Secure Clinical Messaging Moves On - Again Without NEHTA.

The following press release appeared a few days ago.

Medical Director and HealthLink announce secure messaging interoperability

Sydney, 14th October 2010

HCN, the developers of Medical Director, and HealthLink, two market leaders in the clinical IT industry have extended their service coverage by announcing secure messaging interoperability, which has today gone live in the ACT. Both vendors enjoy significant market share; Medical Director is used by more than 17,000 medical professionals and HealthLink is Australia’s largest health communication network with 5,300 practices, hospitals, laboratories and acute care facilities using their solution. This interconnection will enable any practitioner using Medical Director to send clinical information to any healthcare provider on the HealthLink network and it will allow any HealthLink subscriber to send information to any Medical Director user. The interoperability will enable a further 1,000 sites to be able to work with the HealthLink network.

The interoperability solution creates a message network interconnection, which facilitates the secure exchange of messages between users of MDExchange, the messaging component within Medical Director and HealthLink messaging clients. John Frost, CEO of HCN comments: "There is a very real requirement for information flowing securely between acute care and primary care. Medical professionals want to exchange reports, referrals, hospital discharge summaries and similar electronic messages today. Market leaders, Medical Director and HealthLink, have taken this important step towards widespread interoperability and have an operational and interoperable solution installed and live at ACT Health. This initiative will continue to evolve in order to adhere to the Australian secure messaging standards."

The joint eReferrals solution was first implemented by ACT Health, HCN, HealthLink and Orion Health.

"For GPs, the ability to send referrals by secure messaging direct from the patient's electronic medical record, is not only time and paper saving but allows the GP to receive acknowledgments that the referral has been received and to be informed in a timely and reliable way about scheduled appointments," said Dr Peggy Brown, ACT Health Chief Executive.

ACT Division of General Practice President Dr Rashmi Sharma said "connecting all health care providers and developing capacity to support team care and communications between providers will support a viable and accurate personal health record."

"By replacing paper based systems, patient care will be improved, ensure accurate and secure information transfer, supporting the transition when a patient changes or moves between health care providers".

"This initiative will further enhance the ACT Health eReferrals solution by increasing the number of general practitioners and specialists having access to timely and accurate information. It is another improvement to health interoperability between primary and secondary care providers." said Chris Stephens, Regional Director for Australia and Southeast Asia for Orion Health.

HCN has chosen HealthLink as their interconnect partner as both organisations share strong views on the integrity of messaging solutions. HealthLink General Manager, Geoffrey Sayer adds: "The initiative is designed to underpin a philosophy of total service quality for patients in their care as they move through the different parts of the healthcare system. The MDExchange-HealthLink interoperability capability is now available nationally."

The release is found here:

http://www.hcn.com.au/News+%26+Events/Press+Releases/Current+News/Medical+Director+and+HealthLink+announce+secure+messaging+interoperability

I see this as good news, in the sense that what we have here is really the service and software providers just moving on and doing their best to deliver what is needed in the absence of any real sense of urgency from NEHTA. Think what Medical Objects, Argus and others have done over the last few years.

An example of this slowness came into stark view just the other day:

Looking at the Business Specification for Discharge Summaries - an initial draft of this work was delivered in September 2008.

It has taken until 30 August 2010 to get a version 1.1 release out the door and it only appeared on the NEHTA website 8 October, 2010.

The document is here:

http://www.nehta.gov.au/component/docman/doc_download/1144-e-discharge-summary-release-11-business-requirements-specification

This timing is on page 3.

Just why is takes essentially 2 years to get a piece of work done of this sort, given the resources and workforce available to NEHTA amazes me. I guess I just don’t understand how complicated a discharge summary can be!

It is worth noting an Australian Standard for this was certainly created by 2004 and updated in 2007 - but clearly they must have been grossly inadequate. (I have a 2006 Australian Standard for HL7 V2.4 discharge summaries and referrals but this was later updated in minor ways in 2007)

Why this has taken so long I suspect is due to NEHTA’s attempts to pin down the details of every possible content data element and define it etc.

Of course having done that the issue is just how it will actually get implemented - compared with the rather simpler earlier approaches. Essentially they tend to over engineer and under deliver on what is a pretty consistent basis. All the e-communications projects have been core NEHTA business for ages and just how much has actually been implemented to date - not much I fear!

When we see this actually working in practice we will have our answer for discharge summaries I guess - I fear that will not be anytime soon with anything delivered by NEHTA!

David.

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