A Missed Opportunity
 
 

A Missed Opportunity


Matthew Galetto - Founder and CEO

How the Australian Government Failed to Maximise the Potential of the GP Grants Program for Digital Health Adoption

The Australian Government recently launched the Strengthening Medicare – General Practice (GP) Grants Program, allocating $220 million over two years to support general practices and eligible Aboriginal Community Controlled Health Organisations (ACCHOs). The program aims to provide funding for improvements in patient access, support safe and accessible quality primary care, and enhance digital health capabilities.

As an observer of the digital health landscape both as a consumer (patient) and participant as a software vendor, I was eagerly awaiting the unveiling of the GP Grants program. I was hopeful that the grants would finally start to address the pressing issues of our time – a need to modernise digital health infrastructure, both private and public, focusing on standards and real-time information exchange at point of care. These are not just my observations; just about everyone working in the industry understands these problems, including the government itself within health departments and at the Australian Digital Health Agency (ADHA). And, of course, patients get it too. We all experience gross inefficiencies when we visit a doctor.

Recently I learned from a colleague working at a primary health network (PHN), that no further details regarding the eligibility of the grant funding have been provided. The government has seemingly failed to establish eligibility criteria that effectively address the challenges faced by our healthcare system and specifically primary care and GP’s.  I don’t even think security of patient information is a requirement!

Could have, should have – if only I had lobbied harder!

Fast-tracking the benefits of a more connected healthcare system is crucial for improving patient care, reducing medical errors, and making healthcare more efficient. The adoption of Fast Healthcare Interoperability Resources (FHIR) and other interoperability standards can enable seamless communication between different electronic health record systems, thus facilitating information exchange and collaboration among healthcare providers.

Unfortunately, the current GP Grants Program does not set specific eligibility criteria that focus on the adoption of cloud, security, FHIR or other interoperability standards – not even clinical coding standards! As a result, the program risks missing a critical opportunity to substantially enhance digital health capabilities across GP practices.

The government’s lack of focus on cloud services, security, FHIR and interoperability adoption is concerning, considering the many issues GP practices face due to siloed databases and technology platforms designed a couple of decades ago. The current state of healthcare data systems not only hinders efficient patient care but also creates additional administrative burdens on healthcare providers. By not setting clear eligibility criteria targeting these issues, the GP Grants Program will not bring about much-needed improvements in digital health and interoperability.

Unfortunately, there is a history in the Australian healthcare industry for key stakeholders and decision makers to listen to the voice of the ‘market share’, rather than the innovators, start-ups and disruptors looking to make a difference. It’s a chicken and egg scenario, no market share equals no influence, no influence equals no change. If only I had lobbied harder for change!

What could have been, should have been. Recommendations for Improvement

To maximise the potential of the GP Grants Program, the Australian Government should have considered the following recommendations:

  1. Set clear eligibility criteria that prioritise funding for GP practices adopting cloud, security, FHIR and other interoperability standards to ensure a more connected healthcare system.
  2. Encourage collaboration between GP practices and technology vendors to develop innovative solutions that address the challenges of siloed databases and improve data sharing.
  3. Establish clear guidelines on how the grants can be used for enhancing digital health capabilities, including specific recommendations for addressing interoperability and data sharing challenges.
  4. Look to other jurisdictions like the US, which have successfully modernised their digital health ecosystem. The US implemented the 21st Century Cures Act in 2016 which was well funded, mandated standards, promoted innovation, stimulated research and development and encouraged the use and uptake of web-based API’s. This had the effect of uplifting an entire ecosystem and encouraging a raft of new digital health entrants.

An Unintended Consequence: How the GP Grants Programme May Impede Digital Healthcare Reform

While the additional funding provided by the GP Grants Programme is undoubtedly beneficial for practices, there is a valid concern that it may have unintended consequences.

If practices invest grant money in outdated technologies, they essentially lock themselves into using these systems for the next 3-5 years, as assets typically depreciate over this period.

