Specialist Software Industry OfferSpecialist sector agenda and lessons learnt

10 July 2019

The Australian Digital Health Agency

Agenda

• Welcome - Odile Williams (Manager Developer Program and Project Services)

• Enhanced Models of Care Program - Felicity Reid (Program Director) Eliza Hawken (Senior Project Manager)

• Clinical user’s perspective - Dr Steve Hambleton – Co-Chair Clinical Governance Committee

• Healthcare Identifier Service and My Health Record - Joshua Pratt (Manager Analysis & Architecture Services)HI Service functionalityMy Health Record functionality

UploadingViewing Opportunities

• Next steps, Timeline and Resources – Isabelle Luszczyk (Implementation Support Lead)

• Questions

Enhanced Models of Care Program

Healthinformation that

is availablewhenever andwherever it is

needed

Healthinformation that

can beexchanged

securely

High-quality datawith a commonly

understoodmeaning that can

be used withconfidence

Betteravailability

and access toprescriptions

and medicinesinformation

Digitally enabledmodels of carethat improveaccessibility,

quality, safetyand efficiency

A workforceconfidently using

digital healthtechnologies todeliver health

and care

A thriving digitalhealth industry

deliveringworld-classinnovation

National Digital Health StrategyPriority Activities 2018 - 2022

https://conversation.digitalhealth.gov.au/australias-national-digital-health-strategy

Specialists Connection and Use Project

Project Objectives

This project will support:

• Enablement of specialists in private practice to view and upload to aconsumer’s My Health Record (MHR).

• Increase use of MHR in Emergency Departments (ED) in collaboration withthe Australian Commission on Safety and Quality in Health Care (ACSQHC).

Key Activities (Private practice specialists enablement)

PrioritySpecialistsConnection

and Use

Landscape analysis

Education campaign delivered to drive specialists’ utilisation of MHR(in partnership with clinical peak bodies and PHNs)Education campaign developed

MHR registration and connection support for specialists in private practice

Supplemental industry offer and technical implementation support to CISvendors

2019-202018-19Q2 Q4Q1 Q3Q4Q3

Framework For Action Alignment• 1.1.2 Future use of the My Health Record• 5.1.4 Chronic disease management• 5.1.7 Emergency Care• 6.1.1 Supporting adoption by the health workforce

Co-design with CISvendors

Industry offer to CIS vendors

Specialists Connection and Use Project – Critical PathAp

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Specialist practice registration and conformant specialist software are MANDATORY pre-requisites to enable:· Viewing of a consumer’s My Health Record (MHR)

· Uploading of Specialist Letter and Prescription Record

Specialists education campaignvia education partners e.g.

contract agreements with peakbodies

MHR policyimplementation

Practice staff educationand training

Specialist views anduploads to MHR

Software vendorengagement

Contractexecution

Software deployed tospecialist practice

Specialist practiceregistration to MHR via

PRODA and HPOS

Application for HPI-O and NASHOwner of specialist practice registers for:· Healthcare Identifiers (HI) Service· Participation in the MHR system· National Authentication Service For Health (NASH) certificate

Receipt of HPI-O and NASHPractice owner receives:· Healthcare Provider Identifier for Organisations (HPI-O)· NASH certificate

Software ConfigurationSoftware vendors assists practice owner to install NASH certificate insoftware

Specialist Practice Registration to MHR

Software conformant to MHR

Healthcare IdentifiersNOC & CCA

MHR SoftwareNOC & CCD

Practice upgrades toenhanced software

Software enhancements completed e.g. no additionalactions required by specialists to upload a Specialist

Letter

Clinical user’s perspective

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Clinical user’s perspective

Landing Page

Consider adding the following to the landing page:

• Medicines View

• Recent pathology and diagnostic imaging reports

Change in patient’s medicines

When there is a change in a patient’s medicine/s following the specialist consultation,consider allowing the change to be uploaded seamlessly as an Event Summary.

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Healthcare Identifiers Serviceand

My Health Record Functionality

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Healthcare Identifiers (HI) Service Functionality

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Patient Individual Healthcare Identifiers (IHI)

• Automatically checking patient identifiers when the minimum amount ofdata for the patient record is recorded in the system.

• Revalidating after expiry time.

• Automatically check and revalidate IHI as a background task.

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Healthcare Provider Individual Identifier (HPI-I)

• Required for uploading to a patient’s My Health Record.

• AHPRA registration number & last name based search.

• Automatically search for Healthcare Provider’s HPI-I on site activation andadding new users.

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My Health Record (MHR) Functionality

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Uploading

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Consent

• If a patient has a My Health Record as indicated by the doesPCEHRExist webservice call, upload by default.

• Allow patient to withdraw consent for uploads (typically a checkbox insettings).

• Accessing a patient's record is managed by the gain access service.

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Upload and Supersede Document

• Remember to call doesPCEHRExist to check if a record exists before upload.

• Document upload does NOT require gaining access to the patient’s record.

• Clinical documents are uploaded as a CDA package.

• Supersede document is required if a clinical system uploads document. It usesthe same web service as upload document, and specifies the document ID tobe superseded.

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Remove Document

Specify the document ID of the document to be removed.

Specify the reason for removal:

• Withdrawn – incorrect content in a document. May be reinstated.

• IncorrectIdentity – uploaded to the wrong patient. Cannot be reinstated.

Only the organisation that uploaded the document can remove.

