NSW to go live with clinical repositories

NSW Health will go live this month with three new clinical repositories it has been building as part of its work as a lead site for the implementation of the PCEHR.

Part of ongoing work that NSW Health has badged as HealtheNet, the repositories include one for electronic discharge summaries, one for shared health summaries and one for an electronic Blue Book for mothers and newborns.

The repositories will store discharge summaries that are already being generated from Cerner's EMR, which is used in the hospitals taking part in the Wave site, along with shared health summaries being generated by GP desktop software.

Clinicians will be given a single view of the information held within the repositories through a clinical portal built by Orion Health. Orion has also built the electronic Blue Book, using its clinical and patient portal platform formerly known as Concerto. The technology has also been used to provide the consumer and provider portals for the PCEHR.

NSW Health demonstrated what a shared health summary will look like when generated by Medical Director at a workshop held at the Health Informatics Conference (HIC2012) in Sydney this week.

The repositories have been tested for clinical use in several health services in the Greater Western Sydney region and will start to go live next week, NSW Health's CIO, Greg Wells, said.

“Where we are up to essentially is we are going live with this,” Mr Wells said. “They have been in production but as of next week we will start to switch on in hospitals, in community health and in general practices.

“Technically we are across the line and we are starting to switch them on, so by the end of the month all of the deliverables from the lead site project can be ticked off.”

HealtheNet's lead architect, Tony Lopes, said underpinning all the repositories are new services including an enterprise patient registry for patient ID and demographics information, which is connected to the federal government's Health Identifier Service (HI Service).

The second is the repository and portal service that is using an enterprise service bus as a messaging gateway to the repositories, along with an external secure messaging gateway that is sending discharge summaries from health services directly to the GPs' desktop.

Mr Wells said the enterprise service bus is an internal NSW Health messaging service that is being used to connect general practices and is also being used for its new medical imaging repository, which went live in February.

The imaging repository currently holds 200,000 documents – both images and their accompanying reports – and 2200 DICOM-standard documents are being added every day, Mr Wells said. Up to 30,000 views are being recorded every month.

He said the new repositories have not yet established connection to the PCEHR but they have been built to do so. “Our lead site was to test concepts, standards, infrastructure and identifiers locally and that is what we have got working,” he said. “The patient registry and the ESB are being used in clinical settings already as they are facilitating the imaging repository.

“We are working with NEHTA on opportunities to integrate it with the national infrastructure and we are also looking at how we can leverage or expand our state program to do more of this nationally.”

NSW Health also showed its new mobile app for the eBlue Book at HIC. The app, designed by a clinician and developed by Deloitte, will allow new mothers to receive reminders for immunisations and health checks for their babies as well as growth charts with height, weight and head circumference parameters.

The app is for consumers only but providers will have access to the web-based eBlue Book, as will the parents. “We have done all of the technical testing and we are in the final stages of user acceptance testing,” Mr Wells said. “We'll keep it fairly controlled but again this is not a trial; it is the first phase of what we want to do.”

He said the app was NSW Health's first foray into mobile development and the experience had been very positive. “Consumers groups will have it, the clinicians and the midwives – it will really make a difference,” he said.

The HealtheNet services are limited to the Greater Western Sydney region at the moment but Mr Wells said the department was working with the Ministry for Health on a state-wide roll out. There is no defined timetable for this, he said.

“We've built our business case, we have made sure we have proven it in production so our focus for the next six to 12 months is on change and adoption,” he said.

Posted in Australian eHealth


0 # Becker Rae 2013-07-20 14:52
So....hospitals will have access to repositories linked in with the PCEHR. Does that mean any privacy breaches occurring in the hospitals' local Cerner eMR (which in turn will link to one of these repositories) will be subject to the PCEHR mandatory breach notification laws? I note that breaches of information contained in a PCEHR (regardless of whether the breach occurred by access to the actual PCEHR itself, or whether it was just info that is also contained in a PCEHR) are all subject to mandatory notification. Discharge summaries generated by a hospital's local Cerner eMR, then uploaded to the PCEHR, may be inappropriately accessed by hospital staff through the eMR but not through the PCEHR- are such breaches subject to mandatory notification? If so, what about all the breaches occurring from years gone by (hospitals have been using electronic records since at least 2005)- do hospitals then need to back track and notify breaches from years ago, or only since the enacted of the PCEHR act?

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