NSW to link acute and community care to PCEHR in August
NSW Health plans to allow clinicians in its public hospitals and community health services to view clinical documents and images held in statewide repositories and the national PCEHR through a portal integrated into the Cerner acute care EMR system and the CHIME community care solution by the end of August.
NSW Health also plans to begin a wider rollout of electronic discharge summaries from hospitals to GPs, with the ability to upload them to the PCEHR also due by August 31.
Pulse+IT understands this is part of NEHTA's rapid integration project, which aims to have discharge summaries sent to the PCEHR from public hospitals throughout the country by the end of the year.
NSW clinical repository business architect and acute care physician Will Reedy told the Health Informatics Conference (HIC 2013) in Adelaide today that the Orion Health-built portal would enable hospital clinicians using Cerner, and community care clinicians – including those working in aged and chronic care – using CHIME, to view documents held in the patient's PCEHR and in NSW Health's clinical repositories with just the click of a button.
Those health services using Orion's EMR, including the Hunter New England Local Health District (LHD), will also be part of the roll out.
In addition to the national PCEHR, the portal will allow authorised clinicians to view diagnostic images and reports contained in the NSW enterprise imaging repository (EIR), which went live in February 2012.
All of this is enabled by the state's enterprise patient registry, which is able to link the different identifiers used by hospitals and health services and the national Healthcare Identifiers (HI) Service. The repositories and the portal are part of the HealtheNet program, first developed by the Greater Western Sydney Wave 2 site for the implementation of the PCEHR.
“With HealtheNet, we will provide a clinical provider portal which we are building into Cerner or Orion that essentially tells the clinicians that the patient has a PCEHR and that there is information from outside the organisation,” Dr Reedy said.
“They can see information from the PCEHR, diagnostic images (from the clinical repository) and some community information. There is a single click that opens up a separate browser window and it logs the clinician in within the patient context ... and it provides access to all of the state and national repositories.”
Dr Reedy showed an example of the portal in the Cerner EMR. For a particular patient, a simple link shows clinicians that there is information contained within the state repositories and in the PCEHR, with a menu on the left showing what that information is.
In the link to the PCEHR, for example, it shows what shared health summaries have been uploaded as well as medicines prescribed and dispensed through the National Prescription and Dispense Repository (NPDR). The menu mirrors the clinical information contained on the patient's PCEHR.
Joe Hughes, the architect of the enterprise imaging repository, said the portal would allow clinicians to view diagnostic images and reports contained by internal and external public health organisations, including DICOM and HL7 integration.
“If you are a radiologist and you are doing a report on the patient, the images from the EIR will appear as a prior study,” Mr Hughes said.
He said while the private diagnostic sector was not part of the scope of HealtheNet program, the 11 different PACS/RIS systems, nine EMRs and nine PAS systems used in public healthcare organisations across the state will all be integrated in time.
The foundation of the whole HealtheNet program is the enterprise patient registry, which is able to match identities from multiple jurisdictions across the state as well as the HI Service.
Dr Reedy said HealtheNet was also building assisted PCEHR registration within its systems, with a project recently launched at Blacktown Hospital. He said 80 per cent of people approached in an outpatients clinic had signed up to a PCEHR.
HealtheNet, which included the build of the enterprise imaging repository, the enterprise patient registry, an enterprise service bus to allow NSW Health to share information with private providers like GPs, and the electronic blue book, which has since been adapted nationally, is expected to be rolled out statewide.
Some of these elements are also due to go live in August in the Western NSW Local Health District, which takes in regional population centres such as Bathurst, Orange and Dubbo. Mr Hughes said the enterprise imaging repository, which was built with the assistance of Fujitsu, TeraMedica and Oracle, was live in western Sydney and western NSW, with plans for the rest of the state to have access by the end of the year.
Dr Reedy said NSW Health also planned to use its repository infrastructure to support other eHealth innovations such as mobile apps for consumers and providers.
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