Practice guide to clinical software PCEHR functionality
There is no doubt that the new eHealth PIP (ePIP) requirements mean practices will have to start looking carefully at their current practice software capabilities and determine whether they will be able to fulfil the requirements of the ePIP.
NEHTA’s ePIP register is an easy way to check whether your practice software will qualify, but it is recommended that you consult with both your software supplier and IT professional to ensure everything will be in place before the deadlines. While some vendors have already added some functionality, they may not yet be listed on the register.
Vendor panel members
All of the members of NEHTA’s GP software vendor panel are close to full PCEHR compliance and will begin software rollouts soon.
Best Practice has been involved in the vendor panel from the outset, and has also been involved in a number of the Wave 2 sites for the implementation of the PCEHR. It assisted Health Industry Exchange (HIE) by providing it with access to its underlying database structure, allowing HIE’s plug-in product Companion Gateway to upload the first document to the PCEHR in early September.
The company released its HI Service functionality in version 22.214.171.1245 in May, and has had long-standing arrangements with both eRx and MediSecure for electronic transfer of prescriptions and with Argus for secure messaging.
Best Practice version 1.8 is registered on the ePIP register for the HI Service and ETP. It uses a bespoke clinical coding system dubbed PYEFINCH, which Best Practice CEO Frank Pyefinch said is 85 per cent mapped to SNOMED CT.
The company is close to beginning the roll out of its PCEHR-compliant software and hopes it will be ready before the end of the year.
Communicare eHealth Solutions predominantly works in the community healthcare sector with particular expertise in Aboriginal healthcare.
It has been listed on the ePIP register for its interface with the HI Service and has passed all four of the NEHTA CDA conformance tests, which means it will be able to author, render and package CDA documents and create shared health summaries.
Communicare uses ICPC2-PLUS as its clinical coding system and Argus for secure message delivery. According to operations manager Heidi Tudehope, Communicare is hopeful it will fulfil all of the ePIP requirements with its next version, which is due out soon.
“We are on track to have everything going by December,” Ms Tudehope said. “With the ETP specifications, we have got them and are working on them at the moment. Regarding the PCEHR, that is under development at the moment and our B2B interface will be available in version 12.5.”
Genie Solutions released version 8.3.4 on October 28, complete with full HI service integration and PCEHR compatibility.
It has the ability to upload shared health summaries and event summaries to the PCEHR, and to also download the same from a patient’s PCEHR. Genie users have successfully uploaded documents to the PCEHR in practice.
The next version of Genie will add eRX integration for ETP, Genie's managing director, Paul Carr, said. MediSecure integration has been available for several years already, and Genie has had the ability to include coding in either ICPC-2 PLUS or ICD10-AM for many years.
“SMD capability is almost finished,” Dr Carr said. “This will be the final step in making Genie fully compliant with the eHealth program.”
Medtech Global will have full functionality for the PCEHR in version 9.0.0 of its Medtech32 software, which is due to be released shortly. The company achieved integration with the HI Service some time ago and the current version of Medtech32 is able to look up and store patient IHIs.
Medtech has demonstrated it can download a CDA document and has achieved its CCA certificate for shared health summaries. The technology is available for uploading documents but Medtech is still waiting for its certificate. It is ETP-compliant, and users can also choose whether to use eRX or MediSecure as the system can integrate both.
Medtech Global’s CTO, Rama Kumble, said the company had shown the actual workflow of its PCEHR interface to a group in Brisbane recently. “They were pleased to see us showing how this all works in the practice situation, the workflow part of it,” Mr Kumble said.
iSOFT, which was taken over by CSC Healthcare last year, was the first member of the software vendors panel to integrate the HI Service into its practiX software, achieving the milestone in July last year.
The company has been working closely with some of its sites to test how the integration works in real terms, and has found that those sites using the HI Service are very pleased with it, according to CSC’s out of hospitals solution manager and leader of its PCEHR project team, Perry Pappas.
“[We] visited one of our champion practices recently and their comment was they generally [look up the IHI] on admission,” Mr Pappas said. “They’ve got the patient in front of them and they can confirm their details as they are standing there, and their hit rate was in excess of 90 per cent.”
CSC also achieved certification in November last year for its secure messaging component, and successfully achieved the first part of its CDA requirements for the PCEHR – unpacking and rendering – in July. practiX is now registered as compliant with the PCEHR on the ePIP register.
Mr Pappas said the company will soon be in deployment mode, installing and testing the new features at its pilot sites.
Zedmed was the first software package to be fully compliant with the PCEHR requirements and is now in general release. It received notification that it had passed its CCA certificate to both view the PCEHR and to upload shared health summaries in September.
