The eHealth year in review: part 2

July 1 was planned to herald the beginning of a new era in eHealth in Australia with the consumer launch of the PCEHR, but the inevitable delays that seem to haunt all large IT projects had a sobering effect on the big day.

As the year moved on and software vendors rushed to integrate new specifications into their products, however, a number of breakthroughs were achieved, with two desktop clinical software vendors rolling out PCEHR-compatible versions, two other companies releasing plug-in tools that GPs can use to upload documents, and one acute care specialist forging ahead at a tertiary hospital in Sydney.

Outside of the PCEHR, it was a significant moment in eHealth interoperability when details of an agreement between the two electronic prescription exchanges began to emerge. The market-leading GP software product, Medical Director, then opened its doors to third-party integration, and the National Health Services Directory (NHSD) was launched, with big plans to provide a complete electronic directory of all health services providers, along with endpoint location and telehealth directories in the works.

The year ended not with a whimper but a bang, a series of hacking attempts on GP surgeries highlighting for the industry just how vulnerable many are to security lapses. The passing of the new Privacy Act and its long-term ramifications will perhaps direct more attention to essential IT and data security processes.

Back in July, however, and despite little publicity outside of the health sector, the PCEHR was officially launched to consumers. On July 2, the PCEHR call centre was overwhelmed by phone calls, with few able to get through to register.

Online registration was not expected to be ready for the launch, but some managed to work out how to do it, and by the week's end, 803 people had signed up, most over the phone.

NEHTA then outlined its plans for the rollout of PCEHR-enabled software for the coming year, hoping the first compatible products would be available in August. That proved a little premature, and in the meantime the AMA continued to vent its frustration at the pace of the rollout and the complexity of the system itself.

At HISA's Health Informatics Conference at the end of July, DoHA secretary Jane Halton gave a wide-ranging presentation and in an interview with Pulse+IT, reiterated that the implementation of the system would be slow and methodical.

Beyond the PCEHR, health IT companies continued to make breakthroughs, with Precedence Health Care announcing that its cdmNet collaborative care project was going national, and HCN announcing that it was opening up Medical Director to third parties to add extra functionality through its new MD Sidebar and Widget Store.

To the relief of doctors' groups, Health Minister Tanya Plibersek gave in to demands that GPs could claim the longer MBS item numbers, irrespective of the complexity of the case, if they spent time curating a patient's PCEHR during a consultation. She also announced that the ePIP requirement for full PCEHR interface capability, due to come into force in February 2013, would be pushed back to May.

September saw real movement in the capabilities of software vendors to work with the new system. Emerging Systems announced that it had completed its interface to the PCEHR, thought to be the first acute care software specialist to do so.

The first clinical document was uploaded to the PCEHR in early September by a doctor in Brisbane's western suburbs, using the HIE Companion Gateway add-on tool as a link between the system and the GP's Best Practice software.

An actual patient's shared health summary was then uploaded to the PCEHR using Pen Computer Systems' add-on tool by Sydney GP Ray Seidler.

GP desktop software vendors then began to achieve their major milestones, with Zedmed the first to announce it had passed its PCEHR conformance tests.

In between, standards body HL7 International announced it was planning to make much of its intellectual property, including its interoperability standards, free under licence to the international healthcare community.

The National Health Services Directory continued its development, announcing it was working with Medicare Locals to include the names, contact details and opening hours of the country's general practices, community pharmacies, public hospitals and emergency departments to the web-based directory.

NEHTA, meanwhile, said it was developing a product register to list the compliant software products available for practices to help meet the requirements of the ePIP.

The ePIP product register went live in October, while DoHA announced extra funding for Medicare Locals to help spread the word on the PCEHR.

Confirmation finally came through in mid-October that the two electronic prescription exchanges, eRx and MediSecure, had been working together since June to thrash out the details of how to make the respective systems interoperable. Details at first were scant but it was later revealed that the two companies would receive $10 million in infrastructure grants and transaction fees under the Fifth Community Pharmacy Agreement.

One of the biggest headlines of the year was confirmation that NEHTA had terminated its $23.6 million contract with IBM to deliver the National Authentication Service for Health (NASH). Medicare Australia has since taken over work on the project and has issued PKI certificates for PCEHR access and secure messaging.

In a blow to the telehealth sector, the government announced it was changing the geographical boundaries for eligibilty for telehealth rebates under the MBS, meaning metropolitan-based GPs will no longer be financially compensated for providing telehealth services.

Zedmed was again first out of the blocks in late October, becoming the first desktop software solution to upload a document directly to the PCEHR. It also began a wider rollout to its customers of its PCEHR-compatible version 20.

Genie Solutions was soon to follow, announcing it had released its PCEHR-compliant software and uploading both a shared health summary and an event summary to the PCEHR in late November.

Earlier that month, St Vincent's Hospital announced it had integrated with the PCEHR, allowing its clinicians to see whether a patient had a record and opening and viewing it through Emerging Systems' clinical information system. St Vincent's has also been working on electronic discharge summaries and achieved the feat of being the first hospital to upload an eDischarge summary to the PCEHR.

In secure messaging, NEHTA announced it would provide funding to eligible secure messaging vendors to assist them to develop interoperability. In December, HealthLink joined Argus on the ePIP register as SMD-compliant, and was soon followed by the other major player in the secure messaging market, Medical-Objects.

Our story describing the difficulties practices face in getting registered for the PCEHR and calling for a streamlining of the system so that GPs and practice staff can help patients sign up was followed by news that the health minister had amended the PCEHR rules to allow for assisted registration.

The NHSD launched an app to allow consumers to look up local GPs, pharmacists and emergency departments, but the last month of the year was dominated by news that hackers had targeted medical practices and were holding their data to ransom.

The hacks, in addition to the passing of legislation enacting new privacy laws, means data security may very well dominate the news in 2013 the way the PCEHR did in 2012.

Posted in Australian eHealth

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