A tale of two technologies

The big news this week in digital health was the expansion of Australia's roll out of electronic prescriptions to metropolitan Sydney, following the fast-track implementation in metropolitan Melbourne and then the rest of Victoria as a weapon in that state's battle against the Covid-19 pandemic.

Also this week we saw some rare movement in the secure messaging arena, with a number of clinical information system vendors and secure messaging services now having successfully completed the implementation of new interoperability standards that will hopefully allow clinicians and healthcare organisations to more easily exchange clinical information electronically.

The road to secure messaging interoperability has been a tortuous one to say the least, but movement does seem to be occurring. We counted 19 separate systems that have successfully fulfilled the Australian Digital Health Agency's requirements, with the vendors now getting ready to release the capability in their next versions. We expect to see these start to roll out over the next few months.

It is a bit of a concern that three of the bigger names are not taking part in ADHA's secure messaging industry offer but two of them do promise that they are going to use the specifications. HealthLink will implement them as part of its contract with SA Health to build a statewide secure messaging system, and while MedicalDirector is keeping its cards close to its chest, it says it supports the initiative and will implement the standards too.

Secure messaging service Medical-Objects, which dominates the Queensland market, has not yet responded to our queries about its plans but the agency says the company was part of the technical working group that developed the standards and says the agency “continues to work directly with them and other key vendors to encourage and support the adoption of developed specifications outside of the industry offer”.

While this is welcome progress, we reckon there is still a lot of cynicism that it will ever start working as planned. When we ran a poll of readers in September asking if ADHA should scrap its secure messaging project and let the industry start again, 79 per cent of respondents said yes.

We also ran a poll back in March 2019 that perhaps somewhat naively asked whether secure messaging interoperability would be a reality in practice that year. 78 per cent said no in 2019 and 2020 looks like a washout, so sights should probably be set on 2021 before real action begins.

On a brighter note, another poll we ran in June asked about ePrescribing and whether you thought it would be taken up enthusiastically. 84 per cent of you said yes, and it appears that optimism is being borne out. We heard this week that 400,000 eScripts have been generated so far, with ADHA's medicines safety program director Andrew Matthews saying 83 per cent of this had taken place in the last six weeks.

With more than half of all pharmacies in Australia now having dispensed an eScript and only good reactions from patients and prescribers alike, this initiative can probably chalked up as a successful one, albeit it is still early days. Most prescribing systems are still using the fast-track version of eScripts but WA vendor ISA Healthcare, which markets the MMEx system, is now able to generate the fully compliant version and has done so in several Aboriginal health services in Victoria and Queensland.

While the agency has handled the electronic prescribing program well, much of the credit has to go to Fred IT, which built the underlying infrastructure for eScripts with its eRx prescription exchange, and its competitor MediSecure. These two got together (with some welcome government funding) to become interoperable some years ago, and that is now paying off. The next step is active script lists, which Fred says should be coming onto the market in December.

It appears that electronic prescribing, along with telehealth and remote monitoring, look to be the unexpected beneficiaries of the Covid-19 pandemic.

That brings us to our poll for this week: Can electronic prescribing be chalked up as a success in Australia? Yes, no or too early to tell?

Vote here and feel free to leave your comments below.

Last week, we asked: Is the Digital Health CRC living up to its promise? It doesn't appear to be: 74 per cent said no, just 26 per cent voting yes.

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