This potential outcome of the GP Grants Program could have a perverse impact on the government’s ability to implement much-needed digital healthcare reforms. By inadvertently supporting continued use of outdated technology, the Program may slow the adoption of innovative solutions such as cloud, security, API’s, FHIR and interoperability standards. In turn, this could delay the realisation of a truly connected and efficient healthcare system, which is an urgent priority.

It is disheartening to acknowledge that Australia is already lagging behind many other countries in terms of modern cloud-based digital health solutions. This funding, if not appropriately directed, will only serve to widen the gap between Australia and other nations leading the charge in healthcare innovation. The prospect of falling further behind should be a wake-up call for the government to re-evaluate the GP Grants Program and ensure it truly supports the advancement of digital health capabilities across the country.

It is never too late!!

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    MediRecords in the fast lane for FHIR connectivity
     

    MediRecords in the
    fast lane for FHIR connectivity

    MediRecords will be releasing new FHIR integration pathways for clients throughout 2023, as part of our commitment to a better connected Australian healthcare system. 

     

    As can be seen from our FHIR Roadmap below, we not only have established and proven options for data sharing, but we’re investing in the expansion of our Connect platform which comprises of  FHIR (Fast Health Interoperability Resources) and Connect services.

    We now have FHIR integrations with hospital systems for ePrescribing, and updating patient records. New resources in development for MediRecords 2.0 include allergies, diagnostic requests and reports, patient summaries, and inpatient charting.

    MediRecords Chief Executive Officer Matthew Galetto said the Connect platform enabled health care providers and patients to access records quickly and securely, driving better and timelier health outcomes.

    “We’re keen to see more software vendors hit the road and deliver on industry standards for interoperability, resulting in connected health care across Australia,” Mr Galetto said.

    “Some vendors seem to be waiting for a reason to modernise when the motivation should be clear — the right care at the right time, wherever you are in Australia.”

    MediRecords is part of a national consortium, led by Leidos Australia, developing a new Health Knowledge Management (HKM) system for the Australian Defence Force. This project will see MediRecords connect health records for GPs, allied health practitioners, specialists, patients, and hospitals.

    MediRecords is also supporting the Victorian Virtual Emergency Department with an integrated ePrescribing system.

    MediRecords Technical Product Lead Sanjeed Quaiyumi said 2023 would be an exciting year. “We’re working on consultation notes and can’t wait to hit other milestones on our roadmap.”

    MediRecords FHIR Roadmap

    MediRecords FHIR roadmap was last updated 01/11/23.

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      Communication the key to reducing hospital readmissions

      Communication the
      key to reducing
      hospital readmissions

      Can health tech help reduce hospital readmissions?

       

      According to a global research review, telehealth and virtual wards can certainly make a difference.

      The Deeble Institute — the research arm of the Australian Healthcare and Hospitals Association (AHHA) — reviewed international research on the role of primary care in reducing hospital readmissions.

      In its Evidence Brief no. 24, the Institute says telehealth can be used to boost general practice involvement in hospital discharges and subsequent multidisciplinary virtual care, resulting in fewer unplanned readmissions.

      Unplanned readmissions are associated with poorer health outcomes, dissatisfaction with healthcare, increased costs, and bed blockages.

      The report highlighted research that showed improved communication and coordination of care between GPs, hospitals and/or pharmacists is effective.

      “Effective interventions included … electronic tools to facilitate quick, clear, and structured (health) summary generation… use of electronic discharge notifications; and web-based access to discharge information for general practitioners,” reported the Netherland’s Hesselink and colleagues.

      Virtual wards are another way to reduce risk of hospital readmissions and improve outcomes during hospital-to-home transition, with research indicating these can be effective with specific disease cohorts but less so with non-specific, complex diseases.

      The Evidence Brief contrasted virtual wards with Hospital in the Home (HITH). HITH is a form of remote hospital inpatient care whereas virtual wards facilitate transition from hospital care to home care.

