2. HL7 HL7 April Meeting, Toronto, 1999 1 HL7 April Meeting - Toronto 1999 HL7 Standards Development in Australia / New Zealand - an Update Dick Harding / Klaus Veil

3. HL7 HL7 Meeting - Orlando 1999 2 Who’s here? Dick HardingOrders/Observations David RowedMnM Patient Care / Comm. Health Klaus Veil PAFM V2.3.2 Data Warehousing Publishing

4. HL7 HL7 Meeting - Orlando 1999 3 Background Information F In Australia, standards are created by “STANDARDS AUSTRALIA (SAA)” - a government-supported organisation representing all stakeholders. F The Australian Federal and State Govts. often elevate Standards created by SAA to legislation level. F These standards have achieved widespread acceptance in Australia & New Zealand.

5. HL7 HL7 April Meeting, Toronto, 1999 4 SAA HL7 Working Groups

6. HL7 HL7 Meeting - Orlando 1999 5 Patient Administration F Standard is based on HL7 Chapter 3 (AS4700). F Currently being revised to match HL7 V2.3.1. This standard has become the accepted way of implementing Patient Administration messaging in Australia/New Zealand. Fully endorsed by Australian Government.

7. HL7 HL7 Meeting - Orlando 1999 6 Clinical Pathology F Pathology Orders and Results (AS4700.2): Covers parts of HL7 Ch. 4 & 7. F Currently being revised to match HL7 V2.3.1. F Need for an extended Order Message (ORM) for referrals has been identified. F Proposal has been submitted to the Orders/Ob- servation TC for consideration at this Meeting.

8. HL7 HL7 April Meeting, Toronto, 1999 7 The proposed Expanded ORM

9. HL7 HL7 Meeting - Orlando 1999 8 Drug Prescriptions F Australian Standard for Drug Prescriptions (AS4700.3) is ready for publication: formal modelling approach. 8 data entities 76 transaction types collapsed into 19 HL7 messages F New Zealand has adopted AS4700.3 as an NZ Standard.

10. HL7 HL7 Meeting - Orlando 1999 9 Referral Messages F Currently being re-established: Chair: David Rowed New scope being defined.

11. HL7 HL7 Meeting - Orlando 1999 10 Govt. Standards Policy F Comprehensive broad-based study on national requirements (Andersen Cons.) focusing on: Health eCommerce. Digitisation & Consolidation of Patient Inf. Aggregation and feedback of information into the Health System, Privacy, security and access F Steering Committee to issue recommendations later this year.

12. HL7 HL7 Meeting - Orlando 1999 11 Australian HL7 Participation F PAFM V2.3.2 Naming Work Group: Moderator: K. Veil Scope: To internationalise the V2.3.2 ("XPN"). Brief fulfilled. Proposal prepared for PAFM 2.3.2 Meeting this week. F Expanded Order Message F RIM Harmonisation Meeting as observer. F … normal HL7 Meeting attendance.

13. HL7 HL7 April Meeting, Toronto, 1999 12 RAPID Specification F Redevelopment of Acute and Psychiatric Information Directions F Covers entire Australian state of Victoria

14. HL7 HL7 April Meeting, Toronto, 1999 13 RAPID Components F Three main components Mental Health Operational Data Store (ODS) Mental Health Patient Management feeder system Data Warehouse

15. HL7 HL7 April Meeting, Toronto, 1999 14 RAPID Coverage - Data Warehouse F Acute admitted episodes F Elective Surgery (waiting / booking list) F Emergency F Aged Care F Ambulance

16. HL7 HL7 April Meeting, Toronto, 1999 15 RAPID Messaging F HL7 based ADT/ACK –A01, A02, A03, A04, A08, A11, A12, A13, A21, A22, A24, A31, A37, A45 ORU/ACK –R01 QRY/ADR –A19 MFN/MFK –M02, M05

17. HL7 HL7 April Meeting, Toronto, 1999 16 RAPID Issues with HL7 F Aliases F Address (suburb is coded in “other designation” subcomponent) F Financial information (implemented as a Z- segment) F Legal status (implemented as a Z-segment) F “Leave of absence”

18. HL7 HL7 April Meeting, Toronto, 1999 17 RAPID Doctor Master File F RAPID relies on a centrally-maintained doctor master file! That is, thousands of instances of a single Doctor master file for the whole State of Victoria. Synchronisation by MFN messages

19. HL7 HL7 April Meeting, Toronto, 1999 18 Central Registries F Notifiable diseases and conditions F Vaccination F Breast Screening F Pap smear F Dangerous Drugs F etc etc...

20. HL7 HL7 April Meeting, Toronto, 1999 19 Central Registries - Early Stages F Support from all States F Recently commenced F Limited HL7 planning to date

21. HL7 HL7 April Meeting, Toronto, 1999 20 Central Registries - Issues with HL7 F Defining Doctors (particularly Doctors in private clinical practice) Address Nature of role of various Doctors involved We notice similar limitations in Australian Pharmacy and USA Center for Disease Control RAPID avoided problem with Doctor master file F Consistent definitions of what data is required

22. HL7 HL7 Meeting - Orlando 1999 21 Other Australian Developments F Community Health (CHIME, CHIS, etc.) F Aust. Government has commited support for attendance at all HL7 Meetings in 1999!

23. HL7 HL7 Meeting - Orlando 1999 22 New Zealand Developments - 1 F Currently re-establishing its position as International Affiliate. F May send a delegate to next HL7 Mtg. F HL7 well-established in NZ: Central PMI accessed via HL7. >60% of clinical pathology results are sent electronically using HL7. F NZ has adopted the Australian Drug Prescrip- tion standard as a NZ standard.

24. HL7 HL7 April Meeting, Toronto, 1999 23 New Zealand Developments - 2 F New Zealand sent 2 delegates to TC215 Meeting in Berlin two weeks ago: Modelling WG Messaging WG F NZ International involvement will be via: ISO TC 215 Standards Australia F Funding currently being investigated. F No activity on NZ Z-segment register.

25. HL7 HL7 Meeting - Orlando 1999 24 Find out more about HL7 Australia at: http://OurWorld.CompuServe.com/Homepages/KVeil Thank You!