NHSD to develop endpoint location, telehealth directories

The recently launched National Health Services Directory (NHSD) will include the ability to hold endpoint location service (ELS) information for secure messaging by the middle of next year.

The NHSD, developed and managed by the National Health Call Centre Network (NHCCN), is a shared infrastructure project that aims to provide one all-encompassing directory for consumers and healthcare providers looking for a wide range of health services.

It went live in July and is currently being populated with information on general practices and hospital emergency departments. It will eventually contain information about all healthcare services, including aged care, pharmacy and allied health. It is also planned to be used by telehealth providers as a national directory of those participating in telehealth services.

The directory is not yet being promoted to consumers as the information it contains is not complete, but NHCCN is working with Medicare Locals to include as much information about primary healthcare services as possible, NHCCN CIO Anton Donker said.

“All the Medicare Locals are doing the primary healthcare for their areas so we are working closely with them,” Adjunct Professor Donker said. “It is only just being made available to the public as we've concentrated on getting the core service information to a good consistent standard throughout the country.”

At the moment the information includes basic details about healthcare services and providers, such as location and opening hours, but as it matures healthcare providers will be able to update their own information such as whether they are seeing new patients or if parking is available.

While there is an important consumer information element, the national directory should prove invaluable to state health departments and to healthcare providers looking to refer to allied health practitioners, for example.

“And it's not just health services but human services, because GPs don't really communicate extensively with other GPs,” Professor Donker said. “They want to know about specialists, hospitals and allied care because the people they refer to are the podiatrist, the dietician, the specialists or Meals on Wheels, things like that.

“At the moment we are concentrating on general practice, hospital EDs and the service base. There are several reasons for that and one is that consumers want to know about opening hours and locations and the second thing is that it's essentially public information. We've got lots more that is able to be gathered and the system will do that, [listing] languages spoken and bulk-billing, the services at each site, a range of those things.”

Information on healthcare services in Victoria are the most complete, as the national directory has been based on the successful Victorian Human Services Directory (HSD), created and maintained on behalf of the Victorian Department of Health by Database Consultants Australia (DCA).

The development of the NHSD is being funded by all state and territory health departments through the NHCCN, a private company established and funded through COAG.

The idea for a national directory arose some years ago with the aim of collecting information about all healthcare services in each jurisdiction and to avoid duplication. Professor Donker said NEHTA did the initial work on a business model to establish a directory, while at the same time the NHCCN was creating a consumer-facing portal of healthcare services information.

“It is a challenge to bring directory information from across the country together in consistent way. There are hundreds of them out there and none of them are modelled to scale.

“NHCCN manages after-hours nurse triage services for most of the jurisdictions and they were hoping to provide consumer access to a directory on the website. So the NHCCN was doing consumers and NEHTA and the jurisdictions wanted to do it for the providers, and they all agreed to do it once and decided that the best home for it was the NHCCN.”

Professor Donker said the NHCCN had used the Victorian HSD as a base as it did not want to reinvent the wheel. “We decided to find the best one from around the country and use that. Not to say that there weren't other good ones, but Victoria made its IP available.”

With the information from the Victorian HSD already available, the ACT and Northern Territory also used that as a base for their directories. Now, Medicare Locals throughout the country are coordinating the collation and inclusion of data from the other states.

The plan is that when the system is fully complete, which is expected to be next year, that healthcare providers will be able to update their own information. It will also enable links to other services such as the Healthcare Identifiers Service and the Australian Health Practitioner Regulation Agency (AHPRA) to ensure details are as up to date as possible.

“Using the Victorian model we try to ensure there are consent arrangements there, right down to the fact that at one level the public needs to know there is a GP surgery across the road and that it's open, but it's also useful to know they are not accepting new patients or there are no appointments available,” he said. “Our model is predicated on self-authorship, enabling any service provider [to maintain their details].”

The Victorian HSD also includes endpoint location service (ELS) capability, which is used for some electronic messaging services.

Professor Donker said the ELS capability was already in use through the Victorian HSD in the Melbourne Wave 1 site and the Northern Territory Wave 2 project on a daily basis, but warned that there was a large difference between making it work in a trial and making it work nationally. The target is to expand this capability to a national level through the NHSD next year.

“It's one thing to do it in [that] setting ... but it's another thing entirely when it has to work every day, 24/7, with scalability, with resilience, with privacy and security and that's what we have to make sure we put in place,” he said. “[ELS directories] are different from a service directory; there are very detailed provider levels, much more difficult maintenance and management regimes and there is a cost that isn't signed off yet. But we are going to stand one up and make it available and we are on our way.”

He said the network was also working with the various telehealth groups to include telehealth end points and related service information, bringing together the different groups that have created their own directories, many of which overlap.

Creating a directory of telehealth service capability was not dissimilar to creating an ELS directory, he said. “You need to know that someone can do telehealth and you need to know how to contact them and what protocols they can deal with.”

The directory information will be available to any health service participant to use for their purposes, he said. The network is creating widgets and automated programming interfaces so anyone can take the information and use it for approved purposes on their websites or in their services.

“This is a shared resource; it's collected once and then it's made available for wide use. It is collected once but presented in lots of different ways for things that suit different audiences. For example, we are doing a set of collections for child health services to support the Healthy Kids Check and that is going to be a separate interface.

“There is the Better Health Channel and Health Insite and other websites. They can all take this information and use it to meet the specific needs of their audience.”

The NHCCN has an NHSD website up and running that can be searched, along with a mobile website for devices. An Android app is available for free download, while an iPhone app will be ready in a month. A prototype iPhone app has already been created but it is being redeveloped to be a native application.

“If you want to look at Victoria you can actually drill down and find what is open at eight o'clock on a Saturday morning from a service, but if you want to overlay that with public health data or transport data or any other data sets that are available, like morbidity and mortality rates for the area, you can do that. That's just an example of one way a shared directory can leveraged in ways that many people won't even think about.”

Posted in Australian eHealth

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