      “Compared to HITH, virtual wards typically have a higher degree of interdisciplinary care coordination and review, are simpler in design and implementation, and have a broader scope of activities,” The Deeble Institute reported.

      “Transitional care is similar to virtual wards, but usually implemented within existing systems. Virtual wards typically require a completely new care pathway and potentially new organisations to manage its implementation.”

      MediRecords Connect provides FHIR (Fast Health Interoperability Resources) and API options for connectivity with hospital systems, including patient administration systems (PAS). MediRecords is deployed as an ePrescribing system at two Australian virtual emergency departments and as an outpatient billing and claiming system for Queensland Health. New functionality enabling multidisciplinary case management and inpatient care will be released later this year.

      MediRecords is also integrated with the Coviu telehealth platform for streamlined virtual consultations.

      Top three Technologies that reduce hospital admissions:

      Further reading

      ‘A wonderful day’: telehealth to become permanent

      Improving Patient Handovers From Hospital to Primary Care

      Consumer adoption of digital health in 2022: Moving at the speed of trust

      PARR++ is dead: long live predictive modelling

      Impact of ‘Virtual Wards’ on hospital use: a research study using propensity matched controls and a cost analysis

      Applying the Integrated Practice Unit Concept to a Modified Virtual Ward Model of Care for Patients at Highest Risk of Readmission: A Randomized Controlled Trial

      Effect of post-discharge virtual wards on improving outcomes in heart failure and non-heart failure populations: A systematic review and meta-analysis

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        MediRecords 2.0: New ways to Care, Connect and Engage
         

        MediRecords 2.0: New ways to Care, Connect
        and Engage

        MediRecords 2.0 is the most comprehensive overhaul of our electronic patient record and clinic management system since we launched in Australia in 2016. While there have been many product updates over the years, MediRecords 2.0 is designed to use screen space better, streamline workflows, reduce administrative burn-out and support shared care.

         

        MediRecords Head of Product Jayne Thompson says, “Innovation is as important to us as it is to our customers”. The 2.0 product update reflects this philosophy, introducing best-in-class user experience design and other client-driven enhancements, while reinforcing the foundations for next generation digital health connectivity.  

        Having grown beyond its origins as Australia’s pioneering, cloud-based practice management system, the MediRecords platform is now underpinned by three pillars: Care, Connect and Engage. Each of these will gain major new features during 2023.

         

        Care

        The MediRecords Care pillar contains core clinical features such as patient records, ePrescribing, appointment management, investigations, billing and claiming, correspondence, and assessments. New Care functionality will include: 

        • Case Management – Members of a designated Care Team can view and update client case notes. This is particularly valuable where care is shared between a multidisciplinary team working from separate locations or across different shifts. For example, mental health practitioners can collaborate with GPs and rehabilitation specialists as patients progress towards a safe return to work. 
        • Group appointments – Patients will be able to book and join group sessions or classes. This feature will enable group therapy, family consultations and community health programs, with providers able to message an entire group or individual group members. 
        • New mental health and readiness for work assessment templates are being added, including the Glasgow Coma Scale. 
        • Single provider view of appointments: Clinicians practising across multiple clinics won’t have to jump between them to view their appointments. Appointments across multiple sites will be consolidated in a single view. 
        • New communication capability: Real time chat with team members will be available throughout MediRecords, making it easier to message team members on the fly. Our new Comms bar will also provide shortcuts to SMS, email, alerts, and notifications. 
        • Inpatients – In a major new premium* feature, MediRecords will be able to support complex care, including inpatient admissions, detailed charting, clinical escalations, progress notes and Discharge Summaries. 
        • Our Letter writer tool is having a makeover and will be even easier to use, with highly requested new functionality, such as digital signatures. 
        • We’ve added industry-leading means of recording Consent (or denial of consent) and made it easier to add attachments to patient records. 
        • Custom fields and Tagging can be used in patient records, creating new and innovative ways to capture information, search records and report on data. 

