The GPCG Standards page aims to give a brief overview of standards work that is being undertaken in the e-health field and provides links to further related information.
Australian Health Informatics Standards
The agreement to make Australian health information standards available for free, supported by the Department of Health and Ageing, has been confirmed.
The complete list of standards is available from the Standards Australia website.
Excluded from free access are:
direct adoptions of ISO standards - eg health PKI
HL7 base standards, which are available by purchase from HL7 Australia
The General Practice Computing Group (GPCG) is committed to the development and implementation of standards in Australian GP informatics.
Building on work already completed, general practice in Australia has moved some way toward standardised data, coding, messaging, knowledge and security. This "standards based" approach is building a general practice computing environment that has an increasing capacity to communicate and manage information electronically.
Standardisation provides an environment in which the medical software industry can undertake developments with more confidence, while at the same time enabling better use of information and technology to address particular health priorities such as diabetes, asthma or cardio-vascular disease.
The implementation of agreed data models in general practice computing, coupled with the standardised representation of knowledge and evidence based guidelines, offers both software developers and public and population health advocates unique opportunities to facilitate improved health outcomes for at risk populations.
The GPCG has been instrumental in the development of standards in many of the e-health areas. These include the Standards Australia Health Informatics Committee (IT-014), GP Coding Jury, GP Data Model and Core Data Set and Electronic Health Records. There has been significant progress on standards relating to e-health, particularly in the area of communications and data security and privacy.
The GPCG convened an Interoperability and Decision Support Working Group and in August 2002 held a GPCG Standards Workshop to clarify the GPCG work program in the area allocated to the Working Group. It brought together a broad range of stakeholders in health informatics to overview current activities of relevance both within and outside the GPCG. Recommendations were made on an approach for future progress.
GPCG documentation on Standards.
Standards Work Plan (February 2003) Developed as part of the GPCG Work Program, by the GPCG Interoperability and Decision Support working group with input from the GPCG Standards Workshop held in August 2002.
General practice and computing standards Siaw-Teng Liaw, PhD, FRACGP, is Associate Professor in General Practice, The University of Melbourne, Victoria and member of the GPCG Interoperability and Decision Support Working Group. This article appeared in the June 2002 edition of Australian Family Physician, Volume 31, Number 6, pages 509-514.
The fast pace of change associated with the internet and the increasing number of competing demands has created a growing importance on information and communication technologies within e-health care. Producers and users of health information systems participate more effectively when those systems work together - the standardisation process contributes to this process. Consumers feel more confident when systems operate seamlessly, efficiently, securely and effectively and work in a way that respects them as individuals.
Standards within the e-health industry have been recognised as lagging behind other comparable industries (ie finance and banking). Those standards formulated specifically for e-health, and agreed among the various stakeholders, are now faced with the challenge of how to have them adopted and implemented throughout Australia.
TheNational Health Information Management Advisory Council(NHIMAC) has created links with various specialist groups to form the National Health Information Standards Advisory Committee(NHISAC). These groups include:
Commonwealth Department of Health and Ageing;
Standards Australia's Health Informatics Committee IT-014;
Australian New Zealand Chief Information Officers' Forum (ANZ CIOs Forum);
National Health Information Management Group (NHIMG); and
"Setting the Standards" is a key strategic tool formalising the importance of national standards in achieving an integrated approach to health information management and information technology. It provides the opportunity to progress standards issues nationally and lay the foundation for changes to an e-health environment.
Examples of areas in e-health that standards impact on include:
The GPCG continues to work on the development of new and existing standards in the e-health arena. One of the main areas of involvement is with the Standards Australia Health Informatics Committee (IT-014) focusing primarily on the inter-operability of systems as well as technical and security issues.
The GPCG has representatives on:
IT-014 Health Informatics
IT-014/4 System/Data Security, Integrity, Privacy
IT-014/6/3 Health Level 7 (HL7)
IT-014/6/5 Pathology Messaging
The complete structure of the IT/14 Health Informatics Committee and subcommittees is available here.
EHRA
The GPCG is also involved in the Electronic Health Record Architecture project (EHRA). Standards have been used increasingly in this area to ensure compatibility and transferability of patient records from one setting to another. The use of electronic health records has been hampered by a lack of widely agreed and implemented standards for health information. Data needs to be collected in a standard format or it will be virtually impossible to link information generated in different parts of the health system in a meaningful way.
