Monday, September 10, 2012

So We Actually Now Have Some Clinician Authored Information In The NEHRS System. Is This Important or Meaningful And Why Does It Need Special Hardware?

Reports have emerged this week of some progress with the NEHRS.
First we have:

Brisbane GP first to use PCEHR system

7 September, 2012 Paul Smith
More than a billion dollars have been spent to allow Dr Suzanne Williams to press buttons on her keyboard and send a list of diagnoses and medications into the virtual ether.
Last Wednesday the Brisbane GP, became the first GP in the country to upload a clinical document onto the much-vaunted, much-criticised Personally Controlled E-Health Record (PCEHR) system.
It marks the system’s launch into real-world medicine at a time when GP software is being upgraded for doctors to generate the shared health summaries that will form the backbone of the billion-dollar reform.
Dr Williams, who works at the Inala Primary Care clinic in Brisbane, said: “I’m pleased to be part of the whole PCEHR. I suppose I’m less excited about uploading the first health summary than what is going to happen in the future when I’ve done the first 100, the first 200 records, and they are part of bigger system.”
She added: “It is the patients with chronic disease who are likely to gain most — those patients attending multiple doctors, multiple practices.
“I think doctors are going to see the value when they can access the results of tests done in the hospitals, when they can access the full results of investigations.
“It is going to reduce the number of duplicate tests, it’s going to improve care and save money. But it is going to take time to evolve.”
More here:
We also have a report here (among others)

Inala connects to cloud

Kiri Ten Dolle | 3rd September 2012 3:48 PM
AN INALA medical practice is the first in Australia to connect to the eHealth system where patients' records will be stored electronically in a secure online cloud.
Inala Primary Care, on Wirraway Pde, uploaded its first patient record last week marking the start of a major milestone for the nation's healthcare system.
General manager Tracy Johnson said the new online system would increase processing time and eliminate any confusion or doubling up which costs the health system time and money.
"We participated in some pilot work to help generate what the network should look like and trialled the system," Ms Johnson said.
"Majority of our patients have multiple diseases and that's why we were selected to take part.
More here:
You can read a detailed discussion of what has been done here:

Health Industry Exchange releases eHealth conformant GP software and completes the first connection to the national PCEHR System

On 29 August 2012, Dr Suzanne Williams from Inala Primary Care in Brisbane’s west became the first Doctor to upload a clinical document into the national PCEHR System.
Dr Williams used Health Industry Exchange’s Companion application and Best Practice software to create a Shared Health Summary and save it into the patient’s PCEHR record.
Health Industry Exchange CEO, Brett Silvester, demonstrated his confidence in the System by being the first patient in Australia to allow his doctor to share his health summary using the National eHealth Record System.
Mr Silvester was able to view his health summary loaded by the Doctor by logging on to the Consumer Portal.
Much more here:
Browsing around the site I found the following:

Creating, Viewing and Sharing Records

The HIE Companion App is a tool that enables the creation, viewing and sharing of patient’s health information in Shared Health Records.
 Using the HIE Companion App, clinicians can:
  • view a patient’s Shared Health Record during a consultation;
  • review recent patient summaries which may have been contributed by other clinicians;
  • manage the consultation as usual in their PMS; and
  • at the completion of the consultation, upload new or updated health information from the PMS to the patient’s Shared Health Record.
Secure Connectivity to Information Services
The HIE Companion Gateway is a hardware device that works with the HIE Companion App software to securely link GP Practice Management Software (PMS) to external information sources. This enables GPs to provide eHealth services to patients and take advantage of advanced eHealth repository and decision support services. The HIE Companion Gateway is a specialised practice eHealth gateway providing connectivity, information security, access to patient record stores, assembly of clinical data structures and access to national PCEHR services (Personally Controlled Electronic Health Record).  
The full page is here:
What this sounds like to me is a half-baked strung together kludge that is not what has been anticipated - namely seamless access to the NEHRS from the GP PMS. Just what is the hardware doing, how does it work and why is needed? I didn’t see any mention of special hardware from DoHA or NEHTA before this.
This whole project somehow just seems to keep wandering off into some unspecified swamp.
I was also amused to discover that the solution is being supported during thus:

Solution Support

HIE’s Support Team operates during normal business hours, supporting all HIE solutions and systems.
Clearly heavy use is not expected!