State by state: Victoria considering state telehealth network
As Victoria moved into caretaker mode in advance of the November 29 election, the state's manager of telehealth strategy and development, Geraldine McDonald, provided an overview of the telehealth sector at the RMA conference.
Ms McDonald said Victoria was at an earlier stage than most of the other states in its provision of telehealth on a state-wide scale, although groups like the South West Alliance of Rural Health (SWARH) have been active in telehealth for many years.
Last year, the Health Innovation and Reform Council was asked by Victorian Health Minister David Davis to look at telehealth and investigate what Victoria needed to do better to support health services that were considering telehealth service models, Ms McDonald said.
“That working group came up with a set of recommendations, one of which was to establish a telehealth unit in the Department of Health,” she said. “There was a telehealth implementation and action plan, and that was last year.
“The current environment in Victoria is very siloed. There are a lot of proprietary systems, and we are working quite hard at the moment to try and look at what is needed for any state-wide networks. Some regions in Victoria are a bit more mature in their telehealth roll out than others, so the department is looking at how to support those that are not as advanced.”
Ms McDonald said an audit carried out earlier this year found that with some minor investment, the telehealth unit will be able to work towards having a state-wide interoperable network.
“All mental health services with an inpatient facility have been video conference-enabled, which in effect is our first state-wide telehealth system, and now other health services are looking at how they can leverage of that system,” she said.
Victoria's after-hours urgent care program has also been provided with telehealth facilities in 14 urgent care centres in the Hume region of the state. The Victorian Stroke Telemedicine project is also being rolled out in the Hume region following its successful implementation in Loddon Mallee.
“We have been developing a number of resources in the telehealth unit and a discussion paper that will be available in the next week around what are the critical success factors in delivering telehealth services.”
The unit has also engaged DLA Piper to develop a medico-legal communique for health services around the medico-legal issues in telehealth that will be available at the end of the year, and it has also developed a web-based investment analysis tool to help health services identify the best solution on an agnostic basis.
In terms of eHealth, Ms McDonald said the aspiration was that all health services would be able to send national-standard discharge summaries point to point and with consent to the PCEHR.
“State-wide adoption is more dependent on clinical engagement and change management rather than technology and that really is the focus on our discharge summaries,” she said.
“[For electronic referrals], we have state-wide coordination tools and templates, standard referral forms for GPs. The focus is on the business flow and change management, not the technical flow.”
Last week, the government announced the winners of the Innovation eHealth & Communications Technology Fund for the purchase and installation of health information technology, first announced in the 2012 state budget.
This includes $40 million to begin implementing an electronic medical record with medications management at Monash Health, formerly known as Southern Health. This health service includes Monash Medical Centre, Monash Children's Hospital, which is being rebuilt, Moorabbin, Dandenong and Casey hospitals and a new cardiac hospital that both the Coalition and ALP have agreed to fund.
Alfred Health will get $7.1 million towards replacement of its patient administration system, which is understood to be the legacy Homer system that is no longer supported. The Alfred has used Cerner's clinical information system for many years and is likely to either use its PAS module or CSC's iPM system, which is widely used in Victoria.
Grampians Rural Health Alliance will receive $4.3 million to develop and implement shared electronic medical records and health information exchange across the Grampians region, and Gippsland Health Alliance (GHA) will receive $5.6 million for the implementation of electronic clinical documentation and medication management systems into GHA’s four largest hospitals.
SWARH will receive $2.55 million for project and change management resources to accelerate the adoption of electronic medical record functionality, including electronic medication management. SWARH uses a mixture of clinical and patient administration systems including InterSystems' TrakCare and Core Medical Solutions' BOSSnet, and has recently rolled out TrakCare for meds management at Portland Hospital.
SWARH is also ahead of the pack in planning to implement national individual health identifier across both acute and community health.
Hume Rural Health Alliance will receive $8.5 million to replace the PAS for its 17 hospitals and health agencies and four community health services, with Mildura Base Hospital also receiving funds to replace its PAS.
Ambulance Victoria has received three separate grants: one for a feasibility study into implementing National Health Service Pathways solution for triage; one to enhance the National Health Services Directory to meet ambulance requirements; and one for a patient monitor integration to automatically and wirelessly transmit the patient’s vital signs and ECG readings directly to the hospital’s emergency department prior to ambulance arrival.
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