This appeared last week from the ADHA.
Media release - Helping healthcare providers to share information
Created on Monday, 9 September 2019
9 September 2019: Collaboration to develop enhanced secure messaging functionality will ensure healthcare providers can communicate quickly, easily and securely to provide safer and more efficient care.
Eliminating paper-based messaging in healthcare is a priority of the National Digital Health Strategy.
The Agency has been working with the software industry and healthcare providers to develop standards to improve the secure exchange of healthcare information. Following the successful trialling of the co-designed standards in 2018, the Agency today confirmed that it is partnering with 42 organisations to ensure they are able to easily share information when using different secure messaging platforms across 56 separate software products.
Patient and consumer advocate, Harry Iles-Mann, says that finding ways to reduce frustration and have better, safer, and more effective care is important to him. “Two of the most frustrating things about being a patient are having to repeat yourself in multiple care environments and bringing bundles of paper with you to appointments,” Mr Iles-Mann said.
Most clinicians can only correspond electronically with healthcare providers who use the same secure messaging software. These enhancements will allow clinicians to more easily address messages to healthcare providers who are on other secure messaging platforms and will ensure messages and acknowledgements are sent in standard formats. Breaking down these silos will allow clinicians to achieve the full potential of secure messaging and will support the move to axe both the fax and the scanner. GP Clinical Advisor to the Agency’s Secure Messaging Program, Dr Nathan Pinskier, said ensuring providers can communicate quickly, easily and securely allows them to provide safer and more efficient care.
“When patients are visiting different doctors and healthcare providers, or they are referred by a doctor to a hospital or vice versa, it is increasingly important that information relating to that patient’s ongoing care – such as referrals, specialist letters, and discharge summaries – can be exchanged by secure electronic communications,” Dr Pinskier said. “The current work program being undertaking with these organisations will make it easier for healthcare providers to use secure messaging platforms by enhancing the software available to them in terms of functionality, useability and interoperability.”
General Manager of eHealth Solutions at Telstra Health, Tania Oldaker, said this is a great example of collaboration between software organisations and the Agency to support the work of general practitioners, specialists, allied health practitioners and other providers across Australia.
“We’ve worked closely with the Agency and our colleagues in the software industry to develop these new secure messaging standards and test them in a proof-of-concept implementation,” Ms Oldaker said.
“Now it’s time to scale this work nationally, and we’re excited to be implementing these changes across our product suite.”
Australian Digital Health Agency Chief Operating Officer, Bettina McMahon, said secure provider-to-provider communication is a key component of digitally enabled and coordinated care across the Australian health sector.
“We have made significant progress on secure messaging by working with industry on a provider directory model that breaks down barriers between clinicians, while still leveraging the investment that the secure messaging industry has made to date.” Ms McMahon said.
“This is the next step that will ensure those new standards are adopted quickly so GPs, hospitals, specialists and other health practitioners can reap the full benefits of secure messaging, which include timelier receipt of clinical information and not having to chase or resend referrals.
“It also means we are one step closer to retiring fax machines, which is a priority of the National Digital Health Strategy agreed to by all Australian governments through the Council of Australian Governments (COAG) Health Council.”
Find out more about Secure Messaging.
Fast facts
- The Agency announced a program in March 2019 to accelerate the adoption of new secure messaging standards by software providers.
- Providers are required to integrate the new standards into their products by May 2020.
ENDS
Here is the link:
There has been some press commentary here:
An end to paper
Eliminating paper-based messaging in healthcare is now a step closer, says the Australian Digital Health Agency
Following a successful trial in 2018, the Agency has now confirmed that it is partnering with 42 organisations to ensure healthcare providers are able to easily share information when using different secure messaging platforms across 56 separate software products.
The Agency says that eliminating paper-based messaging in healthcare is a priority for the National Digital Health Strategy.
The Agency has been working with the software industry and healthcare providers to develop standards to improve the secure exchange of healthcare information, it said.
Most clinicians can only correspond electronically with healthcare providers who use the same secure messaging software. However these enhancements will allow clinicians to more easily address messages to healthcare providers who are on other secure messaging platforms and are aimed at ensuring messages and acknowledgements are sent in standard formats.
Breaking down these silos will allow clinicians to achieve the full potential of secure messaging and will support the move to “axe” both the fax and the scanner, the Agency said.
Here is the link:
And here:
ADHA partners with 42 organisations to develop secure message functionality across software products
A priority of Australia’s National Digital Health Strategy is to eliminate paper-based messaging in healthcare.
By Dean Koh
September 09, 2019 12:04 AM
WHY IT MATTERS
Most clinicians can only correspond electronically with healthcare providers who use the same secure messaging software. These enhancements will allow clinicians to more easily address messages to healthcare providers who are on other secure messaging platforms and will ensure messages and acknowledgements are sent in standard formats. Breaking down these silos will allow clinicians to achieve the full potential of secure messaging and will support the move to axe both the fax and the scanner.
