Interview: HealthLink

PULSE IT: What is HealthLink?

HealthLink is the leading provider of secure electronic health messaging services throughout Australia and New Zealand. We are in the business of eliminating paper as a form of communication in health care. The services provided by HealthLink integrate and enhance healthcare systems, improving efficiency, accuracy and patient outcomes with a higher order of patient privacy and confidentiality.

For HealthLink, patient privacy and confidentiality is paramount in the sending of patient information to other health professionals. To protect the message in transit HealthLink uses PKI technology for its encryption. PKI ensures that only the intended recipient is able to open the confidential information, protecting the patient’s privacy and giving the sender piece of mind.

HealthLink's software enables all health professionals to become part of the largest electronic health information exchange network in Australia. The HealthLink Messaging System (HMS) is used by diagnostic companies, GPs, specialists, hospitals and allied health professionals. We do this by delivering software that integrates in with a practice’s system as well as integrating in with diagnostic and hospital systems.

PULSE IT: What is a practice required to do to get up and running with HealthLink?

It is relatively easy to get up and running with HealthLink. Practices can register online and a kit is then sent to the practice. The kit contains the software, integration guide for their clinical system and the PKI certificates that are used to sign and receive messages. It takes about 10-15 minutes to install the software.

PULSE IT: Which practice software does HealthLink integrate with?

At the primary care end HealthLink integrates with a long list of practice software – Medical Director, Genie, Best Practice, IBA’s Practix and Spectrum, MedTech’s MedTech32 and Mercury, Profile, Houston, Incisive, My Practice and E-Merge. In a market where people are changing clinical systems or undergoing significant upgrades, practices are still able to keep their HealthLink system in place, with only some configuration of the new system at setup required.

PULSE IT: What market share has HealthLink achieved in Australia?

The HealthLink provides the information exchange needs of GPs, specialists, diagnostic services and the hospital sector and is used on a daily basis by more than 4,000 healthcare organisations in Australia. HealthLink has more than 60% of GPs in Australia connected on its system and continues to grow.

Historically, our share has been driven by the small to medium pathology and imaging providers. We provide great outsourcing models for these organisations and allow them to concentrate on what they are good at - providing diagnostic services.

Going forward we are ever expanding in the area of discharge summaries from hospitals and establishing wider use of specialist communications. This has been possible and is moving rapidly because of the general consistency of coverage across all areas in Australia. Hospitals are taking advantage of our market share and fast tracking away from letters and fax outs. All aspects of the healthcare system want to eliminate paper which is further expanding the HealthLink network in terms of coverage and traffic.

PULSE IT: What functionality of your software are these users typically using?

It would be fair to say that nearly all HealthLink receivers are getting diagnostic results from pathology and imaging companies and have been doing so for a number of years. This is being supplemented with discharge summaries and an ever-increasing number of specialist reports.

We have been involved in nearly all HealthConnect trials and continue to be so in a number of regions and states so other types of patient information is also been shared securely and appropriately through HealthLink.

PULSE IT: As a communication platform, what advantages does HealthLink have over competing solutions?

HealthLink designs its services to provide reliable end-to-end delivery of clinical information. The HealthLink system is readily expandable and easy to use particularly in a general practice environment.

Simply our advantage over competing solutions is our experience and scalability; robustness in delivery of all message types; reliability of our service; and integration with such a disparate range of clinical systems.

The strength of our system and our wide coverage has enabled us to secure business relationships with state and territory governments for the delivery of diagnostic reports and discharge summaries from the public sector.

HealthLink has been around for a long time, has been responsive to the changing needs of the healthcare system and has a sound business model to be around for years to come. We are able to work with and deliver to all sectors of the healthcare system across all of Australia - something our competitors have not been able to do.

PULSE IT: Outline the HealthLink pricing model.

