HealthLink For: Hospitals & Emergency Clinics

In today’s electronically connected world, we press a button on a keyboard and we expect an email to arrive at its destination.  Did you know that that’s not always the case?  How many times have you been told that your recipient never received that email?  Did they overlook it?  Did it get swallowed by the SPAM filter, the local filter, the company filter, or the ISP filter?  Or was it ‘lost in the post’?  When do you, the sender, first know that it’s not arrived?  The most common email systems recognise there are issues here and have the ability to request a ‘read receipt’.  But not only is it optional to request a read recipient, it’s optional to respond to it.

In the clinical world, there is already plenty of historical evidence of paper communication going astray, but in the electronic clinical world help is at hand.  There is a recognised standard to ensure that you, the sender, know that the clinical information you send is correctly received and imported by the recipient system.  The HL7 application “acknowledgement” message is specified in the International and Australian HL7 standards to acknowledge that your message has been successfully imported into the recipient clinical system and waiting to be read and actioned appropriately.

The problem?

Not every computer EMR system in the health sector has implemented HL7 along with its application acknowledgements.  To encourage EMR vendors to continue improving the quality of electronic messaging and to ensure their systems are interoperable, HealthLink has decided to investigate this small area of HL7 compliance and to publish our findings.  It is imperative that every electronic message is received by the intended recipient in exactly the manner and format intended.

HealthLink has started contacting the seventy+ EMR vendors whose customers have dealings with Healthlink, inviting them to confirm their capabilities.  We plan to collate and publish this information in the October issue of Pulse+IT magazine to better inform the wider health community.

A recent article on the Computerworld website has caused quite a stir. Randal Jackson interviewed me to find out more about my open letter to the health sector which was addressed to Dr Murray Horn and Mr Graeme Osborne and copied to the Minister for Health, the Hon Tony Ryall. Click here to read the article.

I wrote the letter in response to the controversial decision over the eReferrals tender for the Nelson-Marlborough DHB, in which the contract was awarded to the worst scoring and most expensive vendor. In the article I propose that instead of funding and running specific projects, the MOH use the same funding to apply incentives to stimulate innovation amongst competing providers. Such an approach is working around the world. I also advocate interoperability standards rather than proprietary solutions. How much use will it be if the Nelson and Wellington eReferral systems cannot communicate with each other? Currently they won’t.

Continue reading »

Photo by Simon Clark/FarmerClark.com

It certainly seems a long time since I was a young Telecom exec,  setting up HealthLink as a specialised Telecom service!  We are now doing rather a lot of healthcare sector integration, delivering over 65 million items of clinical information per year, across New Zealand, Australia and now Canada.  With our recent expansion into Canada and growing demand in Australasia, the future looks bright.  But our key focus is still on service quality rather than service expansion.

You can read more about HealthLink’s origin and history in this week’s NZ Herald article, as well as learn about our three newest services, CareConnect eReferrals, CareInsight and eLab.

Yesterday’s New Zealand Herald Article (front page Tuesday 3rd July, also seen here on the NZ Herald website) showed the critical importance of replacing current manual referral processes with a fully electronic system for effecting the transfer of care of a patient.  In the example given, a man died while waiting on Auckland City Hospital’s semi-urgent heart waiting list after a test result included in a faxed referral was too faint to read and no request was made for a legible copy.

Today the practice of medicine requires large amounts of critically important information to be relayed from one healthcare provider organisation to another and the completeness and accuracy of that information is of vital importance.  It is simply not possible to move information from one part of the health system to another in an effective manner without having a robust electronic system that can transfer information accurately and reliably, as and when needed.  CareConnect eReferrals is that kind of system.  Starting with the automation of referrals from general practices to inpatient and outpatient clinics, and soon to include referrals from one hospital to another, CareConnect is the first eReferrals system in the world to link a large number of organisations’ information systems at such a sophisticated level.

We look forward to the day when problems transferring patient information are a thing of the past and fatal incidents such as the one reported in yesterday’s Herald are just an unpleasant memory.

The CareConnect eReferrals initiative is in the throes of revolutionising the primary-secondary care interface.  As of today it is installed on 185 Auckland general practices (that’s over half of Auckland’s general practices) and we are currently installing at the rate of five practices a day.  Five thousand CareConnect eReferrals have now been sent and that number is climbing sharply.

Using CareConnect eReferrals, referrers can send 24 different customised referral forms to 36 services across three district health boards:  Auckland, Waitemata and Counties Manukau. The CareConnect system automatically detects which DHB the patient should go to, based on the patient’s home address (NHI) and where that particular service is available.  When fully deployed and integrated with the DHBs’ patient management systems, the CareConnect solution will be without doubt the most advanced, standards-based eReferral system in the world.

