Wednesday, November 02, 2016

I Have To Say I Think This Is Good News - As Long As The Execution Is Of High Quality!

This appeared last week from the ADHA.

Digital Health Agency responds to calls to fix electronic messaging

Created on Wednesday, 26 October 2016
The Australian Digital Health Agency is launching a major program with the medical software industry and healthcare providers to realise the direct benefits for providers and their patients of using secure, electronic messaging for communicating with other health professionals.
"I have been listening to key partners in the community on their aspirations for the Digital Health Agency and ways it can support key health priorities in Australia," CEO Tim Kelsey said.
"I have had hundreds of conversations with patient and public advocates, leaders in public and private health services, the clinical community, industry, peak bodies and innovators. I have met with frontline professionals and service-users who have taken me through ways in which digital technology can support them better.
"I keep hearing that our healthcare professionals want to talk to each other routinely, securely, electronically – a situation that many currently find themselves unable to do. One of the first priorities for the Agency will be to partner with the industry, jurisdictions and healthcare professionals to solve the daily challenge of not having a way to send electronic messages to others in the health sector in a seamless, secure way."
The lack of an interoperable, sector-wide messaging system takes valuable time away from frontline care professionals and creates difficulties when a provider sending a message does not know if the message was delivered or received at the other end. These problems are forcing most healthcare providers to continue to use fax machines when the majority of other industries replaced them with digital communication technologies over a decade ago.
In the spirit of co-production, the Agency is adopting a model that will hold it to account to the community and deliver the correct outcomes.
The program will be governed by external Senior Responsible Owners – Dr Nathan Pinskier, Chair of the RACGP Expert Committee on eHealth and Practice Systems, Dr Mal Thatcher, CEO eHealth Queensland, and Ms Fiona Panagoulias as a community representative. These people are not part of the Agency itself, but will shape the direction of the program and hold the Agency to account for delivering a program that results in clear benefits for the community.
"I am on the record as stating that the number one issue to be resolved in health care communications is the ability for healthcare providers to electronically communicate with each other directly, seamlessly and securely," said Dr Pinskier.
"Solving the provider to provider secure messaging usability issue will create the potential to leverage these healthcare communications for other purposes including uploads to the My Health Record. The interoperability solution is within our grasp and I thank the Digital Health Agency and its CEO Tim Kelsey for listening to the sector and making this a high priority item."
Dr Thatcher stated, "I believe in the importance of having a secure messaging environment that allows seamless, secure and safe transfer of patient information between providers.
"Connecting healthcare is a key priority outlined in My Health, Queensland’s future: Advancing health 2026 vision and electronic messaging is a part of this.
"Queensland looks forward to working with the Australian Digital Health Agency and industry to progress this important work."
Ms Panagoulias hopes Australia will move quickly to deliver a modern health service that takes advantage of the opportunities technology offers patients and their carers. "We have an amazing health system in Australia," she said. "I've seen others in the world. We really must do our best to make it better."
Ms Panagoulias, Dr Thatcher and Dr Pinskier will be supported by a Program Board with technology industry, healthcare provider, primary health network, hospital and general practice representatives, as well as HealthDirect Australia. This group will ensure the program stays focussed on the benefits to patients and providers, and prevent the program from becoming a purely technology project.
The Agency is working in partnership with the medical software industry to achieve a better experience for system users.
President of the Medical Software Industry Association Emma Hossack stated that, "Members of the Medical Software Industry Association have been willing and able to make this happen for some time, with a number of messaging companies already carrying out test exchanges. However, without addressing the other obstacles, like terminology and identifiers, as well as involving parties like the clinical information systems, success would not be possible. Tim Kelsey is seeing digital health as a digital ecosystem and with this fresh new approach, we are optimistic that past obstacles will be overcome."
The objective of the program is to achieve a trustworthy, seamless process for a message to flow securely from one provider to another; irrespective of the technology platform they are using, the organisation they work for, the other provider they are communicating with, or the home State or Territory of the patient – to create a better experience for healthcare professionals and patients and, ultimately, safer, higher quality care.
Here is the link:
There is some good coverage here:
28 October, 2016

Secure messaging: the great leap forward?

