ANZ News

The latest upgrade makes it easier for people to control who sees and accesses their health information.

A new update implemented by the Australian federal government will allow doctors, nurses and mental health practitioners to provide telehealth services, such as video conferencing, to people isolated at home due to the coronavirus. 

ADHA is working with RANZCR to launch the My Health Record CPD modules for clinical radiologists and imaging practices. 

Update: The HIMSS Global Conference in Orlando has been canceled due to the coronavirus. Read more here. Founded in 2016, Precision Driven Health is a research partnership between New Zealand’s health IT sector, health providers and universities, aimed at improving health outcomes through data science. Ahead of the HIMSS20 conference, Kevin Ross, CEO of the organization, talks about the significance of data in delivering value-based care and the real challenges of collaboration between different stakeholders in data. What are your thoughts on value-based care (vs the traditional fee-for-service model) and what can be done with healthcare data to create more value and personalized care for patients? Value-based care is far preferable to a fee-for-service model, as long as we agree on value, and can be transparent in our approach. At its extreme, a fee-for-service model rewards someone who takes many attempts to get it right, whereas value-based care rewards the delivery of what matters in the most efficient way. Data has a huge role to play in this, particularly in helping to define and analyze the most appropriate metrics for value.  Data allows us to use a common language for value, and can make transparent the link between the activities undertaken in healthcare, and the value that is received by consumers. When data can be shared, people can see more clearly what they are receiving, and what is having the greatest impact. A fee-for-service tends to lead toward giving the same care for everyone, as we get good at efficiently delivering a particular procedure or program.  Data science allows us to analyze what works for different people, and if the objective is to deliver value, then the world of possibilities opens up. One person may benefit from medication, while another benefits from improvements to their living circumstances; value-based care gives us a framework to consider these in a common way. As CEO of Precision Driven Health, what are some of the lessons learnt through coordinating collaborations between health professionals and data scientists in applying data science to enable precision health to become a reality? Everyone is keen to collaborate and learn from each other, but there is often a lot of work up front to establish common language and understanding. We come with our biases, and are often unaware of how much they influence our thinking and expectations. I find that most people oversimplify the role of another collaborator and assume that it will fit into their own way of viewing the world.  For example, a data scientist thinks of a clinician as having a very transactional role of translating data into a diagnosis or next decision. While this may describe some of the core information exchange in clinical care, it is in reality only a small part of what happens – and much of what happens is not captured in tidy data science language. Similarly, our clinicians often think that data science is one of two extremes – either magic (just throw some data into a pot and out will come an answer), or predictable (the data will show that if we change X then Y will be improved). A good data science process involves a lot of workshopping, trial and error, human input and compromise. What are your observations on the development of precision health in New Zealand? What opportunities do you see? New Zealand has excellent quality data, enabled through a single identifier per person, known as the National Health Index. This allows twenty years of digital records to be linked and analyzed for historical patterns. Combining this data about a diverse population with excellent data scientists, clinicians and software developers, New Zealand is well positioned to be a testbed for innovations in precision health. Having a single-payer health system also helps to ensure that the best care for an individual usually corresponds with economic benefits to the whole system.  However, despite all of these advantages, the task is still very difficult. Healthcare changes slowly, and we must build public trust for/in new uses of data, and new ways of delivering care. Our clinical carers are not trained in data science, and our data scientists are new to healthcare – so the changes that are readily seen in other industries have not yet taken hold on a large scale. How do you think the use of healthcare data has led to better health outcomes in New Zealand? Could you give us some examples? New Zealand has linked healthcare data to other government service data, including housing, education, justice. This has allowed us to understand the link between health and other social circumstances. As one example, a local health board has invested in improving the quality of homes in the neighborhood, to reduce the rates of respiratory issues caused by mold.  At the other end of the system, we have developed a localized calculator for the outcomes from elective surgery, developed based on all surgeries in the past ten years. We can now use this information for anyone considering a procedure, and explain what the outcomes are like for people like them. For minority groups who are not represented well in international studies, this allows a much better-informed conversation between surgeon, patient and family that helps to make the best long-term decisions. Kevin Ross is a panelist at the HIMSS20 AsiaPac Summit’s Panel Discussion titled Preparing Data and Redesigning Metrics for Value-Based Care, scheduled for Wednesday, March 11 from 8.30am to 9.30am in room W240C. Additional registration is required – click here for more details on the HIMSS20 AsiaPac Summit. He is also the speaker for the session titled Ethical Machine Learning scheduled for Tuesday, March 10 from 1.30pm-2.30pm in room W207C. 

An interview with Philip Daffas, CEO of PainChek.

Last week, Victoria-based Melbourne Pathology became the latest pathology provider to upload reports to My Health Record (MHR). This allows both patients and clinicians to have convenient and secure access to their pathology reports. Other Victorian labs sharing reports with consumers and clinicians in the MHR include Alfred Health, Monash Health and VCS Pathology. The full list of participating providers is available here.  THE LARGER TREND Last June, the Northern Territory (NT) Department of Health became the first pathology provider to link the online tests results it is sharing via MHR with Lab Tests Online, HealthcareITNews reported. In the same month, South Australia (SA) Pathology also connected to the MHR. Based on the latest statistics from the Australian Digital Health Agency (ADHA) as of December 2019, there are 22.68 million MHRs, of which 12.99 million records have information in them. ON THE RECORD “Investigation results are one of the most common tools doctors use to evaluate your health. In the 2018-2019 financial year alone, Medicare funded over 147 million pathology tests,” said Professor Meredith Makeham, a GP and Chief Medical Adviser, ADHA in a statement.  “It’s easy to quickly lose track of your results, particularly if you don’t have a regular GP or when you are seeing a range of healthcare professionals to manage multiple conditions and tests. MHR allows you to keep your important test results safe in one place, which you and your healthcare providers can access at any time to make more informed decisions about your treatment or care.” Victorian-based general practitioner, Dr Nathan Pinskier, said: “When I need a patient to have a pathology test, I simply send an electronic request and the patient attends the lab with a paper copy. Since the lab already has the electronic request, there’s no human data entry, which greatly reduces the risk of patients receiving the wrong test. Once there’s a report, I receive a copy through my secure messaging software and my patient receives a copy in their MHR, where it can’t be lost and where future healthcare providers can review it to inform their own clinical decision-making.”

