DI goes live as registrations for My Health Record reach 2.5 million

Diagnostic imaging reports from the Northern Territory are now being uploaded to the My Health Record (MyHR, formerly PCEHR) as consumer registrations for the system reach the landmark figure of 2.5 million, three and a half years after it went into operation.

Over 2000 diagnostic imaging reports in CDA format have been uploaded since the functionality went live at the end of October, Department of Health statistics show. The NT is also contributing specialist letters – over 7000 since that functionality was enabled in April – as well as emergency department and inpatient discharge summaries.

The amount of shared health summaries on the system is also growing, although numbers of the primary clinical document are still very low at just under 65,000, but there are now well over 250,000 discharge summaries on the system, with most public hospitals now routinely uploading them for registered patients.

DoH special adviser Paul Madden told a Primary Health Network (PNH) conference in Sydney last month that on average, 1500 to 2000 people were registering for the system every day, without any significant marketing.

In addition to the 2,501,501 individual registrations, there are 8033 healthcare provider organisations now registered, including 5212 general practices, 214 hospital groups, 1161 retail pharmacies and 155 residential aged care organisations.

Much of the recent movement in clinical document uploads has been driven by the Northern Territory, which is transitioning its My eHealth Record (MeHR) to the national system.

According to a report by the National E-Health Transition Authority (NEHTA) in August, the NT’s system “validates the value proposition” of the national MyHR/PCEHR and has become embedded in clinical workflows.

Pulse+IT understands that the NT Department of Health has worked with IT systems integration specialist DWS to develop software that enables CDA documents to be created from disparate sources. It is also using the Health Identifier and PCEHR System (HIPS) middleware first developed by SA Health and Adelaide-based Chamonix and now licensed by NEHTA.

NT Health has been approached for more information.

Repeat offender: incorrect PBS items pop up again on PCEHR

Another case of incorrect PBS data being uploaded to the PCEHR has appeared, this time involving six scripts being assigned to the wrong person over a six-month period.

A spokesperson for the Department of Health said the situation was rare, but this is the fourth confirmed case that Pulse+IT is aware of in which incorrect PBS data has been exposed on a consumer’s PCEHR.

Three of those cases are understood to be the result of an error by a pharmacist, in which a prescription is filled but the data assigned to the wrong patient in the dispensing system or other pharmacy database. When the pharmacy sends the data to the PBS for claiming, it then automatically appears in the Pharmaceutical Benefits Report section on the consumer’s PCEHR.

In Pulse+IT’s own experience in 2013, two scripts were dispensed to a patient at my local pharmacy but were mistakenly assigned to my pharmacy record. The erroneous scripts then appeared in the PBS section of my PCEHR, and before the intervention of the Department of Human Services (DHS), were likely to appear again as two repeat scripts were dispensed at a different pharmacy a month later.

In this new case, however, six PBS items for common medications have appeared in a consumer’s record but which the consumer says were not prescribed for her. They include a combination antibiotic, dispensed in February last year; a contraceptive pill, a different antibiotic and an asthma inhaler dispensed in July 2014; and another script for the combination antibiotic along with an oral corticosteroid just five days later.

It is not clear as yet whether the scripts were dispensed from the same pharmacy or even whether it is the consumer’s regular pharmacy. It is also not clear who the scripts were written for or by.

The consumer rang the PCEHR helpline on Sunday to report the error but was told by the helpline operator to ring back on Monday between 7am and 10pm as weekend staff were only able to assist with technical problems and had no access to individual PCEHRs.

When she rang on Monday night, however, she was told to ring back during business hours so someone with seniority could assist her. It is understood that the issue will be escalated to a specialist PBS team to investigate, with DHS then working to correct the record with the prescriber or the pharmacist.

The DoH spokesperson said it was “an extremely rare occurrence” for incorrect PBS items to be reported to the PCEHR helpline.