General Manager of eHealth Solutions at Telstra Health, Tania Oldaker, said this is a great example of collaboration between software organisations and the Agency to support the work of general practitioners, specialists, allied health practitioners and other providers across Australia.
“We’ve worked closely with the Agency and our colleagues in the software industry to develop these new secure messaging standards and test them in a proof-of-concept implementation,” Ms Oldaker said.
“Now it’s time to scale this work nationally, and we’re excited to be implementing these changes across our product suite.”
Here is the link:
So I thought it was worth doing a little digging and chatting to ask some in the thick of it just where things are.
Valuable in that was this link:
Other useful links further down are here:
and here:
What the release is actually talking about is having organisations starting work to incorporate the ADHA approved Secure Messaging and NASH certificates and have passed the ADHA validation tests by 15 May, 2020.
For doing this there is a payment of $30,000 according to the offer papers – the total can run to 56 systems to account for different apps from the same vendor – which adds up to $1.68 million.
Contracts to undertake the work had to be signed by late June, 2019.
The organisations that have signed up to go ahead are here:
A few comments:
1. This is yet another future focussed release regarding clinical software functionality which is due to be delivered mid next year. To date we have only a few proof of concept trials completed.
2. It appears. from the 9 September, 2019 Developer Guide document linked above, that message payloads for referral, discharge summaries and specialist letters messages are expected to be a .pdf document in a HL7 V2.4 message!.
3. Its not clear to me just how this fits with this specification, from last year which does not mention .pdfs. See here:
I am sure some smartie will explain it for me, but it really looks to me like a quick and dumb attempt to get something going that will, maybe. work for a while.
You can be sure this sort of approach does not support precision medicine and things like genomics – but worse does not make it easy to get important data from the referral etc into the right places in a CIS.
Chats with real experts suggest there may also issues with the quality and conformance of messages as they flow between various secure messaging providers.
Additionally I am hearing some reservations about the end-point look up functionality between secure messaging providers – which could possibly even replicate the problem seen with faxes of wrong number delivery of messages – out of frying pan and into the fire??
Despite the confidence of the release that all is fixed and will work like clockwork I suspect there will be more than a few problems emerge in the next nine-to-ten months – some of which will prove pretty tricky to say the least. One hopes the quality of the conformance testing will pick up problems in advance but would you hold your breath?
David.
Good god. Is this the state of the art of digital health - replace bits of paper with electronic forms? How about someone pays some attention to the content.
ReplyDeleteTimmie is trying to breed faster horses when we need the internal combustion engine.
I think the missing of ADHA and a hoarse will result in a mule.
ReplyDeleteIt does seem a bit pointless to set the bar this low. EFax already does this, the infrastructure is there, desktops all have efax capabilities built in and it's NBN ready.
If all you want to do is push around unstructured content then this risks the box.
@2:22 PM No, Timmie and his RACGP clinical advisor announced last week that the MHR needs to be replatformed.
ReplyDeleteWhat he is trying desparately to do is to divert everone's attention from the failed MHR project.
He has put enormous energy into presenting at International Conferences and blowing his trumpet about how Australia's Digital Health Project is so advanced and leading the world. He has to keep spewing up the bullshit as a matter of survival lest the government awakes and curtails his funding.
It's the old story; keep saying the same thing long and loud enough and in time someone will believe it.
It reminds me of a quote about Stephen Fry - A Stupid Person's idea of What an Intelligent Person is Like
ReplyDeleteTim Kelsey - an Ignorant Person's idea of What a Digital Health Expert is Like.
The more I read of ADHA's public statements, strategy documents, EOIs, objectives, claims and aspirations, the more I perceive a conflicted web of mixed, contradictory, messages. It's like watching a rudderless ocean liner being tossed around by a couple of maxi tornadoes.
ReplyDeleteMy concern is that we could have done messaging with PIT 20 years ago and it would have been less pretty but very space and bandwidth efficient and apart from a lack of font/images/logos the difference in terms of clinical decision support would be zero to what is proposed currently!
ReplyDeleteIf we allow this we will be locked into opaque documents with no atomic data, including no machine readable allergies or medication for the next 10 years and it is just a very expensive eFax setup. I cannot see how any of the efficiency or safety gains that have been claimed could materialize when it just a fax machine in drag. Maybe that is why they want to kill the fax, they don't like competition?
This is health care and quality counts, its time they insisted that medical IT companies invested in IT and produced compliant software that safely handled data that has been in existence for 20 years!
@9:51 PM ... My apologies Andrew. it might just be me, but with the utmost respect I think your comment is 'confusing'. It is very difficult to synthesize precisely what you are trying to say. Permit me please to attempt to interpret and rephrase your message.
