The eHealth year in review: part 1

In 2013, as in 2012, no issue was more scrutinised in Australia's eHealth sector than the PCEHR. The ongoing saga of the national eHealth system kept the proponents in the spotlight, the naysayers in anguish and Pulse+IT in copious amounts of copy. In the first of a four-part review of the year in eHealth, we take a look at the first quarter.

For eHealth in the general practice sector, January was dominated by the rush to prepare for the first four requirements of the eHealth Practice Incentives Program (ePIP) by the deadline of February 1.

The team at software vendor HCN worked over Christmas and the New Year to have Medical Director and PracSoft listed on NEHTA's online product register for full PCEHR compliance in in early January.

Zedmed and Genie had already achieved the feat late last year, and Best Practice said it was confident its users would qualify by the deadline as well.

While it was no guarantee of actual take up of the PCEHR, about half of all general practices had applied for a Healthcare Provider Identifier – Organisation (HPI-O) in January, which was one of the requirements of the ePIP.

Some of the Medicare Locals that had taken the lead in helping practices become eHealth compliant also moved into helping them register patients, with Barwon Medicare Local a prime example.

One of the most-read stories of the year was our interview with then opposition spokesman for primary care, Andrew Southcott, who dropped a bit of a bombshell when he announced that the Coalition would do a “stocktake” of the PCEHR should it win government.

That promise was kept, with a review of the PCEHR now underway and due to report to Health Minister Peter Dutton any day.

An alternative to the notoriously difficult consumer sign-up process for the PCEHR was announced when known customers were allowed to be registered through their general practitioner. Work on this continued throughout the year, with an assisted registration tool developed by Accenture and later integrated into general practice, pharmacy and aged care software.

The always entertaining Senate Estimates hearings – one of the few sources of accurate information available to the public and the press on what exactly is going on with the national system – heard in February that DoHA believed its target of 500,000 registrations for the PCEHR by June 30 was still achievable. (DoHA eventually missed the target by just two weeks, following a somewhat controversial decision to bring in Aspen Medical contractors to do some recruitment.)

Two major breakthroughs were achieved in eHealth in the first quarter of the year: the two electronic prescription exchanges – eRx and MediSecure – achieved interoperability, and the three members of the SMX secure messaging consortium – HealthLink, Argus and Global Health – announced they would begin trialling interoperability. There were more developments in these two essential elements of eHealth later in the year.

The vexed issue of pathology results and radiology reports appearing on the PCEHR was canvassed in a Pulse+IT story in our February 2013 issue. Later in the year, then Health Minister Tanya Plibersek announced extra funds to make it happen, but the issue is still causing a great deal of angst amongst the pathology profession in particular. Pathology is supposed to go live in PCEHR release five in February 2014, but with no agreement yet on how the results will even appear or who will upload them, this is looking very doubtful.

The acute care sector started to up its role in the PCHER, with Box Hill Hospital in Melbourne and St Vincent's Hospital in Sydney working directly with patients to sign them up. As PCEHR-compliant software became more readily available, Medicare Locals confronted the difficulties in getting local practices ready.

Unexpectedly bursting onto the scene in February was the formerly obscure US-based personal health record vendor MMRGlobal, which announced its presence by saying it was considering taking legal action against NEHTA for patent infringement over the PCEHR. In its home country, MMRGlobal has issued notices against giants such as chemist chain Walgreens, online health information resource WebMD, and a subsidiary of EMR vendor Allscripts.

While MMRGlobal CEO Bob Lorsch offered to meet with NEHTA over a bowl of gumbo at the HIMSS exhibition in New Orleans, NEHTA politely declined the offer. Little has been heard from the company since.

In March, it was announced that the National Prescription and Dispense Repository (NPDR) would go live in May, but in the meantime duty of care concerns caused the suspension of dispense notifications being sent to GP software.

The RACGP asked prescription exchange services MediSecure and eRx to turn off the functionality. GPs who still want to received the notifications – which tells them when a prescribed medication has been dispensed to the patient – can do so on an opt-in basis.

Aged care, allied health and telehealth

In telehealth, NBN Co promised to double the wholesale broadband speeds for the fixed wireless and satellite services planned for non-metro areas. It also announced the official signing of a contract to build the two long-term satellites, due to be launched in 2015.

Then opposition communications spokesman Malcolm Turnbull had long criticised the building of the satellites, saying there was enough capacity. He later changed his tune and agreed to keep them if the Coalition was elected. (The strategic review of the NBN released last week does not go into detail on any changes to the non-fibre part of the new strategy but Pulse+IT will follow this up in the new year.)

In aged care, CareStrong launched a telehealth service to allow residential aged care facilities to receive allied health services remotely.

Aged care began to get ready for the PCEHR, with iCareHealth completing field testing of the system and other vendors such as AutumnCare gearing up.

The federal government began work on its Aged Care Gateway project, which might yet survive the change of government, stroke researchers launched a Wiicycling program, while start-up company Edisse garnered some attention and investment interest when it launched a prototype of its wearable panic alert.

Telehealth provision for aged care was high on the agenda, with the likes of Queensland's Centre for Online Health and Medicare Locals such as Inner East Melbourne announcing several new initiatives.

The big news in aged care was the work being done on uploading advance care directives to the PCEHR. However, like pathology and radiology, the best method for doing so is still up for debate.

There were also developments in the underserved allied health sector, with practice management software vendors such as PPMP and myPractice announcing new integrations, and allied health disciplines such as physiotherapy beginning to gear up for eHealth.

New services, products and apps on the market that caught our eye in the early part of the year included:

This is the first in a four-part series on the eHealth year in review. Look out for the second part tomorrow, when Telstra makes a surprise entry into the healthcare sector and Pulse+IT experiences a PCEHR pickle with the PBS.

Posted in Australian eHealth

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