“Nonetheless, this is of concern and all reports are investigated as they are considered clinical incidents and therefore are taken very seriously,” the spokesperson said.

“Our investigations have shown that invariably it is an administrative error at the patient’s medical practice or pharmacy but the occurrence of this is extremely rare.”

While ensuring paper scripts are scanned rather than typed into the pharmacy system should reduce these errors even further, an argument can be made that the use of Individual Healthcare Identifiers (IHIs) be mandatory for all transactions involving medications.

The DoH spokesperson said further work will be done to reinforce IHI matching. “Reinforcing messages are provided to healthcare providers as these incidents are resolved, and messages reinforcing the importance of IHI matching with healthcare providers will be included as part of the coming healthcare provider education and awareness program.”

In the meantime, another argument can be made that it is only through the PCEHR that these sorts of errors are exposed.

“This report highlights the benefits of having consumers managing their own health records and how that can assist to improve the quality of health information, through consumers actively engaging with their health information, identifying errors and having these rectified,” the Health spokesperson said.

Senate committee recommends passage of PCEHR opt-out bill

A Senate committee has recommended that the bill enabling opt-out trials for the PCEHR and a change of name to My Health Record be passed by the upper house.

The Health Legislation Amendment (eHealth) Bill 2015 passed the lower house with bipartisan support last month but it was recommended that the Senate conduct a brief inquiry into some of the privacy and security ramifications of the legislation.

The Senate Community Affairs Legislation Committee received 12 submissions on the bill, including from the Royal Australian College of General Practitioners (RACGP), the Australian Medical Association (AMA) and the Office of the Australian Information Commissioner (OAIC), along with an extensive submission from the Department of Health.

While the committee took into account factors such as privacy concerns over the opt-out model and two other inquiries currently looking at the legislation, it recommended that the bill be passed.

In its submission, the OAIC recommended that before any decision was made to apply the opt-out model nationally, an independent privacy impact assessment (PIA) should be conducted. As the Department of Health points out, one already has.

The only other recommendation is that the Department of Health consider the OAIC’s views on privacy when developing the public awareness campaign for the opt-out trials, which are due to start next year.

Health Minister Sussan Ley recently announced that the trials will be held in far north Queensland and the Nepean Blue Mountains regions of NSW. Pulse+IT submitted extensive questions about the trials to the Department of Health last week but has not yet received a response.

The bill is likely to be passed by the Senate in the current sitting.

International health IT week in review: October 11

Pulse+IT’s weekly weekend round-up of international health IT and eHealth news:

FHIR interoperability advancing, Cerner expects first apps soon
Health Data Management ~ Greg Slabodkin ~ 09/10/2015

EHR vendor Cerner has unveiled a production version of Health Level Seven’s Fast Healthcare Interoperability Resources (FHIR) framework for information sharing based on the latest web standards.


Harlow trust challenges EHR-related fine
Digital Health News ~ Thomas Meek ~ 08/10/2015

The Princess Alexandra Hospital NHS Trust is facing a fine of around £1.8 million for multiple breaches of the 52-week target for treating patients due to problems with its implementation of the Cosmic electronic patient record from Cambio.


Docs accused of using EHR to steal patients
FierceHealthIT ~ Susan D. Hall ~ 08/10/2015

Valley Children’s Hospital in Madera, California, has filed a suit against three pediatric lung specialists, claiming they wrongfully accessed patient records in order to lure them away.


Senators propose bill to create health IT rating system
FierceEMR ~ Katie Dvorak ~ 07/10/2015

Sens. Bill Cassidy (R-La.) and Sheldon Whitehouse (D-R.I.) have introduced a bill to help ensure that certified health IT systems work as promised.


ONC releases final nationwide interoperability roadmap
Health Data Management ~ Greg Slabodkin ~ 06/10/2015

The Office of the National Coordinator for Health Information Technology today released its final Interoperability Roadmap laying out near-term, mid-term, and long-term goals to advance the safe and secure exchange of electronic health information nationwide.


