SA hospitals sending discharge summaries to PCEHR

Nine hospitals in South Australia are now sending discharge summaries to the PCEHRs of registered patients.

SA Health sent out a directive (pdf) in July mandating a uniform approach to sending discharge summaries to the PCEHR for eight metropolitan and one regional hospital.

Each hospital's medical records department is charged with reconciling Individual Healthcare Identifiers (IHI) on a daily basis to ensure accurate data integrity and the ability to match the details of a patient in hospital with their PCEHR.

It is not known how many discharge summaries have been sent so far, but one Adelaide-based general practitioner who is actively using the PCEHR with patients has reported that a discharge summary from Lyell McEwin Hospital has appeared on a patient's record.

SA Health refused Pulse+IT's request to speak to someone involved in the implementation, but a department spokesperson said the organisation had developed a new IT solution which allows hospitals to send electronic discharge summary information to a patient’s PCEHR if they have registered for one.

“The solution includes the creation of a new database and a change to an existing hospital administration system,” the spokesperson said. “Together, they provide a bridge between current SA Health hospital systems and the national eHealth record system.

“This solution is now operational across all metropolitan hospitals (excluding Noarlunga General Hospital in the short term) and Mt Gambier Hospital.”

The spokesperson said SA now had the largest number of hospitals capable of sending summaries to a patient’s PCEHR and is the first multi-hospital state in Australia to achieve this.

“This new database is being considered by a number of other state health departments, including Western Australia, Queensland, Tasmania and the Northern Territory, as a way to meet their own requirements to send information to the PCEHR.”

St Vincent's Hospital in Sydney has had the ability to send discharge summaries to the PCEHR since late last year, and NSW Health recently revealed it planned to begin a wider rollout of electronic discharge summaries from hospitals to GPs, with the ability to upload them to the PCEHR by August 31.

The SA hospitals that now have the capability are Royal Adelaide, Queen Elizabeth, Flinders Medical Centre, Modbury, Glenside, Women's & Children's, Repatriation General, Lyell McEwin and Mt Gambier.

The SA Health spokesperson said the interim solution will not be implemented at Noarlunga General Hospital, as it is the first trial site for the roll-out of SA's new Enterprise Patient Administration System (EPAS), which has been designed by Allscripts.

The spokesperson said SA Health is currently developing a strategy to allow EPAS to send discharge summaries to the PCEHR.

As part of the contract with Allscripts, SA Health has purchased a licence to provide patients with read-only access to some information in their medical record held in the new EPAS solution through a web-based portal.

Pulse+IT understands that the other hospitals are using their existing patient administration systems, including OACIS, with a health information broker (HIB) add-on. OACIS and other legacy systems will be decommissioned following the wider roll out of EPAS, which is expected to be complete in 2014 or 2015.

The roll out was initially planned to begin in earlier this year, but was delayed by problems with its billing modules.

SA Health CIO David Johnston told the Sydney Morning Herald in March that Allscripts had advised in late 2012 that the delivery of the billing modules would be delayed by about two months.

“That two-month delay really translates into a three or four-month delay,” Johnston told the SMH. “But we can't put an exact date on going live until we've done the last of the billing module tests. If billing is not right we can't go live.

"The irony is the clinicians have signed off, EPAS is signed up and we get caught by the accountants. That's usually not the case, it's usually the clinical components that cause delays due to their high complexity.”

Opposition health spokesman Rob Lucas is claiming that there would be a further delay of 11 months until the whole system was rolled out.

Mr Lucas said the roll-out to the Repatriation Hospital, Port Augusta Hospital and Lyell McEwin Hospital prior to March 2014 “is unlikely to occur”.

SA health minister Jack Snelling told the Adelaide Advertiser that he was confident EPAS would be ready when construction of the new Royal Adelaide Hospital was completed in 2016.

The new hospital has been designed to be paperless, and will have no storage space for old records.

Mr Snelling said Noarlunga Hospital would be the first to receive the program in August, and it would later be extended to larger locations including the old Royal Adelaide for more testing.

NEHTA has not responded to requests from Pulse+IT for more information on how the different states are planning to upload discharge summaries to the PCEHR.

Posted in Australian eHealth

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