Don't forget allied health and specialists in digital health agenda: AAPM

Written by Kate McDonald on 25 January 2018.

Specialist and allied health practices need to be supported in taking part in digital health initiatives such as the My Health Record if the full benefits are to be realised, the Australian Association of Practice Management (AAPM) says, with resources made available to ensure that practice managers across all settings are thoroughly informed about in digital health at the practice level.

In a position paper on digital health released last week, AAPM says there are significant potential benefits that can be achieved through digital health, including better access to care and better health outcomes; improved co-ordination and communication between providers; greater use of data to improve healthcare and influence health behaviours; and economic benefits from system efficiencies.

However, to achieve these benefits, AAPM says several current risks and concerns need to be addressed, including data security through secure messaging; system interoperability across providers and sectors; and reliable high speed internet access across all parts of Australia, including rural and remote areas.

It also says there is a need to achieve high levels of uptake of digital health by patients to succeed, estimating that at least 50 per cent of patients will need to be registered for My Health Record before health professionals will see the real benefits.

“The opt-out model should help to achieve this critical mass, and AAPM is heartened that following successful trials, the COAG Health Council in March 2017 agreed to adopt the opt-out model on a national scale in the future,” it says.

There is also a need to ensure inclusiveness of all sectors, including specialist and allied health practices, it argues.

“The allied health sector has noted that the federal government’s focus and investment in digital health to date has been largely concentrated on general practice,” the statement says.

“It is recognised that this support has been vital and it is welcomed; however, it is important that other providers are also supported to participate in digital health. The allied health community plays a crucial role and would benefit enormously from full access to digital health technology, and should be supported to engage with digital health.

“Similarly, it is important to ensure that medical specialists and their practices are supported to engage with digital health. Specialist practices may have specific issues in relation to patient data management and secure transmission; and it will be important to ensure that the digital system is compatible with all medical practice software systems, and that the digital health agenda takes into account that manual systems are still used by some specialist practices.”

AAPM recommends that resources be made available to ensure that practice managers across Australia, whether in general practice, specialist practice, or allied health settings, can be comprehensively informed, educated and equipped in digital health at practice level.

It also recommends that practice managers be represented in all key committees and policy processes in relation to the further development of Australia’s digital health agenda, and that all practice managers actively embrace the digital health agenda, ensure they are fully educated and informed of developments, and offer leadership at practice level to embed digital health into Australia’s health system.

The position paper is available here (PDF):

I am a psychiatrist who is passionate about eHealth.
I have a great EMR, have subscribed to four different secure messaging systems, promote communication with me by secure messaging in every communication, and send all of my communication to GPs and other specialists by secure messaging.
However, I receive almost nothing by secure messaging, even GPs to whom I regularly send secure messages still seem completely obsessed with fax. Those that I have asked simply say they "don't know how to use it" or "you aren't in our address book and I don't know how to add you" or they rely on practice staff to send referrals who simply revert to fax.
It leads me to wonder who IS actually using secure messaging, and what the volume of secure messages is like when compared to fax.
It seems to me that there needs to be a fundamental overhaul of GP software to make secure messaging easy, to integrate directory look-ups which much smarter searching, and to get the different systems to speak to each other.

# Ian Mcknight 2018-01-30 23:58

In regard to Richards comments which I thought were excellent. As someone who, for the last 2 and a half years in particular sought to drive the uptake of secure messaging in Tasmania, I feel I can add a little to this. The issue is quite simply one of education, of the different parties as to optimal program use and the capabilities of prospective recipients.Ther e is one messaging program that is common to essentially every General Practice in Tasmania, (one of the ones you use), so it is relatively easy to instruct specialists who are interested, or even prompt ones that unknowingly have everything they need. GP Software in Tasmania is essentially Medical Director or Best Practice, and both of them easily interact with this messaging product,....alt hough the MD address book could be better. Publicising "who is playing" to the relevant parties is key. As far as numbers go, electronic letters from Specialist to General Practice in Tassie is running at 10000 documents a month statewide, whilst GP to Specialist referals is around 8-9 percent of this number. The appetite is certainly not as strong from GPs, where I guess they pay the cost of a fax whereas specialists pay $1 per letter. Never the less I describe electronic referrals by GPs as a growing trickle. Some practices have a strong appetite for it and some have none. The main software issue I see actually, is allied health providers who because of affordability issues, use a lower end clinical or accounting only program, that does not have the ability to generate or receive documents in an appropriate electronic format, e.g. HL7 messages. This means they have to find a separate program to create and send/receive documents, and I have yet to see one that I am super-confident to promote.

# Les Posen 2018-01-31 10:52

I often advise allied health practitioners (psychologists) in this domain. There is a slow growth of EHR and PMS for this group, and most are still lousy ports of medical software with a really clunky "look and feel" (YMMV, however). I find I endorse none of them, but provide a pathway for psychologists to evaluate their needs and attempt to future proof their practices. Personally, I use efax software to email faxes to GPs (together they are universal standards after all with much interoperabilit y). Currently, there are too many non-sharing proprietary apps for $-challenged AHProfessionals to choose from. One difficulty is sharing info with patients over email. I password protect PDFs which I send (invoices and questionnaires) which requires an agreed-upon PW. I also maintain a social media policy each patient receives before the first session to let each know how email can be used successfully and when not. Same goes for Twitter, Facebook and LinkedIn. My professional society is currently working on systems of approved and safe information sharing, but some distance off in 2018, despite me suggesting they do something about this 10 years ago. I've always said the two professions who have the most early adopters who can be real influencers are medicine and teaching. Psychology is right down the bottom of the list when it comes to tech adoption. In some ways, it's a good thing.

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Don't forget allied health and specialists in digital health agenda: AAPM

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