but we have updated that now.”

He said there was a six-week delay in implementation of those specifications but they had been fixed and were undergoing testing now. He said the delay had an impact only on that component and it would not have an impact on the ability to register for the PCEHR on July 1.

Asked if there was a cost blow-out due to the error, Mr Fleming said there would probably be no financial cost, just a cost in terms of time.

He also rejected claims that of the bundles of specifications available, only two are fit for use, five months out from the launch of the PCEHR.

“That was stated to me yesterday and I asked if that point could be substantiated and it couldn't,” Mr Fleming said. “I asked to please explain and when I asked for samples none were forthcoming. A statement like that needs to be substantiated. There are people using [specifications] and building to those systems now.”

Mr Fleming and NEHTA's head of architecture David Bunker both denied the accuracy of questions from committee chair Sue Boyce that the specifications and standards were not freely available to vendors or other interested parties.

Mr Bunker said the specifications were openly available on the Software Developer Resource Centre section of NEHTA's website. “That has the specifications and the supporting documents,” he said. “We also have regular webinars for the vendor community.”

Mr Fleming said the portal was open for use but did require a log in, which anyone can register for.

In its submission to the senate hearing into the PCEHR legislation last week, the Medical Software Industry Association (MSIA) said that while there was a lot of documentation in the portal, much of it was incomplete.

Senator Boyce also raised another concern, voiced elsewhere, that the testing currently being done did not constitute “real-world” testing.

Mr Fleming said there were multiple components to the testing from unit testing to systems, integrated, clinical and fit for purpose testing and that was being done through National Association of Testing Authorities (NATA) accredited centres.

“Where we are implementing in GP practices, that is real world. There is some hand holding and there were some issues in CDA implementation. The problem that was detected has been fixed and we are testing that now.”

He also said the national infrastructure partner, Accenture, was currently testing release 1a of the national build, which would continue through to June 30.

According to a seminar given by NEHTA's head of PCEHR Andrew Howard last month, release 1a includes the capability for sourcing and indexing clinical information. Early user acceptance testing is being conducted now, and it will be available to vendors for testing by mid-March.

It involves document exchange capability for shared health summaries and discharge summaries, all B2B interfaces and security functions, and conformant repositories.

Release 1b involves core participation and registration functionality including consumer registration and the creation of their own PCEHR from July 1.

Senator Boyce said not everyone was confident that the system would be ready for launch on July 1. Mr Fleming replied that there was nothing that he could see “that would indicate we will not be ready on July 1”.

Posted in Australian eHealth

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