States commit to rapid eHealth integration project

The majority of states and territories will have the ability to begin allowing acute care clinicians to view clinical documents and send discharge summaries to the PCEHR system by the end of the year.

In a panel discussion at a recent ICT forum organised by the Department of Health and NEHTA, jurisdictional representatives provided an update on their respective eHealth strategies and how they planned to connect acute care to the PCEHR.

No representatives from South Australia and Western Australia were on the panel, although SA has already begun sending discharge summaries from nine public hospitals and has developed software called Healthcare Information and PCEHR Services (HIPS) that is being used by other states as part of NEHTA's unfortunately named rapid integration project (RIP).

Paul McRae, the principal enterprise architect with Queensland Health, told the forum that the jurisdictions were all members of a RIP steering committee that he chairs. Mr McRae said the committee had agreed that the first steps to integrating with the PCEHR was to enable discharge summaries to be uploaded and to allow clinicians to view clinical documents.

Mr McRae said Queensland Health had linked with the HI Service in January this year, and those using it were achieving an 85 per cent match rate when pulling in batches of Individual Healthcare Identifiers (IHIs).

He said NASH certificates and HPI-Os were recently acquired for healthcare organisations to support the rapid integration program.

“We are looking to roll out statewide the ability to send discharge summaries to the PCEHR from all facilities that use our enterprise discharge summary application, which is all bar about three,” he said.

“And we are going to provide the ability to view PCEHR information from our clinical portal, which is called The Viewer. That will be available in around 200-plus facilities and that will all happen early in November.

“At the same time, discharge summaries in CDA format level 2 will be able to be sent point to point as well.”

Yin Man, manager of NSW Health's RIP program – better known as HealtheNet – said CDA discharge summaries and event summaries had been able to be sent to GPs and the NSW clinical repository from within the Greater Western Sydney lead site since August last year.

Clinicians in Greater Western Sydney are now able to access the national system through a clinical portal, which Ms Man said would be rolled out to all public hospitals in the state over the next two years.

“Our clinicians in hospitals within Greater Western Sydney have been viewing CDA discharges since last August and this year we have been integrating with the national,” she said.

“All hospitals will be connected to this one portal. Things have been going quite well and we already have half a million CDA documents within our clinical repository, and we pretty much generate about 6000 a month. As soon as we connect, we will be sending a lot of documents to the national.”

Victoria's representative on the panel, the Victorian Department of Health's advisor on eHealth policy and engagement, Peter Williams, did not go into much detail on his state's plans for integrating with the PCEHR as a review of the state's health IT sector is currently with the health minister.

It is understood that some local health districts – particularly those that took part in the Wave 1 and 2 lead site projects – are soon to begin sending discharge summaries to the national system, but Victoria does not have the centralised approach that the other states are taking.

Mr Williams said Victoria had put a proposal to NEHTA to look at how to expand the viewing capacity of hospitals outside of the lead sites. “Once you have done it for some, you can extend it to others … using common software, and we have licences across Victoria,” he said.

“With the secure messaging project that is being done in SA, while they are using different technology, the design approach is adaptable in Victoria very quickly. That is absolutely the core of what the RIP project is about – fast-tracking some of those things.”

The Northern Territory is currently working through a major project that it is calling the M2N, in which it is transitioning its successful My eHealth Record (MeHR) system over to the national PCEHR. For that reason, it will not go live with full discharge summary and viewing capability until March or April next year.

Robert Whitehead, director of eHealth policy and strategy with the NT Department of Health, said the territory was probably going to follow Queensland and provide a combined view of both the MeHR and the PCEHR for its departmental staff.

The PCEHR will become the primary record for all new information, but the MeHR will also be accessible for historical documents.

The NT is also holding off until next year as the national PCEHR cannot yet receive pathology and diagnostic imaging reports, which the MeHR can. The NT is planning to go live just after the major upgrade of the PCEHR planned for April, when pathology reports are expected to be available.

“We have a unique set of circumstances in that we've been operating [the MeHR] now for eight years,” Mr Whitehead said. “We've got an established community of consumers and providers who have expectations about usability.

“We needed … for our clinicians in particular to be confident that what they see in [the PCEHR] matched what they currently are able to see. That has been the driver for asking DoHA and NEHTA to advance some aspects of PCEHR work in terms of a view that would support an aggregation of some key pieces of primary care information and event summaries.

“Our clinicians at the moment have access to a document that aggregates information ... and that gives them a bit of a context about what has been going on with that patient in the last little while.

“The other thing is around pathology and diagnostic imaging reports in that our clinicians are used to being able to seeing pathology results that were ordered in a primary care context. Hospital stuff at the moment appears in the discharge summary and we are not arguing that should be changed.

“So our go live is a little later in that we are targeting around March-April next year as the go live date because of this need to do a hard transition from one to the other. We will still do a dual view of MeHR for people who are registered so that historical information is still accessible to our current participating healthcare providers.”

Like Victoria, Tasmania is also currently undertaking a review of its eHealth strategy. Tim Blake, deputy chief information officer with the Tasmanian Department of Health and Human Services, said Tasmania was “on the cusp” of releasing its updated eHealth strategy, which is expected to include more details about connecting to the national system.

Pulse+IT understands that Tasmania will adopt the South Australian technology to begin allowing discharge summaries to be sent and clinical documents to be viewed within its public hospitals.

The ACT has been very active in eHealth, with Calvary Hospital playing a large role in one of the Wave 2 projects and already having the ability to send CDA discharge summaries to the PCEHR and to GPs.

The ACT Health Directorate's manager for the national eHealth project, Ian Bull, said the territory had been investigating how to quickly verify IHIs for newborn babies, so their parents can register them for a PCEHR from birth.

“Within our jurisdiction we are building a consumer portal, so consumers can log in and look at their appointments for outpatients services,” Mr Bull said. “We are also building a provider portal for clinicians in the region to be able to submit referrals and get bookings.”

He said the ACT was also in discussions with the federal Department of Human Services to investigate using Medicare's Health Professional Online Services (HPOS) system more widely in the hospital environment.

Posted in Australian eHealth

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