Three nations embark on EHR voyages

HealthConnect Australia Deployment Strategy

Electronic health care just received an intercontinental jump start with the launch of major electronic health record (EHR) projects in Australia, Canada and the United States.

Australia released its national electronic health care strategy today and has already started the first phase of its electronic health record network deployment in Tasmania and the Northern Territory.

Also today, Canada launched a project to show how independent health information systems can exchange information based on open source standards, with Canada Health Infoway, the non-profit corporation spearheading that country’s electronic health programs, making its suite of e-health reference standards available for free on the Internet.

The Markle Foundation launched on June 1 a prototype of a nationwide electronic health information exchange in the United States that will allow users of three different healthy information networks in three states to share information. While projects in the three countries differ in scale and scope, all highlight the importance of standards to the widespread use of EHRs.

HealthConnect, the Australian EHR project backed by that country’s Department of Health and Ageing requires the use of standardized electronic clinical messages to support enhanced clinical communications among healthy care providers.

Richard Alvarez, president of Canada Health Infoway, said in a statement that the free, open source Infoway Reference Implementation Suite "will enable the faster uptake of Electronic Health Record Interoperability Standards endorsed by Infoway and our federal, provincial and territorial partners."

IRIS, Canada Health Infoway said, will help tie together patient registry systems within clinics, hospitals or on a provincewide basis, meets one of Canada Health Infoway's key goals of interchange of information between different health information systems.

The Markle Foundation Connecting for Health projects launched yesterday is based on a "Common Framework" which will rely on open, consensus driven and non-proprietary standards to foster braid use of EHR systems. Late week, the eHealth Initiative, a Washington-based advocacy group for EHR released its own framework for electronic healthcare, which also strongly backed development of standards based systems.

The Government Accountability Office in a report released last week also identified standards as the key to development of a nationwide EHR system in the United States. The United States must focus on creating standards before doing other work on an EHR system, GAO auditors wrote.

Health organizations and governments in all three countries back the Health Level 7 standard for interchange of clinical information and Canada Health Infoway's IRIS software will provide client registry and admit, discharge and transfer modules an also supports registry to registry interoperability all contained in a Health Information Access Layer.

In a speech to the Stanford University School of Medicine last month, Health and Human Services Secretary Mike Leavitt said "unifying health IT with standards [is] a major [effort] on the part the national government," but quickly added the federal government should not mandate standards.

Dr. Mark Leavitt, chairman of the Certification Commission for Healthcare Information Technology, agreed that a mandate would be "very inflexible" and cannot keep up with changes in technology, Leavitt said. But, he added, government can guide standards development through by exercise of its vast purchasing power and influence on a marketplace where it picks up 45 percent of the nation’s health care bill.

CCHIT is an umbrella health IT standards organization backed by the American Health Information Management Association, the Healthcare Information and Management Systems Society and the National Alliance for Health IT and are developing proposed standards for an ambulatory care EHR including functionality, interoperability, security and reliability.

Leavitt said CCHIT plans to bid on an HHS standards consulting contract and said it would take any other organization a considerable amount of time to match the standards expertise CCHIT has developed since it was founded in July 2004.