In his recent blog post, Eric Browne highlights what may be a problem in the design of the Australian PCEHR, due to the well-known CDA feature allowing dual forms of content – text and structured, supposedly equivalent – to be stored in the one document. If Eric’s examples are representative of real data in the future PCEHR system, there is definitely a problem. In any case, there is a general problem, to do with common misuse of the CDA architecture, which itself should be changed to remove such possibilities. Read the rest of this entry »
The CDA ‘dual-content’ conundrum
28/01/2012
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Health Informatics | Tagged: CDA, e-health, EHRs, HL7, standards | 
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Posted by wolandscat
Why e-health really is hard
10/08/2011Every so often, someone asks: why can’t the health sector get its act together with ICT? Tell me why health is ‘different’?
Dilbert - advances in healthcare
Every so often a new and interesting answer to this question pops up… Read the rest of this entry »
4 Comments | Health Informatics, Philosophy | Tagged: e-health, EHRs, Health Informatics | Permalink
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The crisis in e-health standards IIa
13/10/2009Prev: The crisis in e-health standards II
Next: The crisis in e-health standards III – solutions
Unfinished business
I promised pointers to a solution for how to get out of the standards mire in which we find ourselves today. But first, I will intervene with a short post on missed items, pointed out to me by various (justifiably) miffed people.
The Object Management Group (OMG)
For many people in the clinical arena, the OMG is probably quite peripheral, like the IEEE or W3C. They know that it exists, and that it probably does something important they don’t really understand. What many don’t know is that it has been a major innovator in the ‘standards business’ and also been active in the health vertical. The first is relevant because it is an organisation we can learn from. The OMG started in 1989 and created a standard called CORBA (Common Object Request Broker Architecture), which was essentially about making ‘objects’ talk to each other across the network, or in today’s speak, ‘services’. Indeed today’s favourite mantras, Service-Oriented Architecture (SOA) and ‘web services’ owe a lot to the work done by the OMG. Corba is supposed to be dead, but Richard Soley (OMG CEO) once told me that it is quietly whirring away on hundreds of thousands of machines around the world. Companies like Progress Software also seem unaware of its demise.
In more recent times, the OMG has become the organisation that manages the UML standard, business process and workflow-related standards, and a growing ecosystem of ‘MDA’ (Model-driven Architecture) and software quality standards. The OMG standards of greatest importance to the ICT industry are these infrastructure standards, although there are many in vertical domains as well. Read the rest of this entry »
5 Comments | Health Informatics | Tagged: CEN, e-health, ehealth, EHRs, Health Informatics, HL7, ISO, standards | Permalink
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The crisis in e-health standards
17/09/2009Next: The Crisis in e-health standards II
Background
There is a serious problem in e-health today. The main need in e-health is to establish interoperability of various kinds: between systems, between software components, and across enterprises. The current catchphrase is ‘semantic interoperability’, generally meaning that information can be shared (between systems), aggregated (into a single standardised whole), and computed upon, in such a way that originally disparate information about, say a patient, can be safely analysed by a computer program. Achieving this is undeniably hard – I know from having spend 15 years of my life on it. Nevertheless, I know it is solvable. Technically there are many challenges, but also available solutions. It is the political dimension that is harder: this is a ‘commons’ problem, as is any interoperability problem, and it therefore requires the presence of organisations in the public space – usually governments and/or standards organisations. This is recognised, and many countries now have some kind of national ‘e-health programme’ which endeavours to define and promulgate (and possibly legislate) various standards and guidelines to encourage interoperability of health information systems (naturally, within privacy legislation). Read the rest of this entry »
12 Comments | Health Informatics | Tagged: CEN, e-health, EHRs, HL7, ISO, standards | Permalink
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