Where will Telstra Health be in 2022?
This week in health IT got off to a gallop when we revealed there'd been finally been a breakthrough in secure messaging interoperability after many years of reporting on false starts, but by mid-week, all eyes were on the plummeting returns for Telstra's long-suffering shareholders.
We realised that Pulse+IT is getting a bit long in the tooth when we reflected that we've been reporting on attempts to make secure messaging interoperable since the magazine was established back in 2006. Since then, there have been any number of announcements of breakthroughs: the secure message delivery (SMD) standard, the announcement of the SMX collaboration involving the three main vendors, NEHTA's SMD-POD trials, which promised lots and went nowhere.
Just how long this process has taken can be summed up by with a comparison of the date of the announcement of SMX – June 2012 – and the date of this week's communique – June 2018.
But while you'd forgive us for being cynical, it does appear that this time, there has been a real breakthrough. After many years of pistols at dawn, the industry as a whole has agreed to support both CDA and HL7 v2.4 messages. Vendors have agreed to open their private address books to non-customers through a federated search capability, and even the regulators have come to the party, with the Australian Digital Health Agency agreeing to accept private security certificates as well as NASH for authentication.
There's still a bit to go – ADHA's COO Bettina McMahon told us the search functionality was still pretty basic and more work needs to be done – but she had just come out of a meeting with representatives of the two companies leading the proof of concept trials, Telstra Health and HealthLink, and everyone was confident that the finishing line was in sight.
The proof of concepts trials involved not just the secure messaging vendors but practice management software vendors as well, including Best Practice, MedicalDirector, Genie and importantly, allied health software specialist CorePlus. As everyone knows, the next big challenge is to get widespread use of secure messaging outside of the general practice sector, and selling the value proposition to specialists and allied health will be tough.
Spare a thought though for people like Melbourne-based tele-psychiatrist Richard Harvey, who uses the cloud-based PMS Clinic to Cloud and wants to run a paperless practice. Dr Harvey has taken out subscriptions to four different secure messaging services so he can send letters back to GPs no matter what system they use, but try as he might, he can't get GPs to refer to him electronically. Perhaps now Dr Harvey can finally ditch his fax machine, which he never wanted to use in the first place.
The other big story this week was Telstra, which announced a massive restructure of its business on Wednesday and the net loss of 8000 jobs as part of its Telstra 2022 strategy. It plans to hive off its core infrastructure assets into a separate division called InfraCo, containing its data centres, domestic fibre, copper and HFC, exchanges, poles, ducts and pipes, and sell wholesale services back to Telstra and to the NBN. It seems quite obvious that the plan is to sell this off this wholesale business once the NBN is complete, while the retail ISP and mobile business remains with Telstra.
What then happens to ventures such as Telstra Health we don't know, but we can't see how a health software business will fit into either sectors of the new Telstra. Health IT is not retail and it's not wholesale, so it will sit even more uneasily in the new Telstra in future than it does now.
Where once it was possible to see a role for a telecommunications company in healthcare through projects like the National Telehealth Connection Service, it's getting much harder now, and not much has been heard of that particular project for a while. It also seems that Telstra Health has surreptitiously booted its ReadyCare brand and instead combined its direct to consumer telehealth service with its HealthNow app in a new business called … HealthNow.
The app is one of the four that has permission to access the My Health Record but what app-based telehealth services have to do with the MyHR we don't know. It seems an odd juxtaposition and we'll see if we can get some clarity on that in the near future.
We're not holding our breath, however. When we approached Telstra media team this week for some information on what the plans were for the health business, we were told to watch the livestream of the investor conference. As we'd just sat there watching it for three hours we weren't much amused, but according to Telstra's flack, there was no one there to help. Sound familiar?
That brings us to our poll question for the week: Do you think Telstra should sell off its health division following this week's restructure?
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Our poll last week asked: Do you think HealthEngine should close its practice reviews permanently? Most people said yes: 63.5 per cent yea to 36.5 nay.