Posted by Julie Lambert
A team of outsiders, led by Melbourne GP Dr Nathan Pinskier, will oversee the development of secure electronic messaging for the medical profession so that doctors can finally set a bonfire of the faxes.
Australian Digital Health Agency chief Tim Kelsey said interoperable secure messaging was the top digital-health priority to permit healthcare professionals to communicate with each other easily, safely and routinely.
“Many of the problems we have to resolve are not straightforward ones.  I think we all have recognise this is going to be small steps, small steps to build confidence,” Kelsey told the RACGP eHealth Forum last week.
He acknowledged a “history of disappointment” in digital health in Australia, saying he worried that people were fatigued by the overselling of the digital technology in healthcare.
“There has been over-promising and under-delivery. We can’t do that anymore,” the former NHS change manager said.
The program would be driven by a partnership of software suppliers, health jurisdictions and healthcare professionals, taking practical steps towards tangible goals such as development of an electronic directory for clinicians, he said.
Lots more here:
Additionally there was some coverage of an earlier ADHA move here:
24 October, 2016

Can one bloke change the fate of Australian health?

Posted by Jeremy Knibbs
With barely two months under his belt, but a tonne of kilometres already clocked up running around the country listening to stakeholders from all walks of the health spectrum, the new head of the Australian Digital Health Agency (ADHA), Tim Kelsey, is charged up and ready to fire the starting gun on what might be a new beginning for Australia’s health future – one with some semblance of sensible and practical digital health strategy development and execution.
If he could wrangle even half of the  herd of cats that has wandered our digital health landscape in the last few years – the federal regulators, software vendors (eg, patient management systems and secure messaging vendors), health service providers (eg, pathology labs), state government health department empires, the politicians, the GP and specialist lobby groups and the media –  it would be a promising start.
Today he announced the appointments of Associate Professor Meredith Makeham as the Chief Medical Advisor to the ADHA and Dr Steve Hambleton, a key player and digital health influencer and a past AMA president, as the “Senior Responsible Owner” for a number of high-priority clinical digital programs for the ADHA.
Lots more here:
Interestingly I ran a poll a few weeks ago on this:
AusHealthIT Poll Number 339  – Results – 9th October, 2016.
Here are the results of the poll.

Do You Agree It Is A Very High Priority To Fully Electronify Clinical Messaging?

Yes 71% (87)
No 19% (23)
I Have No Idea 10% (12)
Total votes: 122
A useful majority seem to be keen on really working hard to get Secure Clinical Messaging to be ubiquitous.
A great turnout  of votes.
Again, many, many thanks to all those that voted!
David.
Here is the link:
It seems Mr Kelsey and his team are on a winner here if they do it properly, sensibly and get it right! Time will tell I guess. We have all been waiting a good while for a seamless, standardised solution to all this.
David.

14 comments:

Bernard Robertson-Dunn said...

So far so good.

IMHO, a lot depends on the scope of the problem they decide to tackle.

This will be determined by the end-points and the nature of the messages.

If the end-points are individuals and the messages are in human readable form then it's, essentially, a replacement for the fax system.

If the end-points are systems and the messages are system to system then it's, essentially, a replacement for the My Health Record system, but without the government owned database.

We wait for details.

Anonymous said...

My money is on this being a smoke screen to divert us from MyHR being Care.data.2.

I won't be surprised if a few old chums from the UK start popping up now the UK has shut the care.data down. There is to much pride and money to be made out of all this and it will come out eventually large and unseen parent companies and investment house link certain people together.

Would not want to be the Health Minister.

Tom Bowden said...


I believe Tim Kelsey has strong support to solve this problem and I would like to confirm that we as messaging vendors are very keen to see resolution of it.

The essential problem we need to solve is one of over-complexity. Interchanging messages between unalike systems while complying with significantly complex requirements for authentication and security has been very difficult - especially when you consider the large number of parties involved (at a guess 15,000+ medical organisations).

When you try to replace traditional communications (paper/faxes etc) with an electronic medium, it must work well all the time/every time for it to be effective and thus support the transition and that is the challenge (no-one wants to have to rely upon a system that works nearly all the time).

The secure messaging vendors, led by the Medical Software Industry Association (MSIA)chair Emma Hossack, have been exchanging real patient messages among themselves for a while. The task now is to remove any unduly onerous impediments so that we can scale it up fully. That is now underway.