HHS releases updated Meaningful Use rules
FierceEMR ~ Marla Durben Hirsch ~ 06/10/2015

The Department of Health and Human Services has issued the long-awaited final rules changing the requirements of the Meaningful Use program for 2015-2017 and implementing Stage 3 of the program.


Kelsey: EMRs must be ‘fit for purpose’
Digital Health News ~ Thomas Meek ~ 05/10/2015

Electronic patient record suppliers need to improve their engagement with clinicians to create effective systems for the NHS, NHS England’s national director for patients and information has said.


Pulling pharmacists into real time care teams
mHealth News ~ Eric Wicklund ~ 05/10/2015

A home health monitoring project launched by the University of Michigan is giving clinical pharmacists a role that might have previously been handled by the doctor or even a nurse enabling them to intervene quickly when a patient reports blood pressure problems.


Patient advocates reveal what doctors should know about engagement
HealthcareITNews ~ Eric Wicklund ~ 05/10/2015

“Drop the authority. Patients know more about themselves than their doctors do – I am actually the expert in this conversation.”


ONC: Docs sharing data more with patients than other providers
FierceEMR ~ Marla Durben Hirsch ~ 05/10/2015

Physicians increasingly are sharing patient health information, but are doing so more with patients than with other providers, according to a new data brief published by the Office of the National Coordinator for Health IT.


SNOMED to replace Read Codes by 2020
Digital Health News ~ Thomas Meek ~ 05/10/2015

All healthcare services in England will need to switch from Read Codes to the SNOMED system for clinical terminology by April 2020.


Shared record scheme wins EHI Awards
Digital Health News ~ Rebecca McBeth ~ 02/10/2015

A shared care record scheme in the South West of England was the overall winner of the EHI Awards 2015, held in London last night.


ICD-10 day one saw small glitches
Government Health IT ~ Susan Morse ~ 02/10/2015

The long-awaited, oft-dreaded code set converstion has just about everyone talking on October 1.


To med students mHealth is still science fiction
mHealth News ~ Eric Wicklund ~ 02/10/2015

America’s future doctors might like the promise of mHealth, but they’d still prefer seeing their patients in person – even for follow-up visits.


Senator Alexander throws down gauntlet on stage 3 rule delay
HealthcareITNews ~ Greg Slabodkin ~ 02/10/2015

Senate Health Committee Chairman Lamar Alexander (R-Tenn.) on Thursday continued to threaten to use legislative powers to delay the release of the final rules for Stage 3 of the Meaningful Use electronic health records program until Jan. 1, 2017.


ONC to develop patient-generated health data policy framework
FierceHealthIT ~ Dan Bowman ~ 02/10/2015

The Office of the National Coordinator for Health IT will develop a policy framework for identifying best practices, gaps and opportunities for the use of patient-generated health data (PGHD) in research and care delivery through 2024.


Australasian health IT week in review: October 10

Pulse+IT’s weekly round-up of Australian and New Zealand health, IT and eHealth news:

GPs in renewed push against doctor shopping
Medical Observer ~ Staff writer ~ 09/10/2015

GPs and pharmacists have teamed up to complain about the extremely slow rollout of real-time drug monitoring.


Levy steps down from Orion role as Auckland DHBs consider ‘major’ IT investments
NZ Doctor ~ Cliff Taylor ~ 09/10/2015

Conflict of interest concerns have forced Auckland and Waitemata DHBs chair Lester Levy to give up his role as a director of health IT company Orion Health.


Telstra adds to aged care portfolio
Australian Ageing Agenda ~ Natasha Egan ~ 08/10/2015

Telstra Health is in the process of buying ComCare developer EOS Technologies from Silver Chain Group, it has announced today.


Medical, pharmaceutical groups call for prescription monitoring system to stop doctor shopping
Sydney Morning Herald ~ Harriet Alexander ~ 08/10/2015

Nathan Attard was methodical and determined in the way he went about obtaining prescription medicine.


