Pulse+IT Blog

HIE for Victoria as it moves on information sharing

Victoria has moved along at a rapid pace in releasing a tender this week for its planned health information exchange (HIE), the first step towards streamlining access to medical records across the public hospital system. As locals like to argue incessantly, Victoria’s devolved public health system has positives and negatives, but the COVID-19 pandemic has certainly shown up that disparate information systems and services can be a drag on a unified pandemic response.

As such, earlier this year the Crisis Council of Cabinet agreed to a plan to consolidate pathology services across Victoria, including the different laboratory information systems (LIS) that are used in the state, of which we are aware of at least four, all in various instances that do not speak to others. NSW is in a similar situation, and it is looking to consolidate its LIS systems through the NSW Single Digital Patient Record (SDPR), the successful vendor for which is due to be announced shortly.

Hopes for secure messaging interoperability meet reality

Pulse+IT celebrated its 15th anniversary just a few months ago and while we don’t like to reflect too much on the damage those long years have wreaked upon our good looks, modest charms and superior intellect, it would be remiss of us not to mention some of the dashed promises and forlorn hopes that have accompanied our journey.

Our first issue was printed in August 2006, featuring a glamorous photo of a Canon camera and a rather unpleasant skin cancer to illustrate a story on digital clinical photography, along with the wise words of our first ever covergirl, then health minister the Hon Mr Tony Abbott.

Telehealth’s primary care use case side-swiped by danger money

We must admit that we are still scratching our heads at Australian health minister Greg Hunt’s recent announcement of a new $180 million package to support COVID-19 care in the community in the future. There are some interesting bits, such as the subsidy for pulse oximeters for positive patients to use at home, and a small amount of money for medical deputising services and district nurses to visit COVID patients at home.

But putting aside the fact that there is simply no excess workforce capacity for nurses to visit people at home, let alone GPs – medical deputising services may be in a different boat – nor can we find a compelling reason behind the announcement that GPs will be paid an extra $25 to see COVID-positive or suspected COVID-positive patients face to face, in addition to existing MBS items.

FHIR storm still smoulders as connectathon looms

The FHIR standard was back in the spotlight this week with the ongoing fall-out from the recent publication of a super duper report into vulnerabilities that may eventuate from poor implementations of the standard by third parties.

Last week, HL7 International took what is a very unusual step in releasing a statement emphasising that the vulnerabilities are at the implementation end and certainly not at the standard itself, and touting that the author had changed the title of her report to reflect this.

FHIR storm erupts over scary vulnerabilities in third-party apps

In the real world, Australia and New Zealand began to put into action their respective roadmaps out of lockdown this week as vaccination numbers rose to much hoped-for levels. However, in the somewhat obscure world of health IT standards, a quite remarkable report was released late last week that has stimulated a firestorm of debate over the basic security of healthcare data.

Las Vegas-based cybersecurity analyst, former hacker and content creator Alissa Knight – who going by her bio and her Knight Ink business description is surely to become the subject of a novel one day if not a pretty cool movie – released the second phase of a year-long research project she has undertaken into the basic security of apps and aggregators drawing data from FHIR APIs linked to electronic medical records and other patient record databases.

Victoria’s bumpy path to a digital health roadmap

Pulse+IT was a keen attendee at this week’s Health Information Management Association of Australia’s (HIMAA) annual conference, which naturally in this pandemic era was held virtually. It was pretty good too, and revealed quite a lot of information about Victoria’s digital health roadmap, which was launched back in August but got little if any coverage due to the pandemic itself.

The roadmap is in no way a grand, sweeping vision like others purport to be but is instead built around existing projects – most of which have been precipitated by Stephen Duckett’s Targeting Zero review of hospital safety and quality assurance from 2016 and the more recent Royal Commission into Victoria’s Mental Health System – and turns out to be a pragmatic, practical strategy that takes into account the decentralised nature of the state’s health service.

My Health Record and the confessions of a doctor dodger

A landmark report in Australian healthcare was handed down this week with the release of the recommendations from the independent Primary Health Reform Steering Group on the federal government’s primary healthcare plan for the next 10 years.

The report is very much influenced by the Department of Health’s voluntary patient registration (VPR) model, which seems to have taken over as preferred policy from ideas like Health Care Homes and patient-centred medical homes. (It’s interesting that GPs who have in the past railed against the idea of capitation seem to be quite keen on VPR, but that’s a discussion for another day.)

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