The ISO/TC 215 Ad Hoc Group released a Final Report on July 26, 2002 titled Standards Requirements for the Electronic Health Record & Discharge/Referral Plans ISO_EHR_FinalReport.pdf (760.11 KB). The release of this final report follows a discussion document (February 2002) which looked at ways to develop EHR standards and encouraged feedback from all interested parties. This has had major implications also for standards in related areas such as terminology, decision support, security, and messaging.
GP Coding
There has been a need for a national standard for Australian general practice data for use by general practitioners, developers of GP computer software programs, academic and other researchers for some years. The GPCG established a GP Coding Jury in 1999 to determine the best coding system for use in general practice in Australia. The short term recommendation (the next five years) is ICD-10-AM and the long term recommendation is likely to be SNOMED-CT. This long term recommendation is likely to become the future dominant reference terminology with the potential to become the world standard. View the Final Report of the General Practice Coding Jury GP_Coding_Jury.pdf (729.88 KB)
Data Model
The GP Data Model and Core Data Set Project is one of a suite of projects undertaken as part of the GPCG Strategic Framework workplan Statfram.pdf (141.89 KB) to build a technological infrastructure to assist GPs to improve health outcomes in patient care and practice management. This includes developing national standards to underpin the development of computing and information management within general practice. Project outcomes include:
'Functionality' standards
Standards for electronic health record architectures
Professional protocols (associated with clinical decision support)
Other projects relating to the development or application of e-health standards include:
Diabetes Messaging
The Diabetes Messaging project was a collaboration between the Centre for General Practice Integration Studies, University of NSW and the Centre for e-health, Ballarat University. The project developed and implemented an HL7 messaging standard for communication of diabetes data between General Practitioners' clinical management software and Division register/recall systems. The standard were tested across two Division systems for electronic management of diabetes records and up to four types of clinical management software used by GPs. See final report GPCG_Project10_01.pdf (1.58 MB)
Commonwealth Gatekeeper Project
The Commonwealth Gatekeeper Project project will establish a secure environment for electronic communication between the health sector and Commonwealth Agencies including certification, encryption and registration of providers and users. IT/14 is responsible for identifying appropriate security standards and is currently working towards the development of a National Health Sector Security Framework called the Commonwealth Gatekeeper Project.
Messaging and Communication
The HL7 Messaging Standard sub committee (IT/14/6/3) has developed a number of national standards for clinically based electronic messages based on HL7 Standard, and the UN/EDIFACT messaging standard. This Standard has been published for implementing medical and hospital insurance claims messages. A copy of the standard is downloadable from Standards Australia (payment is required).
Key Contacts
GPCG representatives on IT/14 Contacts:
,
,
Standards Australia Contact:
Good Electronic Health Records (EHR trial) Contact:
HL7 (Health Level 7) Contact:
(Chair)
Key Documents
Title
File
GPCG Standards Work Plan Developed as part of the GPCG Work Program, by the GPCG Interoperability and Decision Support working group with input from the GPCG Stanards Workshop held in August 2002.
General practice and computing standards Siaw-Teng Liaw, PhD, FRACGP, is Associate Professor in General Practice, The University of Melbourne, Victoria and member of the GPCG Interoperability and Decision Support Working Group. This article appeared in the June 2002 edition of Australian Family Physician, Volume 31, Number 6, pages 509-514.
Draft for public comment Australian Standard DR 03471 Health care provider identification Standards Australia Committee IT-014 invited public comment on the above draft standard commencing 24 September 2003 and closing on 5 November 2003. For further information see Standards Australia.
Public comment draft of AS 4700.1 - Implementation of Health Level Seven (HL7) Version 2.4. Part 1: Patient Administration Standards Australia invited public comment on the above draft standard commencing 23 April 2003 and closing on 14 July 2003. For further information see Standards Australia.
Public comment draft of AS 4700.2 - 200X - Implementation of Health Level Seven (HL7) Version 2.3.1 Part 2: Pathology Orders and Results Standards Australia is invited public comment on the above draft standard commencing 20 June 2003 and closing on 18 July 2003. For further information see Standards Australia.
Standards Australia The following standards relate to e-health and can be downloaded from the Standards Australia Website by entering the details into the search tool. Most standards require payment.
The following standards relate to e-health and can be downloaded from the Standards Australia Website by entering the details into the search tool. Most standards require payment. ·
The following standards relate to e-health and can be downloaded from the Standards Australia Website by entering the details into the search tool. Most standards require payment.