Region fears businesses will abandon Tasmania’s west coast because it will get NBN satellite, not fibre
ABC News ~ Alex Blucher ~ 08/10/2015

There are fears of population decline and businesses abandoning Tasmania’s west coast because the region will not receive fibre-to-the-node or premises under the NBN.


GPs seek relief from guideline overload
Australian Doctor ~ Alice Klein ~ 08/10/2015

Australian GPs are suffering from ‘guideline overload’ and want more succinct clinical practice guidelines that are easier to access, research shows.


Hospital delay to hit parents
The West Australian ~ Cathy O’Leary ~ 08/10/2015

Parents staying at the new Ronald McDonald House in Nedlands will have to be shuttled to their seriously ill children at Princess Margaret Hospital, because of delays to the new children’s hospital.


Orion Health spreads wings with two international deals
NZ Doctor ~ Bruce Lee ~ 07/10/2015

Orion Health has signed deals with a giant UK pharmacy chain and the US Department of Defense with the potential to reach millions of patients.


WA Health to finally end IT leadership limbo
iTNews ~ Paris Cowan ~ 07/10/2015

WA Health has finally begun taking applications for a chief information officer role that has remained in the hands of temporary appointees since 2010.


Royal Adelaide Hospital using computer simulation to plan patients’ transfer to new site
ABC News ~ Staff writer ~ 06/10/2015

A computer simulation will be used to help medical staff at the Royal Adelaide Hospital (RAH) work out how best to transfer patients from the existing hospital site to the new one next year.


Government sets 50Mbps target for rural broadband by 2025
stuff.co.nz ~ Tim Fulton ~ 06/10/2015

The Government says all but 1 per cent of New Zealanders should get broadband speeds of at least 50 megabits-per-second by 2025.


Royal Adelaide Hospital using computer simulation to plan patients’ transfer to new site
ABC News ~ ABC News ~ 05/10/2015

A computer simulation will be used to help medical staff at the Royal Adelaide Hospital (RAH) work out how best to transfer patients from the existing hospital site to the new one next year.


Private medical information of Kiwis divulged in email blunder
stuff.co.nz ~ Sam Sachdeva ~ 02/10/2015

The Ministry of Health is investigating how an email error revealed the private medical information of 24,000 New Zealanders.


Secure messaging on the Apple Watch as iPad targets the enterprise

Apple has shown off the healthcare capabilities of the new operating system for its Apple Watch, demonstrating a US-developed app called AirStrip that allows doctors to securely communicate patient data as well as remotely monitor vital signs, all on their wristwatch.

The company also demonstrated its new, larger iPad Pro that looks a good competitor at the enterprise level with Microsoft’s Surface Pro. It comes complete with new technology that uses magnetic contacts to convey both power and data bidirectionally and allows peripheral devices such as its new keyboard to connect to the device without the need for Bluetooth or batteries.

The watchOS 2 allows apps to run natively on the device so apps can harness its hardware capabilities without it having to be tethered to an iPhone.

It also has a new feature called Time Travel that will allow doctors to see their patient list on the Watch and to scroll forward using its crown to see what is scheduled for the rest of the day.

Apple has worked with US secure messaging platform developer AirStrip to add its capabilities to the apps built for the Watch, including the ability to securely communicate patient data with other clinicians, to view vital signs and even to remotely monitor fetal heartbeats and the mother’s contractions using its new AirSense Sense4Baby app.

AirStrip co-founder Cameron Powell said his platform can be used on the iPhone and the iPad as well as the Watch and demonstrated how an emergency department doctor could receive alerts.

A HIPAA-compliant message containing an alert can be sent by AirStrip to the Watch as well as live feeds of a patient’s vitals signs such as heart rate and blood pressure. Their lab results can also be messaged, and the doctor can send a reply back with one tap.

