Pulse+IT Blog

eOrders the trigger for My Health Record

This week saw a major move forward for eHealth in Australia with the news that Sullivan Nicolaides Pathology will now be routinely uploading pathology reports to the My Health Record for patients whose doctors request tests electronically.

It's not just the addition of information of real worth to patients and their record that is the breakthrough. There is also the potential spur it might give to the wider use of electronic ordering of diagnostic tests in general. While eOrders aren't new – SNP's CEO Michael Harrison told us that about 80 per cent of orders coming from GPs these days are now done electronically – it will hopefully influence specialists, who tend to order more complex tests but who also tend to use their computers to write a request and then print it out, to also send them electronically.

How to measure meaningful use

It was a big week this week for the announcement of new digital health projects and updates on existing ones, and it got us to thinking about whether we can adequately measure the success or otherwise of this troublesome endeavour that is digital health.

A case in point was one of our top stories this week, in which Stephen Duckett from the Eastern Melbourne PHN called for the fax to be axed by 2025. (And we'd urge caution on the use of this saying, considering the UK's problems with it.) The PHN has set itself a target of helping to get rid of faxed referrals to local hospitals in five years' time, and is helping by supporting an eReferral project in its catchment area, which has seen more than 60 per cent of eligible general practices start using smart forms technology from vendors HealthLink and BPAC Informatics.

EMRs: too big to fail?

One of our top stories this week was the retirement of Queensland Health director-general Michael Walsh after four years in the role, having had a few stints previously with NSW Health. Some in the Brisbane media thought they had a scalp following recent revelations that Mr Walsh had admitted that the roll-out of the state's Cerner integrated electronic medical record had been a big more challenging than acknowledged publicly.

Quelle surprise. Implementing an EMR in a large hospital system is enormously difficult and fraught, as numerous examples here and around the world attest to. And in Queensland, the ieMR roll out has never been smooth. Some clinicians still loathe it and would far prefer to stick to existing software or to try something different. That's highly unlikely at this stage, and we think Mr Walsh's comments were basic common sense.

Last big hiccup for WA Health?

The WA Department of Health got a a bit of a rap over the knuckles this week from WA Auditor-General Caroline Spencer, who noted in her report into a two-year delay rolling out PathWest's new laboratory information system that this sort of thing had happened perhaps one too many times before.

It was a gentle rap considering some of the horrors WA Health has had with IT projects over the last few years – Fiona Stanley Hospital and the centralised computing projectimmediately spring to mind – but you get the feeling that Ms Spencer agreed with former under-treasurer John Langoulant's comments last year that the state really has to pull up its socks when it comes to project governance.

Point of no return

It's been a big week in national eHealth projects with the Australian Digital Health Agency announcing some serious growth in connections to the My Health Record in the community pharmacy sector. More general practices have also connected over the last year to register a substantial 92 per cent of all general practices – we don't think there will be any more growth there as some GPs will permanently opt themselves out – but it looks like the pharmacy sector is seeing some benefit in signing up, even without financial incentives.

There was also some news in the pathology sector, with NT Health revealing it hopes to be the first jurisdiction in the country to add links in the pathology reports it uploads to the My Health Record to the Lab Tests Online (LTO) website. This excellent little resource has been around for a decade or more and provides a wealth of information about the often obscure world of pathology, so much so that the rumour is more medical students use it than the general public.

GP to chase results no more?

There's a lot about working at the pointy end of the healthcare system that annoys GPs, but “GP to chase” test results ordered while the patient was in hospital has to be up there with the worst of them. Even when prefaced with the word “kindly”, reading a discharge summary written by a junior medical officer with a demand that the GP do the work the hospital doctors should be doing is enough to drive many of them to distraction.

While no one is saying that the My Health Record will put an end to this, the ability to see a patient's results with the click of a button or two and not have to spend time on the phone with the hospital is one of the system's selling points for GPs. Last month, SA Health joined most of the other jurisdictions in beginning to upload pathology and diagnostic imaging reports to the My Health Record from its hospitals, but in a new move SA Pathology is also doing so for tests that GPs themselves have requested from the public provider.

Setting the standard for messaging

Brisbane turned on a late autumn stunner for an HL7 Australia meeting that Pulse+IT attended in the Queensland capital this week to hear all about the localised pathology and referral messaging standard that has been published by HL7 Australia. The turnout was pretty good too considering the esoteric nature of the meeting, which covered all things HL7 v2, along with FHIR, PITUS, NCTS, NCSR, NPAAC and other acronym allsorts.

The expert crowd smiled knowingly when mention was made of previous attempts at developing standards that would miraculously bring interoperability to secure messaging over the years. Jared Davison, the chief technology officer of secure messaging vendor Medical-Objects, began his presentation with a slide from back in 2007 that could easily be used today, and pathology informatics expert Michael Legg went even further back when he mentioned there'd been a mention of standards in Hammurabi's code back in 1754 BCE.

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