2. Health information that can be exchanged securely
Below is a summary of some of the actions government, clinical, technology, industry and advocacy organisations told the Australian Digital Health Agency are already underway to ensure health information can be exchanged securely.
Ensuring healthcare professionals can easily find each other
Healthcare professionals should be able to seamlessly search for other healthcare professionals in a single directory, within their chosen system, so they can work together more effectively to provide coordinated care.
ACT Health is working on improving the ACT Provider Index, which aims to be a single source of health provider information for the ACT. The Department of Health in Western Australia is establishing a contract panel of vendors able to provide secure messaging services across the health system to support the exchange of patient information in a secure manner within the WA health system and enable comprehensive coverage of health providers with which the WA health system wishes to interact.
eHealth NSW operates HealtheNet, which is a central clinical repository providing a statewide view of clinical history and seamless information‑sharing between hospitals, community health, GPs, patients and private clinicians. HealtheNet information includes patient demographics and identifiers, eDischarge summaries from Local Health Districts (including alerts, allergies and adverse reactions), inpatient and outpatient encounter listings and more.
Queensland Health is implementing the initiatives outlined in the Specialist Outpatient Strategy, including a statewide service directory to provide GPs access to an online statewide directory of public hospital services to better inform and direct their referrals, and online booking to provide patients the ability to manage their specialist appointments online through the establishment of a patient portal. Healthdirect's service finder provides consumer-access to the health service providers listed in the National Health Services Directory (NHSD) and provides detailed information about the services provided.
To bring it all together to ensure healthcare providers can find each other using a single directory, the Australian Digital Health Agency is developing an addressing service with input from industry and state and territory stakeholders. This service has been designed in accordance with National Digital Health Strategy to ensure that a seamless capability is available for users to find the provider they want to send information to, and their electronic address, regardless of the software used at the facility. This will provide a trusted view of provider details and their electronic address to send information to.
Standards-based secure messaging capability using national infrastructure services
In Australia, there is established use of secure messaging using a range of different electronic communication methods, but these different methods are generally not compatible.
The technology industry are working towards adoption of agreed compliant messaging standards, conformance at the receiving ends, and a federated approach to directories. This will make health communications more seamless and safe. It will also make it easier for industry to innovate in this area, as digital foundations will be in place and ensure that clinical messages are able to traverse different underlying networks and arrive intact at the intended destination, reading exactly as the sender intended.
In a move to provide secure messaging in real world projects the Agency is working with two major industry consortia. The Telstra Health consortium includes clinical software providers CorePlus, Genie Solutions and Zedmed, along with secure messaging vendors Global Health and HealthLink who are testing the delivery of discharge summaries from Royal Melbourne Hospital to a number of GPs. The Healthlink consortium includes MedicalDirector, Best Practice and Genie, supported by Global Health and Telstra Health who are testing the delivery of referrals from GPs to specialists.
In addition, the consortia have developed a federated search capability that will enable transparent searching of provider directories and care provider electronic addresses on different underlying networks. As a result, clinicians will be able to look up and contact other clinicians across Australia from a single search, greatly improving convenience and efficiency.
The Australian Digital Health Agency will continue the secure messaging project, which is being run in collaboration with industry and overseen by a steering committee with wide representation including clinical leadership. A range of clinical professions are represented on the steering committee, including the Australian Dental Association.
The Victorian Department of Health and Human Services and the Australian Digital Health Agency have jointly funded the Victorian eRefferal Program to implement a solution that enables the exchange of electronic referrals between different healthcare service providers within the Eastern Melbourne region, regardless of the primary clinical information system currently in use. This project will help general practice and health services to streamline their referral processes. The Hunter, New England and Central Coast PHN has implemented e-referrals underpinned by agreed care pathways and to support community practice. This solution supports e-referrals from hospitals to GPs and across regional care providers. In addition, Queensland Health have established an e-referrals program to enable electronic health information exchange to support the transfer of patients from one service to another.
MedConnects’ Clinical Contextual Display provides current patient information including real time data into a whole of patient context in a single expandable screen. The system allows for the incorporation of all healthcare participants, nurses, doctors, patients to contribute to the clinical data and context and the handing over of all aspects of patient care in a concise manner.
Royal Australian and New Zealand College of Radiologists has a roadmap towards developing and deploying the architecture and platform to support image sharing by clinicians across different health providers.
Complementary to the Agency’s focus on a standardised secure messaging capability, the Health Informatics Society of Australia (HISA) will tackle sociotechnical aspects. Outputs include to drive communication and exchange of information using secure digital channels though a highly engaged Cybersecurity Community of Practice developing case scenarios of cybersecurity practice, as well as a 2018 snapshot of the cybersecurity posture of the Australian healthcare system (compared to 2017 findings), and the release of an update to HISA’s publication Australian Guidelines for the Protection of Health Information.
The Australian Government is investing in key platforms and technology to improve people’s experiences of government services online. The Digital Transformation Agency has oversight of Govpass, a digital identity system that will provide a simple, safe and secure choice for people to verify who they are and access government services online. Over 2018 and 2019, 8 high-volume government services will be piloted using a digital identity, giving more than 500,000 people the opportunity to test the system. The Australian Government is also investigating opportunities where blockchain could add value and make the access and exchange of information across service providers more transparent, trusted, reliable, and easy to use. This could provide a beneficial digital identifications solution, underpinned by common standards, for both public and private healthcare providers.