Dr Powell said private patient data is secured because the Watch will authenticate the user as soon as they put it on until they take it off.

He said the AirStrip technology is already being used to monitor pregnant women in hospitals, but the company’s new Sense4Baby app allows the doctor to monitor pregnant women at home.

The woman can run a non-stress test by placing sensors on her belly, which sends information on the fetal heart rate and the mother’s contractions to the app on the watch. The watch itself is able to read and monitor the mother’s heart rate.

“Finally, we can differentiate between the mother’s heart rate and the baby’s heart rate, which has been a problem for many years with home monitoring,” Dr Powell said. “While she’s doing the test, she can listen to the baby’s heart rate right on her wrist. Then when the test is done, she can simply send all of that data from her watch back to her doctor.”

The doctor can then send a secure message back to the patient advising her on whether to remain at home or prepare to come in to hospital, all using HIPAA-compliant secure messaging and all through a small device worn on the wrist.

“AirStrip, plus Apple Watch together, will redefine how messaging and communication occurs in healthcare,” Dr Powell said.

Apple also demonstrated the new iPad Pro, which features a large 12.9-inch Retina display and a new 64-bit A9X chip, which Apple says will rival most portable PCs.

Irene Walsh, head of design for start-up firm 3D4Medical, showed how her company’s 3D medical images can be displayed and manipulated on the iPad using the swipe motion but also Apple’s new Pencil precision input device. The app allows healthcare professionals to demonstrate procedures to patients and medical students to get a 3D grasp of human anatomy.

Apple Pencil also works with popular apps like Mail, Notes, Procreate and Office 365 for iPad.

Its new Smart Keyboard further extends the utility of iPad Pro, offering a full-sized keyboard in a durable design. The Smart Keyboard attaches to the iPad Pro’s new Smart Connector port, eliminating the need for a separate battery, on/off switch or Bluetooth pairing.

The Smart Keyboard is covered in custom woven fabric and features keys that provide the accuracy, stability and satisfying key feel of standard keyboards, but is also easily foldable and can transform into a Smart Cover.

The iPad Pro is due in Australia and New Zealand in November, although pricing has not been released.

The watchOS 2 update will be available for free on September 16.

Queensland sees big increase in outpatient services through telehealth

Queensland has seen a 42 per cent increase in outpatient services provided by telehealth in the 2015 financial year, with inpatient services also increasing across the state’s 3000-odd systems.

Oncology medical consultations led the pack in outpatient services provided, while geriatric and general medical/surgical consultations saw the most growth for inpatient telehealth services. Inpatient consultations saw a doubling in growth over the period off a low base, Queensland Health figures show.

Queensland Health Minister Cameron Dick last week confirmed his government’s commitment to telehealth, shared by his predecessor, during a speech to the Committee for the Economic Development of Australia (CEDA) in Brisbane.

Mr Dick said telehealth was able to reduce “the tyranny of distance which has undermined regional service delivery in Queensland for 200 years”.

“Telehealth is generally associated with taking services into remote and isolated communities, which is especially relevant in a state such as Queensland,” he said.

“Queensland currently has one of the largest managed telehealth networks in Australia. Over 3000 systems are deployed in over 200 hospitals and community facilities, supporting more than 70 clinical specialities and sub-specialties in providing telehealth services across the state.”

He said telehealth had real potential in making the delivery of health services more efficient in large regional areas as well as remote.

“In the past, a specialist or more often, the patient, had to hop on a plane and fly to Bundaberg, Mackay or Charleville for specialist appointments.

“But increasingly, that specialist will be able to stay at their home base, the patient stay in their own home and use telehealth facilities to treat patients.

“Whilst we continue to have a strong focus on ensuring we provide the best possible services to our more remote communities, there is much to be gained from a renewed focus on meeting the high volume demand in regional centres.”