AS 4400-1995 Personal privacy protection in health care information systems
AS/NZS 4444.1:1999 Information security management - Code of practice for information security management
AS 4700.1-1998 Implementation of Health Level Seven (HL7) Version 2.3 - Patient administration
AS 4700.2 -1998 Implementation of Health Level Seven (HL7) Version 2.3 - Pathology orders and results
AS/NZS 4700.3:1999 Implementation of Health Level Seven (HL7) Version 2.3 - Electronic messages for exchange of information on drug prescription · HL7-1999 Ver 2.3.1 Health Level Seven
Federal Health Care Informatics Standards Activities (Meeting summary) Since a 1996 compendium of Federal informatics activities was completed, it has been revised and updated as needed by those agencies. In addition, other agencies have contributed information on their activities. This summary describes the meeting held in January 1999 so the contributors could learn more about current activities than they could from the compendium itself and so that agency representatives could identify informatics challenges to be addressed by Federal agencies.
International Standards
Harmonisation between international and Australian standards are necessary to ensure that developers working with international standards also address Australia's needs. These standards include: HL7 and UN/EDIFACT. Standards Australia is working in this area primarily with ISO/TC215 and the General Domain Model for Health Information (ISO N58).
Australia is now taking a leading role with both the International Standards Organisation Health Informatics Committee (ISO/TC215) and Health Records and Modelling Coordination now being chaired by Australia.
ISO/TC215 working groups:
Health Records and Modelling Coordination
Messaging and Communication
Concept Representation
Security and Privacy
International links
International Standards Organisation The International Organization for Standardization (ISO) is a worldwide federation of national standards bodies from some 130 countries, one from each country. ISO is a non-governmental organization established in 1947. The mission of ISO is to promote the development of standardization and related activities in the world with a view to facilitating the international exchange of goods and services, and to developing cooperation in the spheres of intellectual, scientific, technological and economic activity. ISO's work results in international agreements which are published as International Standards.
UN/EDIFACT A UN organization that sanctions standards for electronic data interchange for administration, commerce and transport. They comprise a set of internationally agreed standards, directories and guidelines for the electronic interchange of structured data, and in particular that related to trade in goods and services between independent, computerized information systems.
Health Level 7 (HL7) Health Level Seven is one of several ANSI-accredited Standards Developing Organizations (SDOs) operating in the healthcare arena. Most SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven's domain is clinical and administrative data.
Unified Medical Language System (UMLS) The UMLS is not itself a standard. It is a cross-referenced collection of standards and other data and knowledge sources. The UMLS helps health professionals and researchers retrieve and integrate electronic biomedical information from a variety of sources. It can be used to overcome variations in the way similar concepts are expressed in different sources. This makes it easier for users to link information from patient record systems, bibliographic databases, factual databases, expert systems, etc. The UMLS Knowledge Services can also assist in data creation and indexing applications and a UMLS Metathesaurus.
SNOMED (Systematized Nomenclature of Medicine) Describes itself as 'as a comprehensive, multiaxial, controlled terminology created for the indexing of the entire medical record'. It has been developed on the premise that a detailed and specific nomenclature is essential to accurately reflect, in computer readable format, the complexity and diversity of information found in a patient record. The design ensures clarity of meaning, consistency in aggregation and ease of messaging.
CEN/TC 251 The European initiative for establishing standards in health care informatics and telematics The objectives of CEN/TC 251 are the organisation, the co-ordination and the follow-up of standards development, including testing standards in health care informatics and telematics at a European level (12 EC-countries, 7 EFTA-countries, 7 Eastern European countries).
Healthcare Information Technology - Standards The Children's Hospital "R.Gutierrez" seeks to motivate the use of standards in the healthcare scenario in order to improve communication. It describes some of the most used standards and the organizations that work on them in Argentina.
LOINC The Logical Observation Identifiers Names and Codes data base provides a standard set of universal names and codes for identifying individual laboratory results. LOINC also contains codes for patient history items, clinical observations, and medical record sections.
Standards for health care telematics The implementation of telemedicine applications on a large scale requires standards for the exchange of health care information to be in place. Norwegian Telecom participates in several standardisation projects both internationally and nationally, which develop standards for electronic exchange of health care information. This paper presents the work related to CEN/TC 251, the European initiative for establishing standards in health care informatics and telematics. The objective of this paper is to introduce a method for structuring health care telematics standards.
IT-014 Structure - Standards Australia's Health Informatics Committee
IT-014/2 Health Concept
IT-014/2/1 National Health Information Knowledgebase (NHIK) Registration Authority
StandardsWorkPlanMay2003.pdf (
data_dictionary_excel.xls (