The Australian Digital Health Agency (ADHA) today announced the launch of a new professional development program to identify the necessary digital health capabilities for nurses and midwives to further improve the quality, safety and efficiency of care. Nurses and midwives across Australia will now be consulted on the specific digital health skills they need, what is practical and relevant for them and how a draft digital health capability framework could be used in hospitals and health services as a professional development guide for nursing and midwifery in the digital world. Consultation will start on 3 of February 2020 and will run for six weeks. Nurses and midwives are encouraged to provide their feedback by completing a survey or attending feedback sessions through information available on the Health Informatics Society of Australia (HISA) website. The professional development program is being undertaken by HISA in collaboration with the ADHA as part of the National Digital Health Strategy’s commitment to building health workforce capability in digital health.  Once consultation is complete, the final capability framework and resources would be launched at the Nursing Informatics global congress NI 2020 in Brisbane, on 27 – 29 July 2020. WHY IT MATTERS The 2020 focus on nursing and midwifery in the digital age coincides with the World Health Organization’s International Year of the Nurse and Midwife. Critically, it is also important to ensure that the voices of nurses and midwives are heard when looking at the implementation of technology in healthcare organizations.  In an interview with HealthcareITNews last September, Katie Trott, chief nursing information officer at the Royal Free London NHS Foundation Trust said, “Often, there’s an emphasis on doctors, however, the nursing workforce is often much greater than the medical workforce. And so making sure that they’ve got full representation of that is really important, particularly as we have nurses taking on more and more extended roles where they’re seeing patients autonomously.” ON THE RECORD “In the emerging field of digital health, nurses and midwives are at the forefront, combining knowledge, data, and technology to produce best possible outcomes for patients.” “In this new program, nursing and midwifery organizations will be collaborating to create the first national framework to support nurses and midwives in an increasingly digital workplace, with all the challenges and opportunities that provides,” said HISA CEO Dr Louise Schaper in a statement. Angela Ryan, the Agency’s Chief Clinical Information Officer and a Registered Nurse, said: “Nurses and midwives are once again ensuring that they are at the center of their educational and professional development so that they can deliver the best care possible.” “This program will identify the specific skills nurses and midwives need for them to maximize the benefits for their patients from Australia’s digital health system.”

Nearing the first anniversary of the My Health Record (MHR) collection deadline on 31st January 2020, the Australian Digital Health Agency (ADHA) has announced that the total number of MHRs with information has reached 12.99 million, based on the latest statistics from December 2019. The Agency also said that between November and December 2019, there was an 11% increase in the volume of medicine documents uploaded by healthcare providers like GPs and pharmacies, to more than 100 million documents and a 13% increase in clinical documents uploaded by healthcare providers like hospitals, pathologists and radiologists. In December alone, GPs uploaded nearly 3 million documents and their viewing increased 10%. The total number of documents in the MHR system is now 1.7 billion. THE LARGER PICTURE Based on the latest statistics from ADHA as of December 2019, there are 22.68 million MHRs, of which 12.99 million records have information in them. The Agency said last year that one in 10 Australians have opted out of the MHR system, leaving participation rates at 90.1 per cent. Last December, there was a marked increase in the uploading of information to the MHR. Pharmacists uploaded more than 5 million documents, GPs uploaded nearly 3 million documents, hospitals uploaded just over 1.5 million documents and more than 1 million pathology/diagnostic images were uploaded. ON THE RECORD “While it was not expected that all My Health Records would have documents uploaded in the first year as not everyone would see a GP or other connected healthcare provider service in that timeframe, we are now seeing significant increases in uploaded clinical documents and My Health Records with valuable clinical information,” said Professor Meredith Makeham, Chief Medical Adviser, ADHA in a statement. Paul Smith, a pharmacist at Capital Chemist in Huskisson NSW, said: “In the lead up to New Year’s Eve, Huskisson and surrounding towns in NSW had an unusually large number of travelers and locals seemingly stranded without their prescriptions or regular medications. These medications included your run-of-the-mill blood pressure tablets and the like, but there were patients without their insulin, anti-epileptic medications, anti-depressants, preventative asthma inhalers, and numerous others.” “Having access to the My Health Record database certainly helped me a great deal during this unprecedented time, as I was able to ensure a continuity of care in a safe and legal fashion.”  “The main hurdle I faced was assisting patients who had chosen to opt out of the My Health Record system. It is an extremely bad situation to be in when there were no local surgeries open, the roads to the closest public hospital were closed, and the person had nothing to show you that they are normally prescribed.”

ADHA has been working with industry and governments over a number of years to achieve interoperable secure messaging across different systems.

An interview with James Patterson, CIO, NSW Health Pathology.