The Queensland Health figures show that Metro North Hospital and Health Service (HHS) had overtaken Darling Downs HHS in the number of outpatient occasions of service for the year, closely followed by Mackay, Central Queensland, Townsville, and Cairns and Hinterland. All but one HHS exceeded their targets for the year.

Mr Dick said Townsville Hospital was providing oncology, renal, diabetes and rehabilitation services to regional centres in the Townsville HHS and Mackay, while Cairns services its regional centres on the Tablelands with geriatric, oncology and diabetes services, to name a few.

The top 10 outpatients clinics provided by telehealth throughout the state were: oncology medical consultation, orthopaedic surgery, diabetes, general medicine, paediatric medicine, gastroenterology, haematology, cardiology, primary care and nephrology.

For inpatient separations, West Moreton HHS led from the front, followed by Sunshine Coast, Metro South, Metro North and Darling Downs.

The main inpatient services provided were geriatric, general medical/surgical, palliative care, intensive care, rehabilitation, orthopaedic and medical oncology.

Mr Dick said he was very enthusiastic about future uses of telehealth. “As our population gets older and needs more services, I believe that it is possible that people may be able to be treated in their own home, under the guidance of a clinician.

”This is way into the future, and will be guided by the technological availability of such services. It’s not going to happen overnight. But imagine the efficiencies that can be gained here for both the health system and the health consumer.

“[Telehealth] maximises the precious time of treating clinicians, it delivers services as close to the consumers home as possible and reduces the tyranny of distance which has undermined regional service delivery in Queensland for 200 years.”

Zedmed to go live with MIMS drug-health, online appointments

Zedmed is set to release version 24 of its clinical and practice management software with a number of new features, including a re-released version of MIMS’ drug-health interaction clinical decision support module and an API that will interface with a new integrated online appointments booking service and a recall service Zedmed has built in association with fellow Melbourne firm HotDoc.

Zedmed CEO Richard Ireson said v24 will be available for general release at the start of next week, with the online appointments system to be released at the end of the month. The new release features a revamped version of the drug-health module that MIMS has worked on with Zedmed, which checks for interactions between a medicine about to be prescribed and a range of health conditions.

The drug-health module provides a rating of the potential severity of the interaction, as well as an indication of the level of documentation that supports the evidence and the references from which this has been derived.

While it is still up to doctors to use their clinical knowledge and expertise to make the best decision, MIMS said the drug-health module allows them to consider relevant information that may otherwise be missed in the mass of data available.

Mr Ireson said MIMS had an existing drug-health module but it did not contain the intuitive alerts functionality that is a feature of the re-release. The rating system for severity is similar to a traffic light indicator of green, amber and red, but the main feature is that it doesn’t require the user to have to remember to switch it on or to look for interactions.

“It works automatically in the background and that’s why MIMS is so excited about it,” Mr Ireson said. “You don’t have to enable it; they just put in the drugs that they want to prescribe and it comes up with the alerts.”

Mr Ireson said the module accesses the historical knowledge of the patient and once any new prescriptions is added, it will analyse it for adverse interactions and sent an alert.

“It’s a great feature,” he said. “It is taken quite a while to get right as there are several different types of improvements around it. The developers have made it more efficient, more intuitive and performance has been improved also.”

The drug-health module is also available in other GP and specialist software packages including Clinic to Cloud, Shexie and Stat.

Mr Ireson said Zedmed was also set to go live with an integrated online appointment booking system at the end of the month as well as a new recall service, both of which it has worked on with HotDoc.

Version 24 will have the API enabled but the service is still going through the final stages of beta testing.

Mr Ireson said the company chose to develop its own system rather than use a third-party product for security and privacy reasons, as well as performance.

“When we developed the API we were really trying to embrace those elements into our product,” he said. “We think that’s really important for our customers to have an enriched experience and relying on third-party providers that mainly use the directory model, accessing the database and potentially using patient information for marketing purposes, is something that we don’t really subscribe to.

