This appeared last week:
New resource: Safety and Quality Benefits of Secure Messaging
The need for healthcare providers to connect safely and securely is greater than ever.
Secure messaging is an efficient and timely method for sending and receiving clinical information, minimising the burden of paper and manual processes. Increased uptake improves continuity of care for patients, saves time and can help protect vital health information.
Following a review conducted by the Australian Commission on Safety and Quality in Health Care, the Australian Digital Health Agency (ADHA) has released Safety and Quality Benefits of Secure Messaging. This new resource delves into findings from the review and subsequent recommendations for healthcare organisations.
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You can download the report from this link:
The conclusions of the report are:
Recommendations
It is important to note that the recommendations of this review support the national scaling initiatives outlined in the ‘Communique – National Scaling of Secure Clinical Messaging’. The eight recommendations aim to enhance the safety and quality aspects of secure messaging and enable enhanced models of care. These recommendations support the Agency’s national scaling initiatives, which require industry partnerships to ensure their successful implementation.
There are eight points:
A. Enable the secure messaging ecosystem
1. Identify or leverage existing digital health test beds for evaluating secure messaging for selected use cases and assess user experience
Expanding secure messaging system functionality to support additional use cases is essential to supporting its uptake and increasing adoption across the healthcare sector. Continued evaluation and early adopter testing through the appropriate analysis of healthcare provider networks and potential test beds will enable secure messaging systems and standards. These can be used to enhance clinical workflows within controlled ecosystems, support healthcare provider information exchange and facilitate a patient’s choice in provider.
2. Promote the increased use of structured data elements and understand impacts on clinical information capture and exchange
The use of structured data is seen to be one of the key drivers that will uplift secure messaging solution capability and enhance healthcare system interoperability. Secure messaging interoperability requirements need to align with structured data element capabilities which can enhance the benefit focus areas of safety, quality, efficiency and access.
3. Consider the development of technical incident monitoring framework to assess adherence to standards
A technical incident monitoring framework should be developed in order to monitor the successful exchanges of secure messages and address transmission errors. Currently, standards for secure messaging have been implemented differently by vendors across the secure messaging ecosystem. Implementation of a framework that supports adherence to clinical documentation standards and secure messaging delivery standards will help to address transmission errors. This monitoring framework will be supported by the governance framework initiative and likely to compel all secure messaging vendors to comply. Note that the current secure messaging industry offer provides a conformance profile that will need to be incorporated into this framework.
Furthermore, the use of application level acknowledgement capability will need to be implemented by CIS vendors in order to enable read-receipt functionality. This feature can be used to inform of any incidents that may occur and to enhance clinical workflows by notification of message delivery to the intended end point.
B. Enhance the secure messaging capability
4. Assess the impacts of FHIR implementation on the secure messaging ecosystem and understand opportunities to address key barriers
The use of Fast Healthcare Interoperability Resources (FHIR) standards offers a model for clear conformance and test frameworks with secure messaging vendors looking to provide additional support for the FHIR paradigm. It is necessary to understand the impacts of implementing FHIR and the opportunities provided for the Australian secure messaging ecosystem.
5. Assess the feasibility of incorporating patient–provider communications into the wider secure messaging ecosystem and aim to preserve a patient’s choice
Secure messaging and CIS vendors have started to expand the use of secure messaging to facilitate patient–provider communications and healthcare providers have increased the use of telehealth and remote consultations. The patient–provider communication model can be investigated in order to understand how patient choice in determining their provider can be preserved, and how it can be integrated into secure messaging scope.
C. Optimise the current state of secure messaging
6. Use the secure messaging benefits framework to accelerate national scaling initiatives and the risk profile to address key barriers
The benefit focus areas of safety, quality, efficiency and access outlined in the section Benefits of secure messaging can be used to accelerate the seven national scaling initiatives detailed in the Communique – National Scaling of Secure Clinical Messaging. These barriers can be addressed by using the risk profile for secure messaging to communicate the implications on safety and quality of care.
7. Promote the standardisation of payload specifications relating to clinical documentation templates and clinical terminology for secure messaging
Promoting the standardisation of payload specifications relating to clinical documentation templates for relevant use cases and assessing the use of clinical terminology is necessary to expanding secure messaging adoption and promoting interoperability between secure message information exchange.
8. Use lesson learned from COVID-19 as a lever to further exemplify the need for secure provider-to-provider and provider-to-consumer digital communication
Changes driven by social distancing have accelerated the need to roll out and adopt digital healthcare models and tools. Out of necessity, there has been a shift in provider and consumer attitudes with regard to engaging in and receiving forms of healthcare virtually. This can be used as a lever to demonstrate the benefits of secure messaging. Peak bodies and primary health networks can play an important role in building awareness, promoting advocacy and upskilling the workforce around the need for secure forms of digital communication.
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The Conclusion is telling.
Conclusion
This review has found widespread recognition of the potential benefits of secure messaging across the stakeholders interviewed; however, low uptake as a result of barriers and perceived risks to patient safety and quality will continue to challenge uptake and broader adoption.
The barriers and risks raised throughout the stakeholder interviews led to the identification of opportunities to address gaps in the current secure messaging ecosystem. The increased rate of digital adoption through the COVID-19 pandemic provides one of the major opportunities for acceleration in digital health transformation initiatives worldwide. These opportunities enable the realisation of secure messaging benefits across safety, quality, efficiency and access and incorporate specific use cases where secure messaging or other digital solutions have demonstrated reasonable success. These opportunities also reflect the diverse views of stakeholders interviewed, providing insight into stakeholder priorities and the attitudes prevalent across the sector. To enable the fulfilment of these opportunities and the mitigation of the risks identified with the use of secure messaging, several recommendations were outlined in the review that align to the Communique – National Scaling of Secure Clinical Messaging as well as the National Digital Health Strategy 2018-22 and the associated Framework for Action. This was supplemented by several success criteria that can enable the future state of secure messaging.
