Point of no return

It's been a big week in national eHealth projects with the Australian Digital Health Agency announcing some serious growth in connections to the My Health Record in the community pharmacy sector. More general practices have also connected over the last year to register a substantial 92 per cent of all general practices – we don't think there will be any more growth there as some GPs will permanently opt themselves out – but it looks like the pharmacy sector is seeing some benefit in signing up, even without financial incentives.

There was also some news in the pathology sector, with NT Health revealing it hopes to be the first jurisdiction in the country to add links in the pathology reports it uploads to the My Health Record to the Lab Tests Online (LTO) website. This excellent little resource has been around for a decade or more and provides a wealth of information about the often obscure world of pathology, so much so that the rumour is more medical students use it than the general public.

Embedding a link to information about a test within an actual test report is an idea that has been floated in the past so we'll be keen to see how NT Health goes about it. The people behind LTO tell us they are keen that other jurisdictions follow the leader. (In other pathology news, we are hearing that SA Health is now uploading pathology and diagnostic imaging reports from its hospitals to the My Health Record. We'll bring you that story next week.)

Also this week we heard about some progress on the National Cancer Screening Register (NCSR) front. While this project has been dogged by controversy from the very beginning – from Telstra Health winning the tender to attempts to reverse that contract to problems in migrating data to delays in the HPV test roll out – we are now assured that the system is functioning well and is ready to begin taking over the bowel cancer screening regime from the manual process at the Department of Human Services.

It's an obscure subject to all but those in the eHealth world but the insistence by Telstra Health that the localised HL7 v2.4 pathology messaging standard be used for messages going to and from the register – which has had the effect of upgrading public and private pathology labs – may in future be one of the project's crowning achievements. The increase in use of the Individual Healthcare Identifier due to the upload of pathology reports to the My Health Record will also be a major benefit to interoperability and patient safety in the future. The US, for instance, is still struggling with this problem.

We also heard from ACT Health, which has managed to convince the government to put $70 million towards its digital health strategy over the next four years. That is a substantial sum for what is in effect a three-hospital system so while there are no actual details on whether ACT Health plans to replace its existing scanned medical record with an electronic one – they simply refer to a “digital health record” – there's enough money there to buy an EMR if they are in the market. You would think that if that is the plan, it's possible that the ACT would choose the EMR that NSW uses.

Speaking of which, it was reported elsewhere this week that former eHealth Queensland CEO Richard Ashby, who was forced to resign in January under a Crime and Corruption Commission cloud, will not be returning. A search is now underway for his replacement, six months after his resignation.

Nothing ever leaks from the CCC before it is ready to speak so we are not sure what will come of its investigation, but in the meantime eHealth Queensland may be able to wipe the slate clean and get on with its long-planned procurement of a new PAS to replace HBCIS. There were only two vendors on the shortlist last time we checked – Cerner and DXC – because it was considered that a restricted tender was the way to go.

This decision may now be revisited and perhaps some new players can get their feet in the market. However, considering the complexity of the job and the limited options in the market, you'd still be betting that Cerner and DXC would still be the two most likely.

That brings us to our poll question for the week: do you think ACT Health should buy an off-the-shelf EMR?

Sign up to our weekend edition or Pulse+IT Chat to vote, or leave your thoughts below.

Last week, we asked: Do you think our hospitals take cybersecurity seriously enough? Some do, but most don't. Sixty-five per cent said no.


+2 # Mark Santamaria 2019-06-10 10:18
I always love the concept of ‘off the shelf’ EMR solutions. What does it actually mean? If you look at previous implementations of ‘off the shelf’ EMRs in Australia, and other parts of the world, it is not as easy as the term might suggest. There are a multitude of factors, expense, base model / bells and whistles, inflexibility, proprietary database, interoperabilit y, usability, etc. None of the ‘off the shelf’ models satisfy even half of what clinicians need to provide patient-centred and value-based health care. There are many innovative developers in Australia that have been excluded from the domestic market making commitment to research and development very difficult. Maybe now is the time to look beyond the barely acceptable and finally develop and implement solutions made for Australian health care that supports patients and their clinicians.

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