 Welcome
to the first issue of Connectivity
Welcome to the first issue of Connectivity - HealthLink's
monthly e-newsletter updating New Zealand's health professionals
on developments in e-health across the nation. We hope you will
find Connectivity of interest and would be pleased
to receive your feedback and suggestions of topics for coverage
in future issues. Please contact us anytime at any of the e-mail
addresses in the newsletter.
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Exciting Times in the New Zealand Health Sector
As you will read in an article below, New Zealand has been named
as having the second most integrated primary care IT in the world.
This is due to a combination of good government policy, go-ahead
health professionals interested in using the available tools to
improve delivery of healthcare and a healthcare IT industry that
is ready and willing to work together to deliver services and
solutions.
Today every New Zealand General Practice is computerized and
the vast majority are using secure broadband communications. 95%
of pathology results are delivered electronically and the number
of specialist letters, patient referrals and discharge summaries
is also increasing exponentially. A number of key national systems
such as the Diabetes Annual Review, the National Child Immunisation
Register (NIR) and Pharmac's Special Authorities systems are all
fully electronic. New Zealand's integrated primary care system
is the envy of many other countries and highly efficient to boot.
So amidst the popping of champagne corks and self-congratulatory
shouts, I hear you ask "Where are the challenges? What's
left to do? Is this IT? Well actually there is a lot more to do.
We have recently studied general practice work-flow and have determined
that we have so far managed to replace only 30% of the available
total of documents, forms and pieces of paper. Clearly there is
a lot more to do. In this newsletter you will read news about
what we are doing with electronic test ordering, electronic forms
and a range of other initiatives.
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RSD (Referrals, Status Reports, Discharge Summaries) Ready
Set Do it!
RSD stands for Referral, Status and Discharge Summaries, these
being the main types of correspondence shared between health providers
in the sector. The HealthLink RSD system is a messaging system
which can be used to exchange electronic messages between health
providers' computer systems. Using a common message exchange system
means that health providers can quickly, easily and securely exchange
RSD messages.
RSD was developed from scratch in 1995 by HealthLink and is now
a service being used by approximately 5,000 organisations throughout
New Zealand and Australia. These organisations include hospitals,
specialists, After Hours clinics, Physiotherapists and General
Practices.
Hospitals all over New Zealand are using RSD and more than two
and a half million RSD messages per annum are being sent. This
number is growing steadily every month. We are expecting RSD to
continue to grow, as surely and steadily it becomes the preferred
way of communicating clinical information amongst healthcare providers.
Growth of RSD messages within the New Zealand health sector
For further information please contact RSD Product Manager Jo
de Lisle
jodelisle@healthlink.net.
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 What
is T.H.E. Project?
T.H.E - Total Healthcare e-Enablement
A group of New Zealand Information Technology companies and customers
are working together to introduce an important Health IT initiative.
T.H.E. Project has two key goals: The first is to improve the
flow of electronic communications between General Practices and
all of the other disciplines they work with. The second goal is
to provide the PHO with utilisation data, that is non-identifiable
patient data that provides the PHO with an overview of care delivery
to patients, in order to improve both the way care is delivered
and the way in which funding is obtained and directed.
The diagram below outlines the component parts of T.H.E. Project.
It shows increased use of electronic messaging between General
Practices and the other medical and related organisations that
work with general practices to deliver patient care.
Key Areas of T.H.E. Project
The organisations behind the project are seeking to make some
serious headway in two key areas:
- Improving coordination of patient care by enabling providers
to share relevant clinical information during an episode of
care.
- Improving the quality of information gathered by the PHO to
enable better population health management and contracting with
funders and other parties.
Key Objectives of T.H.E. Project
- Make improvements to the electronic referrals and discharge
summaries system presently in place
- Expand use of electronic referrals and discharge summaries
(RSD) to include a wide range of other health provider organisations
- Enable the exchange of documents between healthcare provider
organisations
- Implement electronic pathology, radiology, ordering and electronic
prescribing services
- Implement online enquiries between primary care providers
and remote databases
- Explore creation of electronic links between GP systems and
their patients
- Investigate the eventual development of a GP held shared electronic
record
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Electronic Special Authorities - The Magic of Online Communications
We have recently gone live with Electronic Special Authorities
(ESA)
The Pharmac Special Authorities system is now available; delivering
instant online approval for those drugs that require special authorisation
by government. ESA uses HealthLink QUANTUM, a new HealthLink feature
that enables medical practices to obtain clinical information
from remote information sources quickly and securely.