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Uploading Documents

• PDF format is supported for some document types.

• Upload automatically as a part of existing workflows.

• Upload via queue for background and offline uploading.

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Clinical Document Conformance LevelMy Health Record allows up to five clinical document conformance levelsdepends on the document types.

Clinical Documents - Common Conformance Profile v1.7

1A PDF attachment referenced in the CDA body

1B At least one section containing a narrative block

2 All mandatory sections containing a narrative block

3A Structured data in all mandatory sections and entries

3B Fully encoded structured data in all mandatory sections and entries

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Specialist LetterAll conformance levels.

Upload trigger > Specialist Letter approved for sending (one copy sent torecipient, one copy sent to MHR system).

Main sections:

• Response Details

• Recommendations

• Medications

• Allergies and Adverse Reactions

• Diagnostic Investigations

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Prescription RecordAllowed conformance level: 3A

Upload trigger > Prescribing.

Main section:

• Prescription Item (Medication Instruction)

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Event SummaryAllowed conformance level: 3A, 3B

Upload trigger > End of consultation

> Change of medication

> Other significant events

Main sections:

• Event Details

• Newly Identified Adverse Reactions

• Medications

• Diagnoses/Interventions

• Immunisations

• Diagnostic Investigations

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Shared Health SummaryClinical document that summarises a patient's health status at a point in time.

Uploaded by the patient’s primary care giver.

Main sections:

• Allergies and adverse reactions

• Medicines

• Medical History

• Immunisations

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Diagnostic Request

Patient consent should also be included in any pathology test or diagnosticimaging exam request.

Indication of Consent - HL7 Version 2.4 provides the Australian Standard toinclude indication of consent in a V2 order message.

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Viewing Opportunities

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getDocumentListSearch for one or more documents in a patient’s My Health Recordbased on search criteria.

Search criteria may include:• Document types (i.e. event summaries, specialist letters)• Date range

Usages:• Landing page - listing all documents on patient’s record.• Indicator listing documents uploaded since last consult.

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Medicines ViewThe Medicines View gathers medicines information from:

• The patient’s most recent (and up to two years) prescription and dispense records andother PBS claims information.

• The patient’s most recent shared health summary and discharge summary.

• Recent event summaries, specialist letters and e-Referral notes uploaded to thepatient’s record since their latest shared health summary.

• The patient’s personal health summary that may include any allergies or adversereactions and other key information.

Returned in the document list.

Usages:

• Accessible one click from landing page.

• Accessible from medicines section of clinical software.

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Australian Immunisation Register

The Australian Immunisation Register (AIR) captures vaccinations given topeople of all ages in Australia through general practice and community clinics.

Returned in the document list.

Usages:

• Accessible from immunisation/medicines section of clinical software.

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Health Record OverviewThe Health Record Overview provides a summary of an individual’s My HealthRecord and is intended to serve as the “home screen” displayed when anindividual’s record is first opened.

• Most recent Shared Health Summary.

• Document available since the last Shared Health Summary.

• Documents available in the last 12 months.

Returned in the getView service.

Usages:

• Can be used as a landing page in the clinical software.

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Prescription and Dispense ViewThe Prescription and Dispense View summaries information about medicationprescriptions and dispensations in a patient’s record.

• CDA® format

• Agency provides XSLT for transform into HTML.

• Can be parsed for native rendering.

Returned in the getView service.

Usages:

• Best placed side-by-side to medicines section of the clinical software.

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Pathology & Diagnostic Imaging ViewThe Pathology Report View and Diagnostic Imaging Report View summarisepathology tests and diagnostic imaging exams of a patient’s My Health Record.

• XML format.

• To be parsed for native rendering.

• Indicators of how many pathology and diagnostic imaging reports available.

• Allow users to import relevant pathology and diagnostic imaging reports.

Usage:

• Best placed side-by-side the diagnostics section of the software.

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Questions

Next steps, Timeline and Resources

Next stepsAfter this webinar you will receive an email with :

• Link to webinar recording (Developer Centre).

• Short Vendor questionnaire.

Kick-off workshops

> Sydney or Brisbane.

> At least two people attend in-person.

> Demonstrate your CIS

> Share ideas on potential software enhancements/new functionality

> How do we collaborate in arriving at an optimised detailed software design document.

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Timeline and milestones

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Whensigned by

last Party todo so.

Tue9 Jul

Wed10 Jul Jul - Aug Aug – Sep

Fri13 Sep

Mon-Fri16-20 Sep

Mon-Fri23-27 Sep

Mon30 Sep

Wed30 Oct

Fri20 Dec

ContractStart Date

Agency +Vendor

Webinar #1:

Introductionto MHRsystem

Agency +Vendor

Webinar #2:

Specialistsector

agenda andlessonslearnt

Agency +Vendor

Kick-offworkshops

Agency +Vendor

Co-design

Ad-hocreviews

Vendor

SUBMITFINAL

DRAFT:

DetailedSoftware

DesignDocument

Agency

Review andfeedback

Vendor

Incorporatefeedback

Vendor

SUBMITFINAL:

DetailedSoftware

DesignDocument

Agency

Final reviewand assesses

foracceptance

Contract EndDate

Resources and more information

Resources and Contacting us

Phone: 1300 901 001 (Agency Help Desk)

Email: Help@DigitalHealth.gov.au (Agency Help Desk)

Website: https://developer.digitalhealth.gov.au

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Questions

Thank you