journal of biomedical informatics
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Sound Foundations: Leveraging International Standards for Australia's National Ehealth System

Author(s): Patricia A H Williams, Vincent McCauley

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 proles as well as Australian Standards and with specications 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 Identication 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 benets from the integrated yet highly dependent nature of the national ehealth system are improved patient outcomes and signicant cost savings. These are grounded and balanced by the current and future challenges that include incorporating the PCEHR into clincial workows and ensuring relevant, timely, detailed clinical data as well as consistent security policy issues and unquantied 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.