A health informatics professor from Sydney University today said Australia's e-health systems should be strictly open source rather than using proprietary software.
Professor Jon Patrick, a health informatics researcher at Sydney University, reckons Australia is heading down a high-cost and ultimately unworkable path for its e-health systems, which could repeat mistakes of the past.
Patrick pointed to frustrations he claimed clinicians are experiencing in attempting to customise FirstNet, NSW's Emergency Department $80 million information system built by vendor Cerner. "One of their frustrations is that they can't get systems changed to suit local needs and there's no pathway to getting change," he said.
Patrick said the current requirement for "closed vendor" supplied systems cannot support code changes to enact new processes to existing systems. "The only way to get these things changed at will is to have access to source code which implies an open source solution," he told ZDNet.com.au.
"They need to be able to get things designed to suit local needs and then changed to local needs," he said.
Patrick's comments follow the release earlier this year of the National Health and Hospitals Reform Commission (NHHRC) which recommended up to a $1.9 billion government investment to kick off e-health in Australia. It had recommended finalising an open technical standards framework by 2012.
However, Dr Mukesh Haikerwal, a former commissioner of the NHHRC, a general practitioner and head of the National E-Health Transition Authority's (NEHTA) clinical unit, said it was too early to debate whether open source was the best fit for e-health. "Before we get to whether open source or proprietary software is better, we need to make sure we get e-health out there. To do this we need the government to commit to the infrastructure first," Haikerwal told ZDNet.com.au.
The problem at this stage, according to Haikerwal, was that while, for example, the Prime Minister had blogged about e-health, there was no financial commitment from the government yet.
"If you look at the Prime Minister's blog, he's talking about [health], but we now need someone to get on the white charger like Tony Blair or Barrack Obama did," he said.
But while e-health lacks its Australian white knight, Haikerwal warned the "show stopper" would be if the government got privacy and medical legal aspects of e-health wrong.
Beyond privacy, though a key piece to delivering health care, in particular for remote areas, said Haikerwal, was the government's current $43 billion plan to build a fibre-to-the-home network, which would aid the use of health applications to be developed in the coming eight years as the National Broadband Network was built. Other pieces of infrastructure under development by NEHTA included health provider and patient identifiers, authentication systems, secure messaging and an index of service providers, said Haikerwal.
"As long as you have those components the source of the software doesn't matter," said Haikerwal.
Haikerwal said NEHTA did not want a "captive system", explaining that "we want to use people in our skilful IT industry to give us IT solutions — and we need to make sure that the standards are interoperable."
"If we have the building blocks right, and [across the board] standards signed-off, we then have some surety about a stream of suppliers," he said.