We look forward to bringing the Australian health sector a robust information exchange mechanism. Please support us and advise us if called upon to do so.

Tom Bowden - CEO HealthLink and MSIA Board Member.

Grahame Grieve said...

"any unduly onerous impediments" - Tom, can you be specific as to what the onerous impediments are?

Tom Bowden said...


Hi Graeme,

I don't want to trigger discussion on detailed matters outside the forum currently set up for this(which has not yet considered the matters I refer to that MSIA and the messaging vendors have raised). Happy to go through them once the forum has considered them but in the meantime want to see if we can advance the discussion through the appropriate forum.

Happy to discuss with you one on one - tom.bowden@healthlink.net /+64 21 874 154.

Grahame Grieve said...

I'm pretty well informed - including contracting to ADHA directly and being a member of MSIA - and I don't know what forum you are referring to. For other readers, at least, can you clarify where the discussions are being (going to be?) held?

Ideally, we'll be digging up the old MSIA profile from the meetings back in 2011 that I polished off that MSIA never finished making available, but I'm not sure whether those are the issues you are referring to

Anonymous said...


Anonymous November 02, 2016 11:01 PM said...
I won't be surprised if a few old chums from the UK start popping up now the UK has shut the care.data down.

Pulse+IT today:
A former colleague of Australian Digital Health Agency (ADHA) CEO Tim Kelsey is set to take up the high-profile role overseeing the functioning of the My Health Record system from early next year.

Ronan O'Connor, who worked with Mr Kelsey at NHS England, has been appointed as executive general manager (EGM) of ADHA's Core Systems Operations division.

Tom Bowden said...



Hi Grahame,

The forum I refer to is the widely publicised group being led by Mal Thatcher and Nathan Pinskier and others, Bettina McMahon is the ADHA person in charge of it.

From my point of view, the issues that need sorting out are the ones I commented on above i.e.:

"The essential problem we need to solve is one of over-complexity. Interchanging messages between unalike systems while complying with significantly complex requirements for authentication and security has been very difficult - especially when you consider the large number of parties involved (at a guess 15,000+ medical organisations).

When you try to replace traditional communications (paper/faxes etc.) with an electronic medium, it must work well all the time/every time for it to be effective and thus support the transition and that is the challenge (no-one wants to have to rely upon a system that works nearly all the time)."

In other countries in which secure messaging plays a key role, things are a lot simpler (Denmark and NZ are the ones I am familiar with).

Kind regards,

Tom


Anonymous said...

Denmark and NZ - both a lot smaller, each a single nation state (i.e. not a federation) with different health systems from us. Do you want Australia to scrap its States and change its constitution? Just to suit s/w vendors?

Dr David More MB PhD FACHI said...

"Do you want Australia to scrap its States and change its constitution?"

For myself that would be great - stop a lot of nonsense!

David.

Grahame Grieve said...

"Do you want Australia to scrap its States and change its constitution?" - that's a bigger issue than health. However nothing in our constitution prevents us from doing the right thing in health, or learning from places that have done the right thing.

"The forum I refer to is the widely publicised group being led by Mal Thatcher and Nathan Pinskier and others, Bettina McMahon is the ADHA person in charge of it." - Thanks Tom.

Anonymous said...

Ronan O'Connor, who worked with Mr Kelsey at NHS England, has been appointed as executive general manager (EGM) of ADHA's Core Systems Operations division.

Sounds like a cosy and rosy deal, tim will want someone he is familiar with and trusts and the Minister in supporting this obviously does not think anyone in Australia is up to the job.

Great move the vendors won't know what hit them now the big boys have arrived

Anonymous said...

The good old guard running something, they always did make the secret service look open and transparent. At least the lot running the strategy are open for debate and all welcome. That is a far better look.

Tom Bowden said...


Totally agree Grahame, we can't blame the size of the country or federal structure for the lack of progress to date with resolving secure messaging.

It is very much a micro-issue - sorting out a handful of very specific impediments and getting agreement amongst parties with slightly different perspectives.

Its true that Australia is a larger country with more people and more viewpoints, however that can't be allowed to stop us from fixing this important problem.

Its thanks to the hard work that people like you (Grahame) are doing to develop, implement and improve communications methods and standards that we are going to get this over the line and we are most certainly going to do that.

I look forward to reporting on further progress soon.

kind regards,

Tom