The HealthLink approach is that the sender pays for the message. To receive messages it costs nothing. This effectively means that GPs have not had to pay to become paperless. Specialists receiving diagnostic reports like GPs have not had to pay to receive these reports. However, Specialists are required to pay $30 per month per practitioner for the sending of reports to referring GPs.

It is fair to say that the economics stacks up when one considers the complete cost of paper based reports and the elimination of scanning at the GP’s end plus, the added bonus of structured data and audit trails when the HL7 “Referrals and Discharge Summaries” message format is used.

PULSE IT: How is support provided?

The company provides a toll-free help-desk service, which is available 12 hours per day across Australia. We believe that our fully supported service as part of the normal terms and condition gives our users confidence that we will address their problems in a professional and responsive manner without any additional charges.

There are also a considerable number of IT support providers across Australia who are familiar with HealthLink. These people have been servicing sites mostly as part of new installation of hardware and migration to different clinical systems. We are able to link sites up with these people who want assistance in their IT matters.

PULSE IT: What provisions does HealthLink make for users of non-Microsoft operating systems?

In addition to Microsoft sites HealthLink supports Mac users. We have been particularly apt at servicing GP and Specialist Mac sites for the bigger and smaller pathology players. Many specialists use Macs and have been able to send reports to their GPs through their installation of HealthLink as well.

PULSE IT: Does HealthLink develop clinical or practice management software?

HealthLink is completely focused on messaging and does not get involved with developing clinical or practice management systems. It is a sound business strategy - sticking with what you do best. It allows us to concentrate in the servicing of existing sites and in the expansion of new sites. Expansion of product sets to get additional revenue without maintaining a high level of customer service can lead to loss of business focus.

We believe that to do messaging properly it is important to ensure that standards are being consistently implemented across the large number of disparate clinical systems and multiple sectors of health. Because we are not competing with the vendors of the clinical systems we have a wider reach in terms of what clinical systems with which we are able to work. This is of greater benefit to ensure a large network of practices is possible and a consistency or experience is achieved regardless of what clinical system a practice is using.

PULSE IT: HealthLink has great success in New Zealand and has surpassed 95% market share. What challenges and opportunities exist for HealthLink in the Australian market?

Australia’s track-record in health sector automation e-health has been substantially less than ideal. Relative to New Zealand, Australia is somewhat behind in the connectivity of the healthcare system, the volume of messaging and the use of HL7 standard messaging. We are fortunate in HealthLink that we have the New Zealand experiences while shaping the Australian business with an Australian based team that continues to grow. In the earlier days there were all sorts of challenges for HealthLink in New Zealand some similar and some different to the Australian market. In Australia, automation of pathology services has been the initial platform upon which a wide range of electronic services has been built. However, these have been built largely around PIT messaging formats and a range of different communication applications by the different providers of pathology and imaging services. This has resulted in most GP practices now having five or more communication applications that are difficult to maintain and support for a practice.

I believe that there will be a consolidation of the communication provider market because of internal and external business pressures in diagnostic and messaging companies. Practices are already demanding fewer communication applications on their systems. Only those providers who are able to compete by providing sustainable and complete solutions for both the senders and receivers of information will survive.

Wider use of the HL7 messaging standards will be an important step for Australia for making significant improvements in sharing information. Implementing the existing core two HL7 messaging standards appropriately for “Pathology and Results” and “Referral and Discharge Summary” alone would automate 40-60% of all general practice messaging.

What is disappointing is that these message standards have existed for a number years, however they are not properly implemented across all software and healthcare sectors. It is important that the end users are demanding of government bodies, clinical system suppliers and messaging suppliers to provide them the benefits of HL7 with the full clinical application loop.

However we are not discouraged by history and embrace the future. HealthLink will continue to assist the healthcare system to realise the benefits of standards based messaging for improving practice efficiencies and patient care while maintaining security and trust in the sharing of health information.

Pulse IT invites organisations and individuals interested in participating in a future interview to contact the editor.

Posted in Australian eHealth

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