It Looks Like Desperation and Heavy Tactics Are Now Taking Over the PCEHR Program. Not Good!

In the last few days some quite alarming stories have been coming to me regarding the relationships between NEHTA, DoHA and the IT-14 Committee of Standards Australia.

The drivers seems to be a rising desperation and frustration with the fact that Standards Australia is the sole national entity that can agree and approve national e-Health Standards. The feeling seems to be that the traditional methods of volunteers working to develop Standards is simply too slow and inefficient and that NEHTA needs to take over the process and drive it forward more rapidly and in a more focussed way.

Apparently at issue now is that if Standards Australia does not agree to much more NEHTA control of the Standards development process that the current agreement between DoHA and Standards Australia for funding of the work will not be renewed - with some threat to the jobs of the staff who are presently doing this work.

Needless to say Standards Australia (as a commercial entity) is not exactly thrilled by these sort of ‘heavying’ tactics.

Driving all this is the desperate need to meet the ridiculous time lines for development and delivery of the PCEHR which have been announced by Minister Roxon and which seem to NEHTA and DoHA to have no flexibility.

The worry is, of course, that Standards are meant pieces of work which are capable of straightforward and reasonably easy implementation when done by industry experts. Sadly what NEHTA / DoHA want approved as Australian Standards have, I am told, never actually been implemented.

Many of the volunteers are said to be concerned that a push for full HL7 CDA adoption, and the progressive phasing out of HL7 V2, is both premature and risky given the unproven and complex nature of CDA implementation. It might turn out that NEHTA’s CDA’s plans are just wonderful, but it would be good to see some large-scale successful implementations elsewhere before we de-commission our V2 messaging infrastructure. The precautionary principle applies here.

Grahame Grieve’s suggestion of using the V2 Infrastructure to Phase in CDA messages (transmitted and wrapped in V2) also seems reasonable and also allows for a planned and managed transition.

See here for more detail on this:

http://www.healthintersections.com.au/?p=392

A number of people are now telling me that things are getting pretty tense and heated.

All I can say is ‘watch this space’. It can only be a matter of time before the tensions between those who think that they should do a ‘proper pragmatic and practical job’ and those who are keen to rush early into complex things (including the still implementation unproven CDA) will collide with unknown consequences for all involved.

Whatever happens this looks to be a substantial management challenge for NEHTA and DoHA as the PCEHR will not go very far without the active support of the Standards Community.

I wonder just how much of all this has reached Senator Boyce’s ears?

David.