Hopes high for GP2GP-style record exchange

Pulse+IT headed to HISA's Health Informatics Conference in Melbourne this week, as we are wont to do, and what a smashing event it turned out to be. The focus at HIC is often on the acute care sector and, naturally, health informatics, and there was certainly plenty of that, but we were very pleased with the depth of presentations from primary care and even aged care this year.

We were also delighted to see the former chair of the RACGP's eHealth expert committee, Nathan Pinskier, pick up HISA's prestigious Jon Hilton award. Dr Pinskier, who does a huge amount of voluntary work in the background lobbying for standards and quality in health IT, joins luminaries such as Grahame Grieve, Adam McLeod, Mike Georgeff and Terry Hannan in winning the award.

In addition to the wider use of standards-based secure messaging, Dr Pinskier has always been keen on the idea of a secure system for transferring medical records when a patient moves to a new practice. The UK and New Zealand have for years had systems, both called GP2GP, that allow a patient's data to be electronically transferred to the new practice even if the practice management system is a different brand. In Australia, those records that are transferred are generally sent by fax or post and scanned in at the other end.

The good news is that the CSIRO's Australian eHealth Research Centre (AeHRC) in Brisbane has been commissioned by the Department of Health to work on a set of primary care projects to improve data quality by using FHIR and SNOMED CT, and one area being worked on at the moment is the practice-to-practice transfer use case. There are plans for this work to be expanded to the residential aged care software industry as well to support the transfer of records in aged care.

This was a pleasant surprise to hear, as we had just attended a workshop on how technology can help aged care and it was disconcerting to say the least to find that the same questions are still being asked about technology in aged care now as they were a decade ago. Former iCareHealth managing director Chris Gray made a mention of this in his presentation, when he reminded attendees that back in 2005, the then government provided funding of $1000 per RACF bed that saw a big uptake in digital adoption. Government incentives work, Mr Gray said.

But while about 90 per cent of aged care facilities now use a resident management system, there is still the problem of transfer of data between care settings, particularly primary care and hospitals. As Macquarie University's Johanna Westbrook told the Royal Commission into Aged Care Quality and Safety last month, the aged care sector is helping to keep the fax business going. (Professor Westbrook's evidence to the commission is worth a read: it begins on page 38 of this transcript.)

The Aged Care IT Industry Council is currently putting together a submission to the Royal Commission focusing on one of its terms of reference – how best to deliver aged care services in a sustainable way, including through innovative models of care, increased use of technology, and investment in the aged care workforce and capital infrastructure – but with 50 per cent of aged care providers running at a financial loss, investment in technology from the industry as a whole seems as far away as ever.

That being said, Mr Gray made the point that technology is just a tool and that innovation starts with people. He pointed to innovative organisations such as Lively, which is bringing together young people and older people living at home to help solve several social problems such as loneliness, which is fast becoming a healthcare concern. This was echoed in an inspiring presentation by RMIT University's Matiu Bush, who has helped develop the world's first wearable aimed at detecting loneliness in elderly people living in their own homes.

Mr Bush pointed to statistics showing that people have a 20 per cent increased risk of mortality if they are chronically isolated and lonely. It also means a 60 per cent increase in the use of GPs and emergency departments, and in what ED clinicians call a positive Samsonite sign, where older people turn up at ED with their suitcase packed ready for a social admission.

Technology is thought to be able to help solve these problems, but it was interesting that in a 90-minute workshop on how technology can assist aged care, the My Health Record was mentioned just once.

The acute care sector was certainly not forgotten at HIC and our story on some impressive figures coming out of Royal Children's Hospital following its Epic implementation quickly became the most popular for the week. There were a few product announcements that proved equally popular, including the new Dragon Medical dictation system from Nuance, which will allow doctors to use their phones as a microphone, and the integration of Pen CS's clinical audit tool with Healthily's GoShare platform.

We'll have a number of stories in the coming weeks from HIC. In the meantime, try our poll question: Will technology improve the quality of aged care?

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

Last week, we asked: Do you support the ACCC's decision to act against HealthEngine? Overwhelmingly yes: 93 per cent agreed, just seven per cent said no.

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