         

        Connect 

        Many clients are familiar with our Connect site. MediRecords was an early adopter of FHIR (Fast Health Interoperability Resources) and API technology and new options for using these to share data are on the way. We have proven integrations with patient monitoring devices, patient-reported outcome and engagement measure systems (PROMs and PREMs), dictation technology and partner products. MediRecords is built on the SNOMED-CT-AU data coding system, which makes the data we share cleaner and primed for analytics. 

        • We now have FHIR integrations with enterprise products such as hospital patient administration systems (PAS) and scanned medical record software. This means a patient record created or updated in MediRecords can be pushed up into hospital systems, ensuring consistency of records and supporting better patient safety. Current options include allergies, medication requests and dispense notifications. 
        • New FHIR resources to be added throughout 2023 include referrals, diagnostic requests, diagnostic reports, and vital signs.  

         

        Engage 

        MediRecords has already connected over 60,000 patients to healthcare records via our patient mobile app. This enables consumers to book appointments, see medication information, receive reports and educational resources, and access and store personal health documents. We’re taking this to the next level in 2023 with an entirely new patient engagement platform. This will include new features such as:  

        • Real time surveys and forms 
        • Clinical assessment and observations data for remote monitoring 
        • In-appointment chat functionality 
        • Secure web access to personal health data. 

        Frequently asked questions

        MediRecords 2.0 is an overhaul of our current platform rather than a new product. All existing customers will transition to 2.0. Sticking with the old MediRecords format will not be an option.

        We will perform the update remotely. Users won’t have to download or do anything.

        We have done our utmost to preserve familiarity and usual behaviour within the MediRecords application, but the new layout may take some adjustment. To help with this, we have been providing Lunch and Learn sessions for clients. Please reach out to our training team if you have any further questions, training.success@medirecords.com.

        Development will finish in March. Rigorous testing will follow before pilot sites switch to 2.0 in late April. Once we have considered their feedback, we’ll finalise the date for general release and shout it from the rooftops to let you know. 

        If you are a current client, please contact your Account Manager if you would like to be a test pilot for these new features. Limited places are available.  

        MediRecords 2.0 is an upgrade of your existing system and will be covered by usual licence fees. However, some of the optional new features will be Premium products and require additional fees. Details will be published as soon as possible. 

         

        For other questions, please email support@medirecords.com.

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          Federal Government digital health upgrade grants on the way

          Federal Government digital health upgrade grants on the way

          Update: 24 April 2023

          New details are now available on the Strengthening Medicare General Practice Grants.

          Grants of $25,000, $35,000 or $50,000 are available depending on practice size. The grants will be administered by your local Primary Health Network (PHN) or the National Aboriginal Community Controlled Health Organisation (NACCHO). To take advantage of this funding, complete a grant application sourced via your PHN or NACCHO.

           

          MediRecords welcomes the news that Federal Government grants aimed at helping to enhance digital health capability for Medicare general practices and Aboriginal Community Controlled Health Services (ACCHS) will become available from April. 

           

          General practices and ACCHS will be eligible for one-off grants of up to $50,000 for innovation, training, equipment, and minor capital works under three categories:

          1. Enhance digital health capability – Accelerate moves to a more connected healthcare system that meets future standards;
          2. Upgrade infection prevention and control arrangements – Ensure infectious respiratory disease (e.g. COVID, influenza) patients can be safely seen face-to-face; and/or
          3. Maintain and/or achieve accreditation against the Royal Australian College of General Practitioners (RACGP) Standards for General Practice to promote quality and safety in health care.

          The grants were an election promise from then opposition leader Anthony Albanese in May 2022. The Strengthening Medicare – GP Grants Program was subsequently allocated $220 million in the October 2022 federal budget.

