SA Health pulls out of NEHTA secure messaging trial
The South Australian Department of Health and Ageing has pulled out of a project trialling point-to-point (P2P) secure messaging between hospitals and GPs, citing a lack of critical technology promised by the National E-Health Transition Authority (NEHTA).
The NEHTA trial, which Pulse+IT understands was established to help states overcome the long-festering problem of hospitals sending discharge summaries to GPs by fax or post – or in many cases not at all – has been kept quiet, with no official announcement it was taking place.
Pulse+IT understands the trial has been testing the use of the Healthcare Identifiers and PCEHR Service (HIPS) technology – which was developed by SA Health in association with a private vendor and is now used by a number of states to link to the PCEHR system in advance of full integration with their EMRs – to also allow hospitals to send discharge summaries to GPs.
However, SA Health yesterday confirmed a tip from a Pulse+IT source that it has dropped out of the P2P trial, saying it could not make NEHTA's deadline of June 30 without certain crucial technology.
“In July 2013, SA Health engaged with [NEHTA] for a limited pilot program to test point-to-point messaging between hospitals and GPs in the APY Lands,” an SA Health spokesperson said, referring to the Anangu Pitjantjatjara Yankunytjatjara-owned lands in central Australia.
“Critical technology has not been provided by NEHTA in time to allow SA Health to test, implement and complete the pilot program by the required date of 30 June 2015.
“NEHTA was unable to accommodate SA Health’s request to delay the program beyond 30 June 2015 and as a result SA Health has withdrawn its participation from the pilot program.”
A spokesperson for NEHTA said the project involved the development of a national end-point location service by Health Direct Australia, which operates the National Health Services Directory.
“Health Direct Australia is developing a key piece of national infrastructure called NEPS (National ELS Proxy Service) that is a window into the NHSD (National Health Services Directory) and provides all of the technical interaction details required to securely address and deliver clinical messages via [the secure message delivery standard or SMD],” the NEHTA spokesperson said.
“The solution is designed to work with the existing secure messaging vendors' SMD products, as they currently provide the GP end points. Therefore each jurisdiction using this solution will still need arrangements with these secure messaging vendors but will benefit from using a national addressing solution that currently does not exist.
“SA Health has deferred participation in the test phase of the project while they determine what their state wide secure messaging strategy should be.”
Pulse+IT's source said SA Health's project team, which developed the HIPS technology, was only informed in February by SA Health itself that testing was due to start last October.
“Despite developing necessary infrastructure (HIPS), successful preliminary testing and funding available for implementation, SA Health has withdrawn from the project citing an inability to adequately test products by June 30 2015,” the source said.
The source said Queensland Health was going ahead with implementation of the P2P functionality, which NEHTA has confirmed. “[Queensland] Health is testing the sending of discharge summaries from Queensland Health hospitals to GPs using this infrastructure,” the NEHTA spokesperson said.
GPs have long complained that they continue to receive communications from public hospitals only by fax or post despite secure messaging technology being widely used for receiving pathology and radiology results from private practices.
There is still limited communication between hospitals and GPs in most states using secure messaging vendors such as HealthLink, Argus, Medical-Objects and Global Health, despite those companies working on developing interoperability between their systems.
The jurisdictions have begun to investigate how best to overcome this problem, including the use of HIPS as middleware or a broker between systems.
NSW, for example, is using its HealtheNet platform to allow discharge summaries to be sent to GPs no matter what secure messaging service they use, although this is still new and in relatively limited use.
However, GPs in South Australia have long complained that while SA Health has promised to institute a system for discharge summaries, it has not yet done so.
The SA Health spokesperson said that “until such time that a national secure communication avenue is established, SA Health considers fax or post the most secure way to send discharge summaries from its IT systems.”
This article has been updated with comments from NEHTA.
Posted in Australian eHealth