MSIAs Clinical Messaging Profile

Aug 2, 2012

Yesterdays’s post about Healthlink’s Messaging Quality Initiative created some email chatter, and I need to issue a couple of clarifications. But I should also explain the process: ## The MSIA Process In late 2010, it became obvious that the Australian Governments’s various initiatives that focused on more secure, robust exchange that was intended to make it easier to exchange content with any healthcare participant would require more robust interoperability at the content level. This underlying cause manifested in the impact that SMD would have on the existing content distribution networks. The way they currently work (roughly) is that they transfer HL7 v2 messages from source to destination, but while doing so, they consult a large lookup table to compare source and destination systems, and see what changes they need to make to the message actually work. Changes are required to work around differences in:

  • Message parsing
  • Message routing and storing
  • Content Processing and Presentation

Some of these things are utility/functionality, but some are basic clinical safety considerations.

As a consequence, MSIA invited any interested vendors - the source systems, the destination systems, and the guys in the middle - to discuss the problems, and come up with solutions, with the intent that all the MSIA members would be required to change their systems to implement the agreements. The overall goal was to remove the need for messaging vendors to modify the messages as they transfer them.

The initial problem list was primarily contributed by Medical Objects, who were enthusiastic participants. Other participants included Kestral (my employer at the time), Healthlink, Genie Systems, Healthscope, AHML, DCA, Queensland Health, Argus, Global Health, Totalcare, Medisecure, Medinexus, and Smarthealth. (If you participated, and you’re not on the list, you didn’t make the minutes, sorry).

The outcome of a couple of meetings over a 3 day period was a report describing the problems and their agreed solutions. This was prepared by Vince Macauley on behalf of AHML/MSIA, and distributed internally to the participants.

I volunteered as a follow up to rewrite the report as a formal message profile with conformance points. This hasn’t gone anywhere, and is what I posted yesterday.

In terms of outcomes, the process hasn’t really ever come to completion. I know that several vendors did make changes to align with the decision that were made, but I suspect that the overall impact has been pretty minor so far. On the other hand, the decisions that were made have been fed back into the standards process for future versions of the AS 4700 standards, and have also informed and influenced decisions on the same or similar issues in the NEHTA specifications.

My Clarifications

Firstly, while Healthlink participated in the MSIA consensus process that defined the clinical messaging profile, they did not lead or initiate it. And, while I’m at it, Healthlink’s initiative wasn’t particularly focused on the MSIA profile, just on standards generally. It’s me that made that link

Secondly, while I volunteered to write the profile, this was editorial work. The decisions it represents, and any authority it has, are vested in the consensus process shared by the participants. The important parts aren’t my work, and I wasn’t intending to claim otherwise.