‘Antiquated and unreliable’ tech must go


They’re out of date and insecure, says the Australian Digital Health Agency: so it’s time to stop using fax machines to share patient information

The Agency, with the Medical Software Industry Association, ran a secure messaging industry collaboration workshop this month to make decisions about secure messaging and interoperability across the health sector.

Key industry players have agreed to improve secure messaging of patient records between healthcare providers using clinical software.

In a statement the Digital Health Agency said that while other sectors discarded fax machines a decade ago, healthcare providers are still using them, causing frustration between healthcare professionals and also patient harm – up to and including death.

In May 2018, a coroner’s report revealed that Hodgkin’s lymphoma patient Mettaloka Halwala died alone following chemotherapy complications.

Mr Halwala’s medical test results were faxed to the wrong number, which meant his treating haematologist did not receive information that could have saved his life.

Coroner Rosemary Carlin called for the hospital involved to phase out fax transmission of imaging results as a matter of urgency.

She said it was difficult to understand why such an antiquated and unreliable means of communication exists at all in the medical profession.

To support the uptake of digital health services, the Council of Australian Governments Health Council approved Australia’s National Digital Health Strategy – Safe, Seamless, and Secure.

A key priority in the strategy is to end dependence on the fax machine and paper-based correspondence by empowering healthcare providers to communicate with other professionals and their patients via secure digital channels.

At the workshop, stakeholders agreed to adopt the tools, processes, and standards that have been demonstrated to solve the interoperability problems across secure messaging and clinical information systems.

Medical Software Industry Association President Emma Hossack said that industry is committed to progressing interoperability in secure messaging, as well as more generally across the health sector.

“Health information is stored in diverse health software and frequently needs to be shared. Without interoperability, this information may need to be scanned and faxed or even posted. Not only can this be dangerous but also highly inefficient.

“To share and manage access to health information, we are working towards adoption of agreed compliant messaging standards, conformance at the receiving ends, and a federated approach to directories,” she said.

“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,” Ms Hossack said.

Secure Messaging workshop attendees
Secure Messaging workshop attendees

The new commitment follows progress with proof of concept projects led by Telstra Health and Healthlink.

Telstra Health is leading a consortium to test the delivery of discharge summaries from Royal Melbourne Hospital to a range of general practitioners. CorePlus, Genie Solutions, Global Health, HealthLink, and Zedmed are also participating in this project.

Telstra Health Head of Strategy and Policy Dr Phuong Pham said enabling providers to reliably connect and securely share information with each other is crucial to support the safety, quality, and efficiency of the health system.

“With the proof of concept activity nearing completion, we keenly anticipate the next phase of digital enablement in healthcare,” Dr Pham said.

Healthlink is leading the other consortium and is testing the delivery of referrals from a range of general practitioners to specialists. MedicalDirector, Best Practice Software, Genie Solutions, Global Health, and Telstra Health are supporting this work.

HealthLink CEO Tom Bowden said that he is pleased with the progress to date on the federation of messaging directories.

“The ability to select any practice from a federated directory search will be a major step forward for eHealth across Australia,” Mr Bowden said.

Both consortia are finalising a federated search capability to allow the searching of provider directories and care provider electronic addresses. This means that a single search will identify Australian healthcare providers, providing convenience and transparency for clinicians looking up other clinicians. The sending of messages across these sites will commence this month.

The projects have also been extended to include allied health practitioners and electronic medical record (EMR) products used in that domain. The Telstra Health consortium will enable allied health practitioners to send reports to their referrers and the HealthLink consortium will extend the sending of referrals to and from allied health.

In addition to laying the foundations for national secure messaging, the lessons learnt in this project are expected to inform other industry collaborations as Australian healthcare drives towards full interoperability across digital health systems.

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