Progress on the path to interoperability

The New Zealand Ministry of Health released its roadmap towards interoperability recently with little fanfare, but we think they should have made a bit more of a big deal about it as the plan is pretty good overall.

Refreshingly free of jargon, the document sets out what the current state of play is, what the future state should be, how the health sector will get there and what is probably achievable in five years. The ministry's Health Information Standards Organisation (HISO) calls it a “living document” which will be regularly updated and reports on progress made quarterly.

At the heart of the plan is a commitment to standards, with SNOMED CT the principal standard for terminology and FHIR the basis for building an API infrastructure that will allow disparate systems to talk to each other and exchange data.

New Zealand ditched its plan to build a national electronic health record a few years back and now plans to build what it calls the national health information platform (nHIP), which will share information between existing systems. This was due to begin its roll out in July but a certain pandemic got in the way.

Rather than a national EHR for each citizen imposed from above, the plan is to establish a record locator service that securely indexes health information from trusted sources. The document does say there is still the potential for a consumer-controlled health record, perhaps using the XDS registry-repository model. NZ will also establish an interoperability maturity model based on the one being developed by the Global Digital Health Partnership, which Australia is also involved in.

At the heart of it all is a commitment to open standards approach to interoperability. We like the plan – take a look and let us know what you think.

The open standards approach is being adopted worldwide and it underpins much of what Microsoft is doing with its new Microsoft Cloud for Healthcare, which will be made available at the end of next month following six months of previews. Microsoft is using FHIR-enabled tools extensively in the platform, bringing in a range of connectors and converters it has built to take legacy data formats and convert them to FHIR and using FHIR APIs to connect to a host of third-party applications.

Microsoft also has big plans for its Teams chat and video conferencing platform in healthcare, working with EMR vendor Epic to allow virtual visits to be launched from within the EMR, and with Nuance to allow its Dragon speech recognition platform to be used within Teams. Nuance and Microsoft have been working together for some years on integrating Dragon, which is hosted in Microsoft's Azure cloud, into EMRs and specialist practice management systems to allow clinicians to use voice commands to navigate around and autofill documentation, as well as its traditional use in dictation.

Speaking of Epic, we had a nice story this week on how Royal Children's Hospital is switching on more functionality in its Epic EMR. Clinical teams are now using Epic's secure chat capability, which works like WhatsApp but is accessed securely within the patient record. Royal Children's has tailored this to the Australian healthcare system by building a role-based internal directory within Epic that means clinicians can quickly find out who is directly involved in a patient's care in real time and message them.

RCH has also rolled out some new Spectralink devices for nurses that allows them to access the EMR on the device, along with Epic's Rover app, a barcode scanner and clinical photography. Allied health professionals will use this device as well in future and doctors can access much of the functionality on their own iOS or Android devices. The other three hospitals in the Parkville precinct have also switched on chat and are now building the internal directory capability. It's pretty neat stuff.

We also discovered this week that the Australian government will continue to fund free access for GPs to Healthdirect's Coviu-based video conferencing system, as well as to subsidised SMSs for eScripts. Electronic prescribing is moving at pace, with the capability rolling out to the whole of Victoria shortly.

Most of the GPs we've spoken to who have used the new technology have found it easy to use and pharmacists seem to like it too. That positivity hasn't come through to some of our readers though: in our poll last week, we asked if you thought the roll-out of ePrescribing in primary care had been a success. There's no pleasing some people: 58 per cent said no, 42 per cent said yes.

That brings us to our poll question for this week:

Have you tried ePrescribing yet?

Vote here and feel free to leave your comments below.


0 # Oliver Frank 2020-09-25 18:04
I would like to, but it's not available to me yet to try.
0 # Annabel Kain 2020-09-26 10:33
We have worked with local pharmacies in Sydney to create a list of which ones have the capability to dispense, and have been supported by our PHN to create an even longer list. Patients love it. Very easy to use from the GP side as long as you know that pharmacy can accept it.
0 # aline smith 2020-09-26 16:58
Hi, PHN has not given the list to all practices. How do we access this Annabel?
0 # Colin Chin 2020-09-27 11:56
The Indici PMS in NZ has e prescribing pretty well sorted and is an excellent system.

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