ReplyDeleteI think you are trying to say that there is no difference between what is being proposed by ADHA today and what was available 20 years ago.
and,
That although the ADHA want to kill the fax, what they are proposing as a 'replacement' will not deliver the efficiency and safety gains that they claim will materialise. Basically what is being proposed is just a very expensive eFax setup best described as a fax machine in drag, which, if this is permitted to eventuate, will lock us into opaque documents with no atomic data for another decade.
I hope I have interpreted your comment accurately.
@9:51 PM - Yes your interpretation is correct. pdf is prettier than PIT but suffers the same lack of machine readable data. These days pdf is the Fax format.
ReplyDeleteWonder where the ADHA Clinical leads, clinical safety team, standards team and informatics team are in all this? I can understand the CEO and COO and the CDO position in all this as stable geniuses and digital health experts. They are all from a civil service background and an early time when documents and lumbering old-style ”records management” systems walked the earth. That is how they see the world, their experience with a fax machine relates to this where they would have stood for hours sending and receiving 300-page red-tape documents to each other.
ReplyDeleteNo innovation, no bold future, no more working together with community, no more trust, the list goes on. Well done ADHA. you are my hero
I have to agree with the general theme here. ADHA would have done more to advance clinical communications and data as a tool if they had done nothing.
ReplyDeleteHas something changed at ADHA? Secure messaging was always a little conservative, but of late it seems to have lost its soul.
acta est fabula plauditeSeptember 16, 2019 7:15 AM
ReplyDeleteWhere are they all? Good question. Perhaps they are hiding behind the belief if they say nothing they might be listened to. Meanwhile, the next round of ”co-designing” vultures are perching on the fence ready and waiting.
Denver the goal here is ‘Eliminating paper-based messaging in healthcare is a priority of the National Digital Health Strategy.’ so the enemy here is the office printer and fax over internet protocol must be allowed to enter the market.
ReplyDeleteWonder what quirky slogan the ADHA marketing team will come up with to address the evil inkjet printer?
Can't comment on Denver, but they ADHA sure is somewhere over the rainbow. I like your point regarding the office printer. That does need removing if you are to get a paperless health system. Over to you Tinman.
ReplyDeleteNot only do health records become inaccurate over time, they are often inaccurate in the first place.
ReplyDeletehttps://jamanetwork.com/journals/jamanetworkopen/fullarticle/2751388
Secure messaging and interoperability won't fix that little problem. Maybe doctors should spend more time doing data entry and admin. That'll improve things.
"Not only do health records become inaccurate over time, they are often inaccurate in the first place."
ReplyDeleteThat's why the patient idea of not being asked the same questions will never been solved. When you can't figure out whats going on you have to go back and take the history again, check again if they took any herbs, did they live in some tropical place in the past etc etc
The current referrals, with medication as text, are very inaccurate and I would cross off half the listed medication typically, but its a good place to start. Concentrating on a medication list would have been a good start for Healthconnect/Nehta/ADHA but they go for a grand plan which gets watered down over time to a rough sketch on a napkin....
"rough sketch on a napkin...."
ReplyDeletewhich has cost over $2 billion and is being touted as world leading....
....world leading in terms of increasing waste and inefficiency.
What Tim doesn't realise is that the longer he associates himself with failed projects the harder it will be for him to get a job in healthcare. Which many would say is a good thing.
On a flight to Perth Stephen Conroy and Kevin Rudd agreed to the business plan for the Nbn using a "rough sketch on a napkin"!
ReplyDeleteAnd look how well the NBN has worked out!!!
ReplyDeleteThose napkins are downright dangerous!
David.
In 2013 the NBN was to deliver each household some $4,800 in cash able benefits by 2020.
ReplyDeleteNever mind axing the fax, how about they napalm the napkin?
Dangerous they may be, but they are meant to be used to protect against or to clean up a mess!!!!!!
ReplyDeleteI don't know if this return to the past by the Department of Health was documented on a napkin, but it illustrates the central nature of Digital Health in general and the ADHA in particular
ReplyDelete"Deputy secretary Dr Lisa Studdert to steer new preventive health strategy"
https://www.themandarin.com.au/116324-deputy-secretary-dr-lisa-studdert-to-steer-new-preventive-health-strategy/
Check out the expert steering committee, all 24 of them.
Not a mention of ADHA and/or anyone representing Digital Health although Health & Biosecurity, CSIRO can probably cover off that subject if required.
The article makes mention of an address by the Minister of Health to the press club
https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/national-press-club-address-long-term-national-health-plan
Once again, no mention of Digital Health, ADHA, My Health Record,and/or even health records in general. Not even in any of the questions by any of the journalists.
All in all Digtial Health and health records seem as hot a topic as a bowl of cold rice pudding.
A pretty poor achievement for $2 billion and ten years effort.