“We felt that by developing our own API and collaborating with HotDoc, who share a common philosophy with our own strategic technology roadmap, that we could develop a really ground-breaking product together.

“We like the consumer base products they have and they like the fit that we provide in our practice management and clinician products. It’s a good symbiotic arrangement.”

The new SMART recalls system allows practices to send a secure notification to the patient’s mobile phone rather than having to print out and post a recall letter. The patient is sent a link to their recall information, which they can access after completing a three-point identity check.

The patient can then see their recall information and book an appointment online or on the phone. Zedmed is offering recalls and online appointments separately or as a bundle.

Mr Ireson said this sort of mobile technology is increasingly favoured by consumers and is leading the future development of Zedmed in terms of the interaction between practice, clinician and patient.

“Our aim is to provide efficient, integrated and secure mobile communication,” he said.

“Communication from the patient back to the practice or to the clinician needs to be smarter. These are the types of mobile solutions we are working on with HotDoc and other third-party providers to make the user experience more expeditious and more streamlined. That’s where the real power of efficiencies comes from.”

Zedmed v24 has a number of other features the company is set to reveal, including bulk billing integration with Tyro with batch processing.

It also resolved some time ago the error that caused a Zedmed user to be labelled a ”meat inspector” when writing a shared health summary for the PCEHR.

Mr Ireson said that problem occurred due to a mismatch between some codes delivered by the National E-Health Transition Authority (NEHTA) and similar codes that were developed in one of the earlier releases of Zedmed. It reappeared due to the use of templates by some users, but has since been fixed, he said.

Pharmacy Guild ramps up pressure for controlled drugs system

The Pharmacy Guild has joined calls from other healthcare provider groups for the introduction of the Electronic Recording and Reporting of Controlled Drugs (ERRCD) system in light of continued avoidable deaths from prescription drug overdoses.

The Guild has joined the Pharmaceutical Society of Australia, the Royal Australian College of General Practitioners, the Royal Australasian College of Physicians and the Australian Medical Association in lobbying for the system, which is currently available for implementation by the states and territories.

The RACGP repeated its support for a real time system as recently as last month following another coroner’s inquiry into an accidental overdose.

The Medical Software Industry Association (MSIA) has also backed the calls, with a spokesperson saying the association agrees wholeheartedly with the Guild’s call for prompt implementation of the national system.

Writing in last week’s edition of its Forefront newsletter, Pharmacy Guild executive director David Quilty said it was time for doctors and pharmacists to unite in demanding a national system for the electronic recording and reporting of controlled drugs.

“For too long, governments have dawdled and blame shifted, instead of putting this vital medication management tool in place,” Mr Quilty said.

“Coroners in virtually every jurisdiction have consistently called for an ERRCD to no avail. It is a sad situation when the voice of the coroner is starting to sound repetitive.”

Mr Quilty said money was made available under the Fifth Community Pharmacy Agreement (5CPA) to develop a national ERRCD solution, which was based on Tasmania’s Drugs and Poisons Information System Online Remote Access (DORA) system.

DORA involves a controlled drug electronic register that is integrated with pharmacy dispensing software and is also accessible by prescribers. It allows for real-time reporting as opposed to the paper-based system that pharmacists use now.

However, while NSW is understood to have made some progress, the MSIA spokesperson said only the ACT had implemented it.

“Under the 5th Community Pharmacy Agreement, the MSIA was contracted to develop nationally consistent specifications for reporting the dispensing of controlled drugs to state and territory health departments,” the spokesperson said.

“This work was completed in April 2014. To date, only the ACT health department (Health Protection Services) has adopted this solution.

“Dispensing vendors stand ready to implement this important reform. We know it will save lives.”

Chief pharmacists from all jurisdictions are understood to have discussed the issue at an opioids roundtable in Canberra in late May.

Mr Quilty said the reasons given for the lack of progress with the ERRCD vary from squabbling over funding to disagreements in relation to the best technological solutions.

