Sound Foundations: Leveraging International Standards for Australia's National Ehealth System
Faculty of Computing, Health and Science
School of Computer and Security Science / eHealth Research Group
Background: Australia is currently in the process of deploying a national personally controlled electronic health record (PCEHR). This is being built using a combination of international standards and profiles as well as Australian Standards and with specifications developed by the National eHealth Transition Authority (NeHTA). Objective: There exists a poor appreciation of how the complex construction of the overall system is supported and protected by multiple international standards. These fundamental underpinnings have been sourced from international standards groups such as Health Level Seven (HL7) and Integrating the Health Enterprise (IHE) as well as developed locally. In addition, other services underlie this infrastructure such as secure messaging, the national Health Identification Service and the National Authentication Service for Health (NASH). Methods: An analysis of the national e-health system demonstrates how this model of standards and service integration results in a complex service oriented architecture. Results: The expected benefits from the integrated yet highly dependent nature of the national ehealth system are improved patient outcomes and significant cost savings. These are grounded and balanced by the current and future challenges that include incorporating the PCEHR into clincial workflows and ensuring relevant, timely, detailed clinical data as well as consistent security policy issues and unquantified security threats. Conclusions: Ultimately, Australia has designed an ambitious yet diverse and integrated architecture. What remains to be seen is if the challenges that the medical software industry and clinical community face in leveraging the political process in order to encourage provider and public participation in ehealth, can be achieved despite the sound underpinnings of international standards.