          Medicare general practice grants will be administered by local Primary Health Networks (PHNs) and ACCHS grants by the National Aboriginal Community Controlled Health Organisation (NACCHO). Practices and health services owned or operated by a state, territory or local government agency are ineligible.

          MediRecords Chief Executive Officer Matthew Galetto welcomed the move and said he hoped it signalled a shift to better data connectivity between GPs and the broader health care system.

          “We would like to see incentives for general practices to switch to the cloud, given the environmental, security and interoperability benefits that flow from leaving behind legacy software and hardware systems.”

          Mr Galetto said the grants program was an opportunity for the Federal Government and PHNs to drive industry-wide reform and boost adoption of new technology platforms.

          “Just as PIP (Practice Incentives Program) grants helped shift GPs from paper-based systems to electronic, this grant funding should seek to do the same for next generation interoperable technology.”

          “This is bigger than improving the My Health Record. There is an opportunity to follow the United States example and provide genuine connectivity of digital health records for patients, from primary to tertiary care.”

          MediRecords is a true cloud electronic health record system featuring global standards-based interoperability and SNOMED-CT-AU clinical coding. MediRecords pioneered cloud practice management software in Australia and is now used by general practitioners, specialists, multidisciplinary clinics, hospitals, and government departments.

          Practices considering using their grant to upgrade to cloud clinical software are welcome to reach out to MediRecords. We provide onboarding services including training, data migration and configuration of electronic prescribing, telehealth integration, Medicare claiming and more.

           

           
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            MediRecords on FHIR at Northern Health
             

            MediRecords on FHIR
            at Northern Health

            Mental Health teams at Northern Health now have access to the MediRecords e-Prescribing platform, following successful integrations with the hospital’s patient administration system (PAS) and Clinical Patient Folder (CPF) software.

             

            The pioneering FHIR (Fast Health Interoperability Resources) connections mean doctors don’t have to search a second database for patient records and can generate electronic prescriptions quickly, informed by current clinical information, including allergies and medication histories. Prescription records are then sent to CPF in real time, and no longer have to be posted to patients or manually scanned and uploaded to hospital digital records.

            The FHIR go-live signals Phase 2 of MediRecords’ implementation at Northern Health, following an initial launch as a stand-alone system for Victorian Virtual Emergency Department (VVED) doctors in July 2022. Wider use of the e-Prescribing system is being adopted, with Northern’s Outpatient clinics and mental health included in a staggered roll out from 31st January 2023. This implementation was the first FHIR implementation performed at Northern Health.

            MediRecords Chief Executive Officer Matthew Galetto said Northern Health had demonstrated the benefits of using industry-leading FHIR technology to streamline data interoperability and support efficient patient care in a hospital setting.

            “It is important for healthcare organisations investing in new digital health projects to future proof their investments by adopting the latest standards. Implementing FHIR will help organisations stay ahead of the curve and meet near future regulatory requirements,” Mr Galetto said.

            Mr Galetto said MediRecords would be releasing additional FHIR integration pathways for clients throughout 2023, as part of the Connect pillar underpinning the MediRecords platform.

            “We are fortunate to be at the forefront of FHIR development in Australia, thanks to our role in the Leidos-led consortium delivering a new Health Knowledge Management (HKM) system for the Australian Defence Force,” Mr Galetto said.

            “Data sharing for the HKM project has applicability throughout Australian healthcare and means we will be able to connect health care records in primary care all the way up to hospital, or tertiary care. This will help provide patients and clinicians with access to the right data at the right time, with significant safety benefits.”

            Mr Galetto thanked Northern Health for being an early adopter of the technology, the first time MediRecords has been deployed in a hospital setting supporting virtual care.

            “The Northern Health team are pioneers in virtual care and are now leading the way in connecting patient information systems.”

            Northern Health’s Mental Health Division provides hospital-based, community and specialist mental health services to youth, adults and aged people across northern and western Melbourne. The introduction of ePrescribing means prescriptions can be sent instantly and electronically to patients or carers, with a QR code to be scanned at pharmacies for dispensing. This provides significantly faster access to new and repeat medications for mental health clients.

