Continued growth in EMR adoption

It turns out to be nice timing that we ran a poll of readers last week asking if you thought electronic medical records were now an essential technology for acute care services. The vast majority of you did – 91 per cent said yes, just nine per cent saying no – and this week we heard public hospitals are following suit, with about 65 per cent of Australian public hospitals now using one.

Digital health consultancy The Checkley Group's managing director Bruce Pedersen gave one of his now regular round-ups of the state of EMR adoption in Australia at the Sydney leg of the Australasian Institute of Digital Health's mammoth virtual summit this week. Mr Pedersen likes to keep track of who is using what and he noted that Victoria had seen the largest growth in the last two years, boosted by the Epic implementation at the Parkville precinct in Melbourne no doubt.

Victoria is just trailing Queensland by a smidgen now in terms of EMRs per bed numbers and is likely to take over with Bendigo Health set to go live with an InterSystems EMR shortly and Northern Health confirming this week that it would roll out a Cerner system in the next year or so. Queensland Health currently has a pause on further implementations of its statewide Cerner ieMR but may restart it next year for the 18 or so hospitals in the queue now that the Palaszczuk government has been returned, including the largest hospital in the state in the Royal Brisbane and Women's.

As we reported last week, SA Health has been funded to finish the roll-out of its Allscripts system in metropolitan hospitals. For country hospitals, the absolutely prehistoric Chiron system keeps chugging along, SA Health having signed an extension for another year with vendor Global Health. WA Health is likely to go to tender in the next two years for a statewide system, ACT Health is hiring project staff for its Epic roll-out, and the Northern Territory is making slow but steady progress with its InterSystems community and acute care build.

Mr Pedersen took a look at the private hospital sector where EMRs uptake is rather more sparse, finding few implementations outside of the public private partnerships that use Telstra Health's system and the well-known Cerner system at St Stephen's in Hervey Bay. He made mention of what he called a compelling offering from the digital medical record vendors like InfoMedix and Vitro, along with Allscripts, which provides the BOSSnet system to some public hospitals in WA and Victoria.

InfoMedix is used by ACT Health amongst others and in Tasmania's four public hospitals, and this week we learned that it will be rolled out to St John of God Health Care's private hospitals in WA, following a roll-out in its Victorian sites.

Mr Pedersen said he expects the private sector to get a move on eventually, driven by factors such as consumer expectations, the expansion of virtual care, and demand from clinicians. Where 10 years ago acute care doctors in particular abhorred EMRs and many refused to contemplate using them, it is now becoming an expectation. If they can have their EMR on their mobile device, even better.

We have seen a lot of this reflected in the presentations at the Digital Health Institute Summit this month. Whereas at digital health conferences in the past it has all been about breaking down barriers to digital health adoption, this year it has all been about speed of uptake. The summit concludes next week in Adelaide.

Elsewhere, the Australian Digital Health Agency has released its tender to replace the Oracle API gateway underpinning the My Health Record system with a new Health API Gateway. This is the first step in the national infrastructure modernisation program, which we like to call the NIMP.

Among the vast documentation is a diagram of ADHA's vision of a national digital health ecosystem future state concept, which is surprisingly good and appears very much to be influenced by the Fast Healthcare Interoperability Resources (FHIR) community. It envisages an environment in which existing digital health systems are linked through APIs and are interoperable, and reminds us somewhat of New Zealand's concept of a national Health Information Platform (nHIP), which is also out of tender at the moment. Linking existing and emerging systems rather than building monolithic platforms that no one really cares to use is an idea that has well and truly arrived. We'll have more on those two tenders over the next few weeks.

That brings us to our poll for the week:

Is the Health API Gateway model a good first step in modernising the national infrastructure?

Vote here and feel free to leave your comments below.

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