Incentives on offer for private hospitals to link to PCEHR

The National E-Health Transition Authority (NEHTA) will offer funding to private hospital groups to begin integrating their systems with the PCEHR.

NEHTA has announced it will shortly release an invitation to apply for its Private Hospital PCEHR Rapid Implementation Program (RIP) to offer funding to allow private hospitals to deploy PCEHR viewing and clinical document upload capability.

A NEHTA spokeswoman declined to reveal how much funding would be available, but said the invitation to apply would be released within the week.

NEHTA CEO Peter Fleming told the Rural Medicine Australia (RMA) conference in Sydney recently that the organisation was in discussions with the private hospital sector about the potential to use middleware developed by the South Australian Department of Health to link to the national system.

SA Health and a vendor partner designed the Healthcare Identifier and PCEHR Services (HIPS) software to allow its public hospitals to view a patient's PCEHR and upload discharge summaries in advance of the roll-out of software that can directly link to the system.

HIPS was then licensed by NEHTA for use in other jurisdictions and a rapid implementation program for public hospitals undertaken.

In addition to uploading documents and viewing the PCEHR, HIPS is able to link hospital systems to the Healthcare Identifiers (HI) Service.

Pulse+IT also understands that the state and territories are planning to use its secure message delivery (SMD) capabilities to improve outbound and inbound document exchange between public hospitals and primary care, including electronic referrals and discharge summaries sent to GPs, to overcome the stalemate in interoperability between the secure messaging vendors.

HIPS is being used by public hospitals in South Australia, Tasmania, Western Australian and Victoria. Queensland is using HIPS to send discharge summaries but is also using its The Viewer technology to view records.

NSW has developed its own integration through its HealtheNet service within the Cerner clinical application, while Sydney's St Vincent's Hospital – the first in Australia to link to the PCEHR – can do it directly through its EHS clinical information system.

Mr Fleming said that every jurisdiction had committed to linking to the PCEHR in terms of discharge summaries and viewing the record, but was also working on medications data as well. This work is being led by Tasmania.

Mr Fleming said the technology would now be offered to the private sector. “The work we have done to integrate that we are now making available to the private hospitals, the HIPS system, and entering into some quite detailed discussions with them at the moment,” he said.

The difficulties in getting the private hospital sector involved in the PCEHR were laid out by Healthscope CIO Paul Williams at the Health Informatics Conference (HIC) in Melbourne in August.

Mr Williams told a Q&A session at HIC that convincing private hospital management to invest in public eHealth programs like the PCEHR was tough.

Healthscope, which runs 44 private hospitals and 69 pathology labs as well as 46 medical centres, announced in June 2013 that it would be offering the PCEHR through its general practices. Those practices use PCEHR-compliant software, and while its labs are not yet linked, they have been using integrated software and secure messaging systems for many years.

On the hospital side, however, Mr Williams said that his managing director was “unconverted” on the benefits of hooking up to the system and the lack of engagement from the sector as a whole was not necessarily due to scepticism but more to do with the fact that few were aware the system even existed.

“My MD is unconverted and it’s a tough gig,” Mr Williams said. “Even if you’ve got a will and a desire, trying to make a business case for a private entity that is publicly listed, that’s got to show a bottom line return for every dollar that you spend, becomes tough.”

Mr Williams said Healthscope was happy to link its medical centres because there was government funding for that process, but he doubted there would be “a big bang approach” to the PCEHR for its hospitals.

“There needs to be a realisation that today there’s not an obvious economic return,” he said. “We do things when we can obviously make a buck, save a buck, or there is significant patient quality issues.

“We’re very heavy on that within Healthscope. We believe if there’s a quality initiative [that] reduced risks, improves good outcomes, we get good outcomes for our patients – those are the three things that would obviously drive our organisation. Those are the things that would get the ear of the decision makers.”

Posted in Australian eHealth

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