Wednesday, January 25, 2017

I Have To Say I Am A Little Confused About All This. What Is Really Happening?

In 2015 there were some studies and reviews that, as I read them, suggested that the successful Shared EHR that was in use in the Northern Territory was to be migrated to the PCEHR / myHR.
See here:

MyEHR to National eHealth Record Transition Impact Evaluation

At the COAG Health Council meeting in Darwin on 7 August 2015, Health Ministers received a presentation on an evaluation of NT’s My eHealth Record service undertaken by the National E-Health Transition Authority (NEHTA).
For the first time in Australia, we have strong evidence of the benefits of eHealth records in bridging the gaps in information that occur as patients move between different healthcare providers in the public and private sectors. The evaluation provides a clear case in support of the national PCEHR system.
Here is the link:
I had naively assumed all this was in train when I spotted this.

Successful openEHR EHR implementation featured in WHO eHealth report

January 07, 2017  |  from: Heather Leslie
In Australia, the Northern Territory's My eHealth Record service has been featured as the only example of a successful electronic health record (EHR) implementation in a newly published WHO report on eHealth - a great win for the openEHR community as the EHR is underpinned by an openEHR platform.
The whole of  the report, 'Global diffusion of eHealth: making universal health coverage achievable - Report of the third global survey on eHealth' makes interesting reading, but focus on page 106 for the openEHR-related case study.
This  follows a very positive evaluation report, commissioned by NEHTA (now the Australian Digital Health Agency' and completed in August 2015, about the same My eHealth Record service. Importantly, the report stated:
"For the first time in Australia, we have strong evidence of the benefits of eHealth records in bridging the gaps in information that occur as patients move between different healthcare providers in the public and private sectors."
The 'My eHealth Record' service is a widely used and popular EHR that is making a practical differencen in health outcomes for remote and indigenous Australians. It is built on a state-wide implementation of OceanEHR platform from Ocean Health Systems (previously Ocean Informatics)!
On the basis of these two independent reports, it is clear that OceanEHR has provided a robust and rigorous foundation for a critical and highly successful shared electronic health record, based upon the openEHR specifications. 
For more details, read Ocean's case study and testimonial from NT Health's CIO, Stephen Moo.
Date, time and place: January 7, 2017
More here:
On this basis I had a look at the case study.

Case Studies

OceanEHR platform - NT Health, Australia

Published: 16 August 2016

Demonstrates: a secure way of sharing an individual’s healthcare information between care providers

Project:
My eHealth Record - a territory-wide shared electronic health record
Background:
The Northern Territory Department of Health provides health care to all territorians across the vast, remote geographical area of the northern Australia, including servicing the health needs of the indigenous community.
Goals:
  1. To store structured atomic clinical data in a shared Electronic Health Record;
  2. To enable decision support;
  3. To enable advanced care planning;
  4. To consolidate health information using a common data structure; and
  5. To address identified inadequacies in security, access control and privacy management.
Overview:
NT's My eHealth Record (MeHR), formerly known as the Shared Electronic Health Record, is a way of securely sharing an individual’s health information between their healthcare providers. The MeHR service was designed to overcome fragmentation of clinical information by ensuring it could be accessed quickly and easily by participating healthcare providers. The MyEHR service is operated by eHealthNT, NT Department of Health. It began operating since 2004 using PDFs as a means to share basic information and is based predominantly in the Northern Territory, with some coverage in surrounding Northern and Central Australia. It is similar, but separate, to the national eHealth record system, My Health Record (previously known as the Personally Controlled Electronic Health Record or PCEHR).
Objective:
To support healthcare in NT, especially the remote indigenous population. Also, to enhance the existing Shared EHR platform so that it can store atomised, structured data using detailed clinical models (DCMs)/archetypes from the Australian Digital Health Agency's Clinical Knowledge Manager repository.
Our solution:
The NT Department of Health worked with our Ocean team and utilised our OceanEHR eHealth platform to create a solution that included:
  • Shared EHR architecture/infrastructure
  • Structured clinical data conforming to the Agency's DCMs/openEHR archetypes 
  • Clinical engagement to agree the meaning of data and defining data structures representing antenatal data requirements
Key results:
  • Over 250,000 health patient records in standardised format
  • Over 10 million health record documents converted and stored on the OceanEHR platform
  • A shared EHR that interfaced with many disparate clinical systems including acute hospital, general practice and community care
  • Structured, pdf, CDA and other data types in a single view
  • Integration with existing systems using standards such as HL7, CDA and, of course, openEHR

Key Benefits:

  • Improved healthcare for the mobile indigenous population
  • Improved efficiency due to access to a shared electronic health record
  • Reduction in risk, by giving the correct information to the clinician at the point of care
  • Increased probability of project success by having clinical engagement with clinicians that understand their domains
  • Flexibility to interoperate with future systems such as the national 'My Health Record' (previously known as the Personally Controlled Electronic Health Record)
  • The ability to comply with current and future Australian standards
Testimonial:
“The successful My eHealth Record project, using OceanEHR, has enabled NT to consolidate health information from multiple data types and health repositories into a single, standard and consistent health record for a person. Implementing “atomic” health data in the EHR is building the foundation for the next phase to offer Decision Support and Advanced Care Planning.”
– Stephen Moo, Chief Information Officer, NT Health and Executive Sponsor for My eHealth Record project.
Here is the link:
Now, while I may be wrong I was not aware Ocean Informatics was initially involved in the development of the NT Shared record – which seems to imply that there has been some transition to this new platform. It also seems to suggest the system is no longer for the chop.
However a web page dated last week says the transition to the myHR is still happening:
Here is the link:
Can anyone fill in the gaps and plans for me (and readers) – recognising that the NT also released a major tender for hospital systems mid last year:
and also has had some recent outages and data-integrity issues.
See here:
You can explore current info from NT Health from here:
As I said years ago, it seems silly to shut down a working NT system to replace it with a non-working myHR.
Clarifying updates welcome!
David.

1 comment:

Hugh Leslie (CEO Ocean Health Systems) said...

Hi David,

Just to let you know, the case study that you quote was actually published on the 7th November 2012 (with the quote from Stephen Moo.) The reason that the date was December was that we have a brand new website and the case study was uploaded with that date. We have corrected that now.

Hugh Leslie.