Media release - Industry collaborates to end the era of the fax machine

Out of date and unsecure fax machines are being used to share patient information between healthcare providers, despite other sectors discarding them over a decade ago. Not only do fax machines cause frustration for healthcare providers trying to communicate with each other, they can also cause patient harm.

In May 2018, a coroner’s report revealed that Hodgkin’s lymphoma patient Mettaloka Halwala died alone following chemotherapy complications. His medical test results were faxed to the wrong number, which meant his treating haematologist did not receive information that could have saved his life.

Coroner Rosemary Carlin called for the hospital involved to phase out fax transmission of imaging results as a matter of urgency. She said it was difficult to understand why such an antiquated and unreliable means of communication exists at all in the medical profession.

To support the uptake of digital health services, the Council of Australian Governments (COAG) Health Council approved Australia’s National Digital Health Strategy – Safe, Seamless, and Secure. A key priority in the strategy is to end dependence on the fax machine and paper-based correspondence by empowering healthcare providers to communicate with other professionals and their patients via secure digital channels.

On 6 June 2018, key industry participants at a secure messaging industry collaboration workshop agreed to adopt the tools, processes, and standards that have been demonstrated to solve the interoperability problems across secure messaging and clinical information systems.

Through this collaboration, Australia is on track to end the use of fax machines in healthcare, with key industry players agreeing to the next steps to improve secure messaging of patient records between healthcare providers using clinical software.

Secure messaging workshop attendees Attendees at the Secure Messaging Industry Collaboration Workshop agreed to adopt standards demonstrated in recent projects that achieve interoperable secure messages.

The meeting was co-chaired by Medical Software Industry Association (MSIA) President Emma Hossack, Agency Chief Operating Officer (COO) Bettina McMahon, and Dr Nathan Pinskier, Chair of the Royal Australian College of General Practitioners (RACGP) Expert Committee – eHealth and Practice Systems, and Chair of the Agency’s Secure Messaging Program Steering Group. Over 50 participants from the technology and healthcare industry also attended.

MSIA President Emma Hossack said that industry is committed to progressing interoperability in secure messaging, as well as more generally across the health sector.

“Health information is stored in diverse health software and frequently needs to be shared. Without interoperability, this information may need to be scanned and faxed or even posted. Not only can this be dangerous but also highly inefficient.

“To share and manage access to health information, we are working towards adoption of agreed compliant messaging standards, conformance at the receiving ends, and a federated approach to directories. This will make health communications more seamless and safe. It will also make it easier for industry to innovate in this area, as digital foundations will be in place,” Ms Hossack said.

Today the Agency and MSIA released a communique with a commitment to support message formats that give healthcare providers flexibility to construct messages and consume content within their clinical information systems. Authentication and the approach to sharing endpoint locations across directories was also addressed.

Proving interoperable messaging in real world projects
This commitment follows good progress with proof of concept projects led by Telstra Health and Healthlink.

Telstra Health is leading a consortium to test the delivery of discharge summaries from Royal Melbourne Hospital to a range of general practitioners. CorePlus, Genie Solutions, Global Health, HealthLink, and Zedmed are also participating in this project.

Telstra Health Head of Strategy and Policy Dr Phuong Pham said enabling providers to reliably connect and securely share information with each other is crucial to support the safety, quality, and efficiency of the health system.

“Telstra Health is proud to be collaborating with industry colleagues and the Australian Digital Health Agency to make interoperable messaging possible. With the proof of concept activity nearing completion, we keenly anticipate the next phase of digital enablement in healthcare,” Dr Pham said.

Healthlink is leading the other consortium and is testing the delivery of referrals from a range of general practitioners to specialists. MedicalDirector, Best Practice Software, Genie Solutions, Global Health, and Telstra Health are supporting this work.

HealthLink CEO Tom Bowden said that he is pleased with the progress to date on the federation of messaging directories.

“The ability to select any practice from a federated directory search will be a major step forward for eHealth across Australia,” Mr Bowden said.

Both consortia are finalising a federated search capability to allow the searching of provider directories and care provider electronic addresses. This means that a single search will identify Australian healthcare providers, providing convenience and transparency for clinicians looking up other clinicians. The sending of messages across these sites will commence this month.

The projects have also been extended to include allied health practitioners and electronic medical record (EMR) products used in that domain. The Telstra Health consortium will enable allied health practitioners to send reports to their referrers and the HealthLink consortium will extend the sending of referrals to and from allied health.

In addition to laying the foundations for national secure messaging, the lessons learnt in this project will inform other industry collaborations as Australian healthcare drives towards full interoperability across digital health systems.

Dr Nathan Pinskier reflected on the progress made with secure messaging in Australia.

“In late 2016, Agency CEO Tim Kelsey visited my practice to obtain a better understanding of the complexities frontline healthcare providers were facing when attempting to utilise secure electronic messaging.

“During the visit, Tim offered me the opportunity to become involved with a new and invigorated secure messaging program. Clinicians have been understandably frustrated with the ongoing delays and lack of progress towards achieving truly interoperable, easy to use and highly available secure messaging in the healthcare sector.

“Well the good news is that as a consequence of the significant work undertaken in the past 18 months we are closer than ever to achieving this vision. I’m looking forward to the outcomes from the proof of concepts and then moving on to national deployment. It has been a privilege to collaborate with industry and all key stakeholders to support this vital piece of national work,” Dr Pinskier said.

Agency COO Bettina McMahon said that the key to solving the interoperability issues has been partnering with industry and their customers.

“Secure messaging systems and standards have been in place for many years, but as a country, we’ve struggled to implement at a national scale. It has taken time to co-produce a workable solution with industry that meets the expectations of the clinical community – we started this project 18 months ago. But to adopt a true co-production process takes this long, and ultimately, has allowed us to reach consensus about how we will scale digital communication,” Ms McMahon said.


Further information
Industry Collaboration for Secure Messaging and Interoperability communique
Secure clinical communications are coming article

Media contact
David Cooper, Senior Media Manager
Mobile: 0428 772 421 Email: [email protected]

About the Australian Digital Health Agency
The Agency is tasked with improving health outcomes for all Australians through the delivery of digital healthcare systems, and implementing Australia’s National Digital Health Strategy – Safe, Seamless, and Secure: evolving health and care to meet the needs of modern Australia in collaboration with partners across the community. The Agency is the System Operator of My Health Record, and provides leadership, coordination, and delivery of a collaborative and innovative approach to utilising technology to support and enhance a clinically safe and connected national health system. These improvements will give individuals more control of their health and their health information, and support healthcare providers to deliver informed healthcare through access to current clinical and treatment information. Further information:

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