Medtech's FHIR engine a game-changer

It has been a pretty big year for New Zealand's market leading practice management system vendor Medtech Global, which was bought by a private equity firm from long-time owner Vino Ramayah in June in a deal engineered by new CEO Geoff Sayer.

Dr Sayer quickly set about putting his mark on the company, which also has a small share of the Australian market with its Medtech32 and Medtech Evolution products. Medtech has been the stalwart in NZ general practice for two decades but has been challenged recently by Indici, the cloud-based system developed for healthcare home practices and recommended by a number of PHOs.

Medtech is still the dominant player however, and it is now heading into new territory, with the launch of a new partnership program for third-party applications such as patient portals, appointment booking systems, telehealth platforms and prescription apps. This will see Medtech introduce a new platform Dr Sayer is calling the Application Layer EXchange or ALEX, which will see the third-party systems integrate with Medtech through FHIR APIs rather than directly accessing practice databases.

It's a new way of doing things and it is sure to be considered strongly by the other PMS vendors, some of which are heading down this path now. Australia's Best Practice, for example, has a partner network that qualifies third-party tools to ensure they are compatible with BP's standards.

The API approach is one that promises to be simpler for third parties to use, cheaper and a lot more secure in that applications that may have integrated with PMSs through unorthodox or backdoor approaches, potentially exposing them to external threats, will now need to be based on published specifications. It will also enable a nice environment for innovation by using contemporary web APIs.

Some heavy hitters are involved in working with Medtech on ALEX, including Microsoft through its Azure API for FHIR platform, and Medtech has a number of partners that already integrate with its systems onboard, who are happy to move to the new approach. The standards community is also on board, with HL7 New Zealand chair Peter Jordon helping out.

We think the other PMS vendors will take a good, hard look at what Medtech is doing, and Dr Sayer is open to working with them to enhance interoperability in healthcare. A distributed rather than centralised approach is being taken on a national level with the Australian Digital Health Agency's re-platforming of the My Health Record and New Zealand's national Health Information Platform, so it appears to be the way of the future.

Elsewhere, something is starting to smell a bit fishy about the roll-out of electronic prescriptions in Australia. The token model has been tested in communities of interest and is available to the whole of Victoria, the ACT and metropolitan Sydney, but is still restricted otherwise. We've been contacted by several GPs who are champing at the bit to get going in their regions, and we've asked ADHA three times in the last three weeks for details on when the other jurisdictions can start using them outsides the communities of interest, but we've been stonewalled.

Just this week Health Minister Greg Hunt announced South Australia would be the next cab off the rank. It was ADHA who announced the previous go-lives, but again they are staying shtum about who comes next and when, and nor are they saying why.

Our top story this week was our report on Jackie McLeod's presentation at the recent Australasian Institute of Digital Health's virtual summit on the go-live of the Epic EMR at the Parkville precinct. It was courageous stuff to do so but it appears to have paid off and will prove a case study on sticking to your guns in future.

That brings us to our poll question for the week:

Is the announcement of Medtech Global's FHIR API a positive development?

Vote here and feel free to leave your comments below.

Last week we asked: Is cost the main factor in aged care's digital divide? A slim majority thought so: 60 per cent said yes, 40 per cent said no.

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