QUANTUM is designed as a generic capability that enables practice
management systems to transact "Online" with a range
of remote applications that can deliver information to the doctor's
desktop during a clinical consultation. In order to use HealthLink
QUANTUM, the practice needs a secure broadband connection. The
ESA requests are sent from the General Practice's computerised
patient management system to Pharmac, where they are processed
by the Pharmac rules engine and a response returns in approximately
15 seconds. The response returns into the practice's patient database
and is stored along with other relevant information in the patient's
file.
What Practitioners are saying about QUANTUM
"HealthLink's QUANTUM Technology is revolutionising the
way we deliver care. It is simple, easy to use and works dependably.
I can envisage a day when I will be able to access a wider range
of information from hospitals, disease management programmes,
immunisation programmes, government agencies and other sources,
all at the touch of a button."
Dr Jonathan E M Fox
MB BS MRCS LRCP MRCGP FRNZCGP
Senior Partner, Meadowbank Medical Centre
"Real-time access to remote clinical databases and systems
has the potential to make a profound difference to the efficiency
of a medical practice. We look forward to gaining access to a
wide range of online communications system as soon as possible."
Dr Gary Sinclair
Managing Partner
The Doctors, Mangere
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New Zealand - World Leader in Healthcare IT
New Zealand's leadership in the integration of clinical IT systems
into medical general practice has been confirmed by the findings
of a landmark ten-country study that names New Zealand as the
most integrated advanced country after Denmark.
The 2005 study, commissioned by Canada Health InfoWay, analysed
the use of IT within primary healthcare in Australia, Austria,
Denmark, England, Germany, the Netherlands, New Zealand, Norway,
Scotland and Sweden.
Canadian Professor Denis Protti, presently Professor of Health
Informatics at City University, London and Professor of Health
Informatics at the University of Victoria, British Columbia, recently
presented the study's key findings in London. The research showed
that:
- There is wide variation between countries as to whether public
and/or private sectors are best placed to implement technology
e.g. Denmark uses a non-profit organisation while much of New
Zealand's primary care IT integration occurs via a private company
(HealthLink Limited).
- A national unifying organisation such as Medcom in Denmark
or HealthLink in New Zealand is common to all well-integrated
countries, with some type of Government impetus also present.
- In all ten countries studied there is recognition that significant
progress towards an Electronic Health Record is impossible without
the full participation of GPs.
- Actual 'hands-on' delivery of healthcare varies only slightly
between countries but the ways in which the respective healthcare
systems are financed, administered and managed differ markedly.
For instance, in the Netherlands and Austria 80% - 90% of GPs
are individual practitioners whereas the comparable figure is
only 10% in New Zealand.
Professor Protti will soon undertake a directly comparative study
between healthcare IT integration systems in New Zealand and Denmark.
We expect that some of the systems currently under development
will put us ahead of the Danes by some measures. For example,
New Zealand's exchange of electronic referrals and letters between
GPs and specialists already significantly exceeds that of Denmark.
Some of the new web-forms, electronic referrals and electronic
special authorities projects will put us ahead as well. We view
beating the Danes in this contest as a matter of national importance
and we hope that the rest of the sector will work with us to help
keep the Vikings at bay.
We look forward to working with you to make the New Zealand health
sector the most automated in the world… stand aside Denmark,
we're coming through.
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The New Zealand Meningococcal screening programme - saving lives
and saving practice time
While there is still some controversy surrounding New Zealand's
national meningococcal screening campaign, there can be no argument
that it was highly successful in its primary aim which was to
stop children dying or being permanently maimed by this terrible
disease.
The following article clearly shows the sudden reduction. HealthLink
provided the complete electronic messaging system used by every
general practice in New Zealand to connect to the Meningococcal
screening system and The National Child Immunisation Register.
Click to enlarge
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