In my previous posting on this blog, I cited hospital discharge summaries as a potential barometer of broader e-health capability. I’m sure there are significant organisational and “change management” factors that have impeded the deployment of information sharing typified by electronic discharge summaries. Many commentators dismiss technological obstacles as a minor distraction in some vast sea of change management issues besetting the healthcare community. I beg to differ. I believe that lack of good technical solutions and standards are a significant, if not the major reason for the endemic inability to share clinical information between systems easily and effectively.
The current standard being promoted by NEHTA, by the NHS in England, by various bodies in the USA, and within a number of other countries for packaging electronic discharge and other health summaries, is HL7’s Clinical Document Architecture, Release 2. CDA is an XML-based format that provides for both a human-readable view (via a web browser) and a purportedly computer-processable part based on HL7’s Reference Information Model.
It is relatively trivial to encode a discharge summary for viewing in a browser. It is a major challenge to produce the standardised computer-processable components upon which e-health depends, let alone for the array of GP and other systems to reliably and safely digest them.
Such a challenge is it, I believe, that I have today established the Global HL7 CDA Challenge to test if HL7 CDA is indeed the appropriate technology for this important and fundamental role. I encourage all of you to support this initiative so we can make some real progress towards a viable infrastructure for exchanging health information and fostering potentially useful decision support.