In late October one of its users, general practitioner Bernard Shiu, successfully uploaded a document to a PCEHR.
Zedmed business analyst Jane Blakeley said Zedmed has had HI Service interface capability in its software since last year.
The software also currently supports the ETP requirement, with the ability to use either the eRx or the MediSecure prescription exchanges. It also has full SMD standard capability, although it is not yet listed on the SMD register.
“We are working with both Argus and HealthLink on SMD capability and my understanding is that they and Global Health are working together on a project to work interoperably,” Ms Blakeley said.
Broader market progress
In addition to the software vendors panel, other clinical software companies have been working to integrate PCEHR functionality into their products.
Australia’s market-leading supplier of clinical software will have full interface capability with the PCEHR in advance of the deadline to qualify for the ePIP, according to Health Communication Network (HCN).
Medical Director is on the secure messaging, ETP and HI Service registers, and will have full PCEHR connectivity in place for users well before the May 2013 deadline, former HCN CEO John Frost told Pulse+IT.
For SMD, users can use the MDExchange component in Medical Director or sign up with secure messaging vendors such as HealthLink or Argus. The software integrated with eRx some time ago.
Health Identifier and CDA capability for specialist letters was released in Medical Director in January this year, and Mr Frost said this would facilitate standards-based secure communication between clinicians and the ability to connect to the PCEHR, the release of which is imminent.
Stat Health is also working on its functionality, and is already listed on the ePIP register for ETP. It has integrated with eRx for electronic transfer of prescriptions and was the first product to be listed on the register when it launched.
Stat Health CEO Carla Doolan said the company was now working on integrating the HI Service, which is expected to be completed soon. “SMD will follow IHI development and then the integration of the PCEHR,” she said.
Specialist clinical software vendor Shexie is also working on adding PCEHR compatibility. It has recently undergone a major overhaul to run on a SQL database, and has taken the opportunity to add a few more enhancements to its product.
While it is mainly used by specialists and surgeons, Shexie has some day surgery and GP clients as well. Shexie director Dean Jones said his company has been working closely with NEHTA to add PCEHR and other eHealth capability.
He said his team was aiming to have the new version, called Shexie Platinum, up and running at the end of the year, but as it will contain a number of new functions, a full rollout might take until early next year. Shexie will add SMD capability as well as HI Service search and validation.
Mr Jones said users will be able to access and upload documents to the PCEHR, which in the case of specialists will predominantly involve uploading event summaries and specialist letters.
Intrahealth is working towards being fully compliant with the new requirements for its Profile practice management system for GPs and Profile Specialist for specialists.
It has been listed on the ePIP register as conforming with the requirement to interface with the Healthcare Identifiers Service.
Intrahealth's area manager for Australia, Karam Kanan, said the company was currently working on integrating ETP with one of the two vendors of electronic prescription exchanges, as well as developing SMD capability.
He said Profile will qualify for the third requirement, clinical coding, as it is able to use the ICPC-2 PLUS, ICD-10 or SNOMED clinical terminologies and classifications.
For the full interface to the PCEHR, Mr Kanan said the company had started work on specifications and would be ready in time to enable users to comply with the May deadline.
While it does not have a large customer base as yet, web-based EHR vendor HTR believes it was the first company to have demonstrated connectivity to the PCEHR, presenting at a health consumers’ conference in WA with NEHTA in late June.
Its Telhealth solution has been available since 2011, when it passed its compliance certification for the SMD standard.
Telhealth also has full PCEHR functionality, including the ability to create, upload and download shared health summaries, event summaries and discharge summaries, and has been listed on all four of the product registers.
Acute care and aged care
The acute and aged care sectors are also gearing up for the PCEHR, adding functionality to allow authorised users to play their part in the PCEHR system.
In acute care, Emerging Systems and CSC have been heavily involved in developments. Emerging Systems’ EHS system is used at St Vincent’s Hospital in Sydney, which is part of the Eastern Sydney Connect Wave 2 site.
In early November St Vincent’s was able to allow hospital clinicians to view the shared health summary that a patient’s GP had uploaded. The system was also able to send an electronic discharge summary to the patient’s PCEHR.
CSC has also demonstrated its functionality, having incorporated the HI Service into its i.PM patient administration system, which is used in over 300 hospitals in Australia and New Zealand. As CSC owns both the practiX and i.PM brands, it has been able to demonstrate that it is capable of sending eReferrals from practiX straight to i.PM using secure messaging and the HI Service.
In aged care, work has already begun on PCEHR compatibility and an aged care vendors panel has been established, consisting of Autumncare, DCA, iCare, Leecare Solutions and ComCare. Both Leecare Solutions and iCare have already integrated HI Service functionality into their software.
Posted in Australian eHealth