2. Secure Messaging

Health information that can be exchanged securely

WHAT WILL BE DELIVERED BY 2022

  • Every healthcare provider will have the ability to communicate with other professionals and their patients via secure digital channels if they so choose. This will end dependence on paperbased correspondence and the fax machine or post.
  • From within their chosen system healthcare providers will be able to search for other healthcare providers in a single directory, and easily and securely share clinical correspondence.
  • Patients will be able to communicate with their healthcare providers using these digital channels.
  • Patients’ health data will be safeguarded and able to be shared securely at their discretion. They will spend less time having to retell their story, and their healthcare providers will be able to work together more effectively to provide coordinated care.

The purpose of the activities under this priority area is to enable health and care providers across primary, community, secondary care, aged care, and ancillary services to easily find each other online and securely exchange clinical information.

Reliable, secure provider-to-provider communication is a key component of digitally enabled integrated and coordinated care across the Australian health sector.

Secure messaging is a foundational capability enabling interoperability and safe, seamless, secure information sharing between healthcare providers.

Healthcare providers want confidence that their electronic message will be sent securely, then received, viewed and acted upon.

The Australian Digital Health Agency’s Secure Messaging Program is working collaboratively with industry, state and territory governments, suppliers of secure messaging solutions and clinical software vendors to reduce existing barriers to adoption and provide pragmatic and implementable solutions.

The benefits for Australians and the Australian healthcare system are:

  • Providers will have access to more complete patient information that will improve clinical decision making.
  • Consumers will have increased confidence that
  • Clinicians are informed when making clinical decisions. There will be reductions in administration and processing time as well as a reduction in paper handling.
  • There will be savings from reduced costs.

Roles of participants in order to achieve benefits

2. Participants role table
Healthcare consumers Drive market interest by expecting their healthcare providers to be able to communicate with their care providers securely and seamlessly. Be engaged to identify where digital communications could add most value to their health and care experiences
Healthcare providers Inform and validate user requirements and experience to ensure the development of a fit for purpose secure messaging infrastructure that supports local healthcare provider needs. Participate in implementation activity as senders and receivers of clinical correspondence and continue to inform their priorities and requirements for electronic clinical information.
Industry & technology sector Co-design and co-develop national infrastructure ensuring adoption of technical standards, governance, data lifecycle management and operations. Co-development of profiles and specifications and partnering in implementation projects as suppliers of electronic medical record, clinical information and secure messaging solutions used by clinical care providers across the sector.
Peak organisations Participate in providing clinical expertise and leadership on behalf of their members to support the development and adoption of standards and guidelines.
Australian Digital Health Agency Lead the secure messaging project in collaboration with industry and the health sector which is overseen by a steering committee with wide representation including clinical leadership, ensuring the development of appropriate development standards and adoption guidelines.
Commonwealth Government Review policies and legislation to support the appropriate use of national infrastructure and the provision of health provider information appropriately and securely through that infrastructure. Lead the development of national identification and authentication to provide streamlined channels for government provided services, addressing legislative and policy changes as required.
State and territory governments Co-design and co-develop national infrastructure ensuring adoption of technical standards, governance, data lifecycle management and operations. In managing and funding state operated services, lead local strategies and programs which leverage and support national initiatives to enable secure messaging capability. Inform and validate technical and business requirements and ensure the availability of fit for purpose and useable infrastructure in line with jurisdictional needs.

Priority actions for co-development 2018 - 2022 

2.1 Enable secure exchange of clinical information

Enable health and care providers across primary, community, secondary care, aged care, and ancillary services to easily find each other and securely exchange clinical information.

2.1.1. National provider addressing service

Establish a national provider addressing service

Timeline for establishing a national provider address service

A key challenge to achieving a standardised approach to secure messaging is the existence of multiple health service directories and the lack of confidence in completeness and currency of data in these directories and addressing services. That is why a national provider addressing service will be established, building on the design work already undertaken. A key first step is progressing requirements and options analysis, and confirming the scope of this service co-designed with states and territories and industry stakeholders.

2.1.2. Standards based secure messaging capability

Integrating standards based secure messaging capability

Timeline for Integrating standards based secure messaging capability

In Australia, there is established use of secure messaging using a range of different electronic communication methods. These different methods are generally not compatible – meaning that these proprietary secure messaging approaches do not work with each other. There is a need to seamlessly integrate standards-based secure messaging capability using national infrastructure services, facilitating a co-design approach within primary, specialist, and allied health clinical information systems, and jurisdiction clinical and administrative systems.

2.1.3. Nationally coordinated programs

Continuing nationally coordinated adoption and implementation

Timeline for Continuing nationally coordinated adoption and implementation

The set of information in a message, and how it is displayed, is not currently standardised, hindering confidence in the reliability of secure messaging capability. Nationally coordinated programs will continue to develop and refine specifications and national reference architectures, co-produce implementation profiles with vendors and demonstrator health services, and drive national adoption and use for priority usage patterns, including discharge summary, referrals, specialist and allied health reports (e.g. including specialist to specialist and psychologist to general practitioner correspondence).

2.1.4. Improving experience by leveraging national infrastructure

Improving the consumer and clinician experience by co-producing a roadmap for leveraging national infrastructure

Timeline for Improving experience by leveraging national infrastructure

The digital health national infrastructure has the potential to support a number of usage patterns that benefit the healthcare experiences of consumers and clinicians. To achieve this, there needs to be a comprehensive market scan of available solutions and co-production of a roadmap outlining how national infrastructure services will be further enhanced and leveraged to support potential new usage patterns, for example:

  • National protocol for transferring diagnostic images, and accessing historic images
  • Electronic prescribing [see Medicines Management priority activity 4.1.2]
  • Unstructured secure email
  • Healthcare provider to provider record transfer
  • Enabling consumer and community access to clinical information
  • Providing consumers with health information and transparent information on comparative costs of treatment and service provider quality
  • Online consultations supported by smart forms
  • Healthcare provider-to-consumer messaging
  • Healthcare provider-to-provider instant messaging
  • E-requesting for diagnostics
  • Enabling consumers who receive a referral to choose their health service provider and book an appointment
  • Ensuring freely available, accurate and up to date health service and provider information for the public and healthcare providers by enhancing the National Health Services Directory

Make it easy for providers to participate

Streamlined registration processes and user friendly national infrastructure services

2.2.1. National Authentication and Identification

Services Enhancing authentication and identification services to support secure messaging

Timeline for Enhancing authentication and identification services to support secure messaging

Throughout the consultation, healthcare providers raised the difficulty they have using existing national foundations, including registration, renewal of Public Key Infrastructure (PKI) certificates, and identifier match rates. Existing national authentication and identification services will be enhanced, and existing specifications developed to support secure messaging and future usage patterns. This will involve the co-production of an integrated digital identity framework, using the Digital Transformation Agency identity and authentication framework and services, for health and care provider individuals and organisations that can be used to access a variety of private sector and government sector digital services including clinical services, Medicare services, secure messaging services and the My Health Record system.

View the Actions Across Australia Case Study – Secure Messaging