“The stop-start approach to e-health has not helped, with a comprehensive e-medication management system providing the most sensible longer term solution to the problem,” he said.

“While the States and Territories have made varying degrees of headway in introducing real time electronic monitoring systems, a national ERRCD is still an unacceptably long way off.”

While the proposed ERRCD only monitors Schedule 8 drugs like opioids and Xanax, a solution is also required for Schedule 4 drugs of addiction such as benzodiazepines, which when combined with other drugs and alcohol are the most frequent cause of death from multiple drug toxicity, Mr Quilty said.

He said Project STOP, the Guild-developed system that targets pseudoephedrine misuse, showed that it was possible to product a reliable, real-time monitoring system.

“It is time for governments around the country to do the right thing, sort out their differences, remove the roadblocks and ensure that the ERRCD is put in place as quickly as possible,” he said.

“The issues are clearly identified and it is time to produce the solutions, including a timeline of where each state and territory is up to in its implementation of the ERRCD.”

HealthLink goes national with ‘any to any’ eReferrals

Auckland-based secure messaging vendor HealthLink is making its CareSelect eReferrals system available to GPs throughout New Zealand for secure ‘any to any’ referrals, allowing them to search for and select from a comprehensive range of specialists, allied health providers and non-government organisations.

CareSelect is widely used in Auckland, Northland and Wellington to send eReferrals to hospitals, but it has also been trialled for the last 18 months to communicate with non-hospital specialists and allied health professionals.

According to HealthLink, over 180 practices in Auckland and Northland are using CareSelect to send over 1000 eReferrals a month. HealthLink has worked with its First Movers’ Forum, a group of tech savvy GPs who provide direct user feedback on new services, to develop the system.

CareSelect contains a database of specialists, allied health providers and non-government organisations that GPs can easily search and then select a suitable practitioner. The eReferrals are pre-populated with the patient’s data extracted from the practice management system (PMS) or electronic medical record (EMR) and the system uses HealthLink’s familiar Health Information Standards Organisation (HISO) form interface.

The GP can send the eReferral by secure messaging if the recipient has a HealthLink EDI, with compatible EMRs receiving the eReferrals directly into their system., or it can be printed out and faxed.

While most GPs would refer to certain specialists regularly, CareSelect allows them to do a wider search to find the best available referral option for their patients. It involves a simple key-word search for name, specialty or diagnosis.

Specialists and allied health providers are being offered a free or standard listing that details their core speciality and contact details as well as the ability for GPs to create a HealthLink referral, but there is also a paid option that allows practitioners to list their full bio including a photo, logo, details about their various specialties, interests, qualifications, affiliations and languages spoken.

HealthLink CEO Tom Bowden said the average referral can be created and sent within one minute in more than 60 per cent of cases.

“This makes it very straight forward to use within a standard general practice consultation,” Mr Bowden said. “The technology itself is highly reliable and well understood by users, as it is currently being used for approximately 90 per cent of all GP to hospital referrals in the Auckland, Northland and Wellington regions.”

Mr Bowden said the significance of being able to make ‘any to any’ eReferrals cannot be underestimated.

“The implications for improving certainty in care for patients is phenomenal, with GPs being able to easily and reliably refer patients to the most suitable provider,” he said.

“The reality is that GPs have a tough job when it comes to referring patients to anyone other than a hospital. With a huge and growing range of providers it is difficult for a GP to stay on top of every service and provider available for their patients.

“CareSelect is a game changer because it matches a GP to the relevant provider for any given patient need.”

HealthLink plans to make further enhancements in future to include the ability for an informal dialogue between referrer and referral recipient, and the ability to track a referral’s current status. Some of this functionality is already available in the Auckland GP-hospital eReferral system and will be fine-tuned prior to implementing in CareSelect.

HealthLink also recently launched a new service allowing GPs to lodge work capacity medical certificates with Work and Income New Zealand (WINZ) electronically.