HealthLink in the midst of a paradigm shift to online services

Over the past five years, Auckland-headquartered HealthLink has made the transition from secure messaging provider to what it calls an online services hub, undergoing an intensive development process that it says is set to completely redefine electronic referrals in New Zealand and Australia.

According to HealthLink CEO Tom Bowden, more than 70 per cent of the three Auckland District Health Boards’ GP referrals are delivered using its new online eReferral technology, and the company now provides electronic hospital referrals for approximately 60 per cent of New Zealand’s population.

HealthLink, which handles pretty much all secure messaging in both the primary and secondary health sectors in New Zealand, is trialling the new technology with a number of GPs and community-based specialists to ensure the company gets it right before offering it to both the New Zealand and Australian markets.

Mr Bowden said messaging-based referrals and specialist reports are widely used in NZ, with an average general practice communicating with 64 other parties electronically. However, the move to online services is what he calls a new paradigm that will see the traditional referral process changed completely.

“The way it works in messaging is that your EMR is used to define a referral and to pick a party you want to send it to,” he said. “That then turns it into a message and squirts it into our system, where it gets picked up by the party you are referring to. But what it doesn't do is allow the recipient to define what he or she wants by the way of a referral.

“Our new system works with the GP selecting the referral type that they want to use and choosing the recipient from a cloud-based server. Whether they are sending a referral to a hospital or to a specialist or whoever it might be, the recipient defines what information he or she would like to receive in the referral.

“That definition then instructs the EMR as to which fields of information to send and which attachments to present.”

Mr Bowden said the EMR then automatically populates the referral with a large number of fields of information in a much more comprehensive manner. “It is the recipient of the referral who has defined pretty much what they want to get,” he said. “It is a much smarter process.”

Not only will this overcome the problem of inappropriate referrals, but it will ensure that the referrer can no longer send too much or too little information, he said. By defining the fields and allowing the EMR to take care of populating it, the referrers themselves won't need to do much work.

“We are in the throes of introducing that now and we have put it into a number of pilot sites first,” he said. “And we are doing a lot more development work to improve the service, applying what we have learned, because in our view, the whole thing about the technology is getting it right. We'd far rather spend all our time getting the product right rather than trying to sell it. If you get the product right, it'll sell itself.”

The online service will be able to be launched from within practice management systems, which Mr Bowden prefers to call EMR, and as all NZ general practice EMRs use a common interface based on a national standard, it will work for all.

“This is revolutionising the referral process,” he said. “With the hospital referrals, GPs have told us in focus groups that they can already see better patient outcomes from this process.”

The same EMR interface is being used for another of HealthLink's products, the eLab pathology ordering system it has developed with Danish company DMDD. eLab allows GPs to order electronically, with the order sent directly into the laboratory's system with no manual input required.

Mr Bowden said eLab is now used extensively in the lower North Island region following its launch in Wellington in late 2011. HealthLink will also begin a renewed push in the next few months to get the system implemented in Australia.

“Because it uses the same EMR interface, [NZ users] don't need to change the EMR system,” he said. “You just plug it in and it pulls out the same fields and off it goes.”

The company is also implementing its Care Insight system in more NZ regions following its first introduction in Hawke's Bay. Care Insight, which has been developed in partnership with Dr Info, allows emergency department doctors access to a summary of medical information held in the patient's GP's or pharmacist's system, including diagnoses, medications and alerts.

Care Insight is now used in Gisborne, throughout Northland and in Nelson on the South Island. Mr Bowden said the company was also looking at implementing it in other parts of the South Island, as well as the first implementation in Auckland that is now underway.

While HealthLink and Dr Info have been in talks to introduce Care Insight to Australia, recent changes in health policy and health service realignment means that has been delayed somewhat. Australia also lacks a national secure network for general practices, meaning implementing it on the West Island will be infinitely more difficult than in NZ.

“There are all sorts of firewalls – or no firewalls – to try to get through in Australia whereas that doesn't apply in New Zealand,” he said. “In New Zealand we have pretty much have a complete, universal secure network running across every general practice.

“The key to Care Insight is its reliability, so if you've got 100 medical practices and 10 of them are going offline all of the time, then it won't work. Care Insight is a very elegant solution but it has to be choreographed correctly.”

Posted in New Zealand eHealth

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