In this video, Dr Kim Bannister, GP at Mairangi Medical Centre and Primary Care Advisor, says, “It’s great to to put a referral through and you get the acknowledgement back within half a minute that the referral’s been received and acknowledged.”

Continue reading »

As the journey to the PCEHR begins its approach to the station, is the end result going to be a smooth disembarkation or an absolute train wreck? The answer may lie somewhere in between, but whatever happens, it is important that the work already done on standards, terminologies and the foundation pieces of eHealth are not lost for the future.

Read the rest of my article on PCEHR here, at Pulse + IT magazine.

Have Your Say

Will the PCEHR have a happy ending or will it be a complete train wreck?  To leave a comment, click on the title of this article or the comment link just below the title.  You will see the comment section at the bottom of that page.

At HealthLink’s recent eLab roadshow, Erik Jacobsen (CEO of Danish Medical Data Distribution or DMDD) shared the numerous benefits Denmark has enjoyed since scrapping its paper-based system in favour of electronic pathology ordering eight years ago.

DMDD’s WebReq service enables fast and accurate capture of information directly from a GP’s practice management system/EMR into a laboratory information system (LIS).  Denmark is the world’s most advanced ePathology environment, with 80 labs using 13 different LIS systems and all GPs embracing WebReq.  HealthLink has worked with DMDD to make WebReq available in New Zealand under the eLab brand and it has launched successfully at Aotea Pathology in Wellington.  eLab will be available in Australia in the near future.

Continue reading »

January provides the opportunity to reflect on the previous year and the experiences we enjoyed and learnt from, both in our working and personal lives.  What experiences in 2011 enabled you to grow and develop?  For me, it was leading a team of Diocesan students to victory in a Dragon Boating Challenge.

I started coaching Dragon Boating in 2007 after being invited by Busting With Life, a woman’s breast cancer survivor’s team. I had just spent the previous year as their sweep, working with the coach of the corporate dragon boat team I had been a member of for seven years. Apart from five years of waka-ama outrigger canoe training, I had little coaching experience to offer but trained under an excellent coach. With a little trepidation, I then proceeded to take Busting With Life to win three consecutive nationals competitions.

Dragon Boating and breast cancer research has an interesting history which can be read in the Canadian Medical Association Journal. Besides the physiotherapeutic benefits researched here, I can attest to the social benefits, and I have no doubt there are psychological benefits to a team sport amongst members who have gone through traumatic experiences and live in fear of its reoccurrence.

Sean Ogden leads the Diocesan School for Girls Dragon Boating team to victory

Over the years my team of women have become family. One is the sister-in-law of Jo Robertson, the Leadership Programme Director of Diocesan School for Girls. When I was asked if I could help with coaching year 10 girls in a Dragon Boating Challenge, I was more than willing. Not only was this an opportunity for the girls, the Auckland Dragon Boating Association (ADBA) and the sport in general, but it was an opportunity for me to test my abilities to convey what I had learned in leading a dragon boat team. This was not just a coaching exercise. I was not being asked to baby-sit. I was being asked to teach these girls what it takes to succeed.

Leadership is a quality that HealthLink actively encourages in its employees and since the Dragon Boating event was in syngery, HealthLink had no problem donating my time to the cause.

Continue reading »

It is often easier to say nothing and hope things will sort themselves out.  However, when you you see the same mistakes about to occur again it is time to say something. At HealthLink we are passionate about what we are doing. We are adamant that we must learn from both the lessons of failure and the lessons of success.  Both Tom Bowden and myself have written and spoken about incremental steps in progressing the eHealth agenda and getting the fundamental building blocks right before embarking on lofty ideals.  Our submission to the PCEHR Inquiry was focused on this philosophy.  It seems to have hit the mark in the media…

Read Thursday’s full article at The Australian, including details of our submission on the PCEHR project.  You can find our submission here as well as track the other submissions received by the committee.

What are your thoughts on Australia’s PCEHR plan?  We would love to hear your comments…

The Australian space is trundling along towards even greater connectivity with HealthLink leading a number of projects at ‘Wave 2′ PCEHR sites. The latest site to go live with electronic discharge summaries is the Blue Mountains District Anzac Memorial Hospital in Katoomba. As with many hospitals around Australia, HealthLink’s position as leading secure message delivery (SMD) player in the catchment area made it an easier transition from concept to actuality.

Read more about the E-Discharge Summary project in Greater Western Sydney that will be further replicated in other areas across Australia.