Nationwide secure clinical communications are on their way

20 December 2018: The Agency is working closely with industry, suppliers and vendors to deliver a true nationwide secure messaging capability.

“The future is already here – it’s just not very evenly distributed.”

This William Gibson quote – a staple of cyberpunk lore – perfectly describes the state of secure clinical messaging in Australia. Several clinical software vendors are already providing secure messaging solutions to specific markets within Australia’s healthcare system. Unfortunately, these systems are not compatible with each other, so our challenge is to implement a nationwide solution that embraces existing solutions and unifies them seamlessly.

Secure messaging is a foundational capability enabling interoperability and safe, seamless, and secure information sharing between healthcare providers. Nationwide adoption of secure messaging would enhance the security, safety and efficiency of clinical information sharing across all sectors, with attendant improvements in both outcomes and costs.

To realise this vision, the Agency’s Secure Messaging program is working collaboratively with industry, suppliers of secure messaging solutions, and clinical software vendors to reduce existing barriers to adoption and to provide pragmatic and implementable solutions.

Consistency is the key

The underlying theme in this domain is consistency. At the most fundamental level, messaging formats need to be consistent and interoperable across all vendor implementations. To achieve this, an industry-based technical working group has developed specifications for Health Level Seven International (HL7) messages and shared provider address information.

With these specifications agreed, we can progress to implementing them in vendor software. The Agency is working with messaging providers and vendors to send electronic messages safely and securely across the sector. In addition, we are collaborating with vendors to improve the interoperability of their provider directory services, and working towards a transparent, nationally federated model. The end result will be the equivalent of a national yellow pages for all registered healthcare providers, enabling them to easily contact each other.

The ultimate challenge for implementation is to embed the industry-agreed secure messaging capabilities into live clinical services to test their real-world suitability, and to improve workflows for sending electronic messages. Two industry consortia – led by Telstra Health and Healthlink respectively – are running proof of concept tests on live clinical systems in Victoria. These projects are due to be completed in late 2018, a significant milestone in Australia’s digital health journey.

What’s next?

The Agency has commenced information exchange projects across two jurisdictions to extend referral capabilities. These projects will build upon the proof of concept projects that are nearing completion and pave the way for a full-spectrum unified secure clinical messaging capability.

Once this information exchange capability has been established, the next task is to populate the referral system with high-quality trusted data about the providers. To enable this a new provider registration tool, also known as a service registration assistant, will be co-developed with stakeholders and distributed to practices across Australia. This tool will facilitate the registration of provider information from the source clinical information systems with content validation by the Australian Health Practitioner Regulation Agency (AHPRA) and other authorities. The guiding principle of this process is enter once, use many times.

The Agency is also encouraging healthcare providers to use existing secure messaging systems, instead of relying on faxes and physical letters. Our target is to secure a 25% increase in the number of specialist and allied health users exchanging messages electronically by mid-2019. This user engagement is matched by corresponding clinical software vendor support for adoption of the new services and capabilities being developed.

Secure messaging engagement Sector engagement activities embrace both vendors and users

Later in the year, the Industry Participation Agreement and Trust Framework should be in place, which will formalise agreements between messaging vendors to trust each other’s certificates, and to support vendor participation in the unified system. This will pave the way for transparent and seamless secure clinical messaging across Australia, finally enabling healthcare providers to exchange information with all the ease and simplicity we have come to expect in other aspects of our lives.

Sari McKinnon is the Agency's Program Director, Secure Messaging and Interoperability.

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