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Despite the hope for really concrete plans and proposals and some real quantified benefits and impacts the reader is left with what amounts to a ‘mush sandwich’. It’s just motherhood and apple-pie!
In the real world we have a range of private players (HealthLink, Medical Objects, Telstra Health and others) just getting on with he job and providing pretty useful services to 1000’s of clinicians all over the country.
To me this
glossy report gets us no further ahead and offers no agreed path forward
towards a universally standardised secure clinical messaging environment with a
nationally supported end point addressing facility to offer full easy national addressing
and rich – rather than the least useful – message content and interoperability. NEHTA / ADHA have been at this for what seems decades but somehow the progress is glacial!
On current evidence the ADHA does not appear to be the entity to get the job some and the Australian Commission on Safety and Quality in Health Care has re-confirmed it capacity to produce useless but graphically pretty reports. Does anyone know of any valuable and impactful reports the Australian Commission on Safety and Quality in Health Care has produced in the last few years. I don’t.
The reports on the safety of the #myHealthRecord set a benchmark for not answering the questions posed!
David.
19 comments:
They do not understand the difference between benefits and value. Something may have all the benefits everybody could possibly want, but if nobody values them and are prepared to pay the price then it won't get used.
In order for these incompetents to survive they only need to ensure the politicians think they understand. To achieve that they only need to produce 'Reports' which look and sound knowledgeable, and that's easy to do simply by fattening the report up with lots of technical buzzwords and meaningless goals which the average decision maker is ill-equipped to interpret and comprehend. So the can keeps getting kicked down the road ad infinitum.
... until treasury and finance say: where's the money?
Treasury and Finance? Don’t hold your breath. They have proven that they also only run a process for prices sake and have little interest in actually measuring ROI. As we are witnessing the APS is governed by fear and has a culture of silence no matter what. To get ahead and promoted you are championing deceit, unethical behaviours and downright abuse and cruelty. But hey other than that a great bunch of people.
The Department of Health is not covering itself in glory with the vaccine delivery program. They had plenty of time to plan it and are still stuffing things up. Just wait until the vaccine booking/monitoring system and the vaccine passport systems get releaased.
Agree, you can almost sense a focus group of communication darlings is being pulled together. The vaccination will be over before the department releases working software which will then be pitched as essential infrastructure against figure pandemics.
Have you seen the complaints from GPs (who are experts in delivering vaccines) that they have not been consulted by the department.
Does that sound familiar?
Seriously - why would a bumbling department of fluffy communication parts engage a group grounded in evidence driven decision making? Utter madness.
G Carter, harsh but true, spoken like you know this arena well.
and have you seen how many states and territories have implemented their own COVID check-in system, totally ignoring the Federal Government's COVID-safe app?
Just about all.
If the Feds had any shame they would be embarrassed. In their hubris, they just carry, regardless.
To be fair they have been busy ignoring the ill treatment of our senior citizens in the aged care camps.
and then there's this:
"Victoria's mental health system operates in crisis mode, has "catastrophically failed to live up to expectations" and must be rebuilt, a damning report from the state's mental health royal commission has found."
The Federal Department of Health is responsible for health policy and regulation and plays a large part in funding health.
No doubt they will be ducking and weaving (just like Scomo and the rape allegations against a cabinet minister) but someone needs to have a good hard look at the Health Department.
The problems are not due to Hunt or Murphy, they're in a long line of people who believe the bureaucrats. The problem is systemic and probably beyond the capacity of anyone in Health to fix.
This report purpose seems directly linked to the latest general manager role going at ADHA Standards, Interoperability and Conformance.
So after years of Kelsey and MacMahon clearing the house of people you a. Have a hoot, b. Could hold a conversation, c. Steer investments to support standards investments, conformance, architectures and work with the clinical community - it has come full circle and no ability to capitalise. (Short sighted bigots).
This report has obviously triggered something - I am still trying to figure out the value of the Chief Digital Officer.
You will be pleased to know the one recommendation is Aged Care adopts the My Health Record
Anyone applying for the role simply needs to see interoperability as an integration exercise between federal databases.
"You will be pleased to know the one recommendation is Aged Care adopts the My Health Record"
AFAIK, it doesn't, it just recommends that aged care homes can access myhr as part of their accreditation.
All that will take is one registerd nurse to go through the process and then they can forget all about it.
Big deal. /s
Just to clarify, a registered health professional (e.g. a nurse) can use the healthcare provider portal. There's no interoperability etc hurdles.
You are not incorrect on both comments Bernard. However I wager that as AnonymousMarch 02, 2021 1:13 PM did, many will take it as the answer is MyHR, the gateway to more data, data is good, more data must be even better.
Currently we have a standard response from Government - throw half a billion dollars at it, that will generate lots of positive puff processing and action without vision. Meanwhile the cancer that inflicts the aged care sector will continue uninterrupted.
Just to clarify ... you are not incorrect in simple terms means .. you are correct.
"You are not incorrect" said like a true bureaucrat.
You are not incorrect" said like a true bureaucrat. - Not correct, in fact quite wrong. Is it all bureaucrats or just ones without a COVID stamp that you have disdain for?
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