Healthlinks Messaging Quality Initiative
Aug 1, 2012From the ever excellent Pulse-IT:
Electronic messaging providerHealthLinkhas launched a campaign to encourage electronic medical record (EMR) and practice management software companies to improve the quality of electronic messaging.
Tom Bowden from Healthlink spoke to me about this yesterday at the HIC conference. I thoroughly endorse this initiative - we need much better compliance with “standards” to make messaging safe, and there’s no question that it needs to be safe. But what standards? Quoting from the article:
He said these examples showed the importance of ensuring consistent implementation of messaging standards, in particular the correct and reliable use of HL7 message acknowledgements.
Yes, in particular, we need to get everyone to correctly and reliably use HL7 message acknowledgements, though this is more difficult than it sounds since “correct and reliable” use of acknowledgements is not very well understood or even defined in the HL7 standard. Actually, it would be an improvement just to have all vendors actually using acknowledgements at all, let alone correctly. I’ll make another post shortly about the ins and outs of using acknowledgements correctly.
So what other things are included in the not-particularly part they are going to be looking at? Well, Tom indicated that they were looking for conformance to AS 4700 standards - but we know that they don’t go far enough - there’s still known clinical safety and implementation issues with messages that conform to the standards. Because of this, a couple of years ago the MSIA developed a clinical messaging profile that covered the common issues.
I drafted the profile, but it seems to have fallen off the priority list at the MSIA, and I don’t know why - it’s very important. Since I’m frustrated with the lack of process, I’m posting the draft here:
Draft MSIA Clinical Messaging Profile
Alert - this is a draft, and MSIA needs to finalise this. Conformance to this will resolve many of the known safety issues. The intent from MSIA was that all members would be required to implement this by last year. Obviously, the time line has lagged badly, but we need to do this: the current message delivery systems are not safe.
Note that Healthlink participated in the work that lead to this profile, and Tom indicated that they were interested in including this work in their register.
What about CDA?
Someone asked me yesterday why we should spend time on fixing v2 messaging, when all this would be resolved by using CDA, especially given that many of the vendors have now implemented a CDA handling infrastructure, and there’s a NEHTA e-Referral specification. And I do think that adopting the CDA stack would resolve all these issues - I have argued this before. But adopting the whole CDA stack is a large piece of work, and it’s not going to happen quickly. In fact, the diagnostic industry has no intent to adopt CDA, in spite of the evident advantages. As long as message senders are stuck using v2 - and I assume this will be for at least a decade yet - then we need to fix v2. This is only pathway I’ve seen to address these issues.
If you believe that we should have clinical safe messaging, then you need to push your vendor / your industry organisation / college to get this profile finished and adopted.