National E-Health Transition Authority (NEHTA) was tasked to develop the standards and provide and manage the development of infrastructure, software and systems required to support connectivity and interoperability of electronic health information systems across Australia and today is an integral part of the Australian Digital Health Agency.E-Health records must be managed throughout their life-cycle and may be composed of multiple other documents in an overall compound document known as a product. Before an e-health document (or product component) could be published and made publicly available digitally, it needed to go through an approval process that included transformation and digital signoff.
Activiti, a leading open-source BPMN engine, was used to orchestrate the product component approval process with the document and metadata stored in Alfresco ECM. Before becoming an e-health record or product component, the document must be sanitised and reviewed by internal and external engineers. Once approved the document is transformed into PDF format and digitally signed so that it cannot be tampered with on publication. These tasks are done automatically using service tasks. The last step is to apply publishing metadata for associated documents and publication details. Alfresco metadata services were used manage metadata and links. A Rest interface was then provided to allow the document to be retrieved from Alfresco and published on the Australian Digital Health Agency website for public viewing.
The publication of e-health document (or product component) provided the key building blocks for a national eHealth system including standards and specifications; identity management; security and authentication; disease and medicines terminology; secure messaging; clinical safety assessment; conformance and compliance management; and procurement and supply chain solutions. The solution ensured that documents could be effectively managed throughout their life-cycle and only published in a tamper proof format following a controlled review cycle.