            Media inquiries

            For further information, please email Matthew Galetto on matthew@medirecords.com or Tim Pegler at tim.pegler@medirecords.com

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              8 health-tech trends to watch in 2023
               

              8 health-tech trends to watch in 2023

              Tim Pegler

              Tim Pegler - MediRecords Senior Business Development Manager

              The pandemic years have been actioned-packed for health-tech. What have we learned and what can we expect from 2023?

              1. The cloud is (still) coming 

              Based on conversations with customers, the market is increasingly aware of the security and infrastructure benefits of shifting to cloud. So why is the transition so slow? Partly because the healthcare industry is often understaffed, time poor and therefore change averse. The good news is that those who embrace fresh and more flexible technology rarely look back.

              Speaking of shiny and new…

              2. Robots are here to help 

              Staff shortages due to illness, burnout and pandemic-related workforce changes necessitate doing more with less. We can expect automation to play a bigger role in repetitive tasks, and robots to play support and even investigative roles.

              Exhibit A: Robot dietitian RMC adds robot dietician (thetandd.com)

              Exhibit B: Robot meds Mayo Clinic picks up stake in startup making pill-sized robot (beckershospitalreview.com)

              Exhibit C: AI bed management NUHS’s AI platform predicts bed state 2 weeks in advance | Healthcare IT News

              Exhibit D: Robot cleaning crews Cameron employs robots to super clean facilities | Heraldrepublican | kpcnews.com

              The automation trend also means…

              3. Lock in telehealth

              Virtual and remote care are generally cheaper than hospital beds (How to implement a virtual ED in 10 weeks – Wild Health Summits : Connectivity) and more consumer friendly than queuing for in-person care (see The cost and carbon savings of telehealth, quantified (beckershospitalreview.com)). Virtual mental health care, in particular, appears to be cementing its role. However, digital literacy and equitable access to technology, including Internet coverage, can be barriers to care.  Successful virtual care hinges on having accurate information, tools and help whenever needed so…

              4. Maybe it’s time to make new friends

              Difficulty accessing developers and tight tech budgets mean partnering can be the faster (and cheaper) path to product enhancement, in contrast to D-I-Y builds. Which means…

              5. Interoperability is king

              Products designed for integration have a strategic advantage over those that have not committed to interoperability at their core. Speaking the same language helps and Fast Health Interoperability Resources (FHIR) (Welcome to the HL7 FHIR Foundation) are the way to future-proof your health tech. Another interoperability truth is…

              6. Clean data counts

              Making sense out of a hotchpotch of data dropped into a free-text box is time consuming and painful for data analysis. Storing information in a logical, consistent and correctly coded format (MediRecords uses SNOMED CT AU SNOMED CT-AU and Australian Medicines Terminology June 2022 Release | Australian Digital Health Agency) helps the data wranglers do their thing. Quality, clean, actionable data has value and needs to be kept safe because…

              7. Cyber attacks are on the rise

              US data shows ransomware attacks more than doubled from 2016 to 2021 (JAMA Health Forum – Health Policy, Health Care Reform, Health Affairs | JAMA Health Forum | JAMA Network). The UK and Australia are also under siege. Minimising risk is mandatory and, while no system is risk-free, cloud technology allows you to outsource security management and those never-ending software updates so you can concentrate on core business.  This is important because…

              8. Change is gonna come

              Australian governments are still exploring how to introduce systemic change following royal commissions into aged care and mental health services (Victoria). Royal commissions are ongoing into disability, and defence and veteran suicide. The Australian Digital Health Agency is promoting collaboration and reform. NSW is working on a Single Digital Patient Record (SDPR). Victoria is moving toward a health-information exchange system, connected to a statewide Mental Health Client Management System. Queensland is pursuing better health information connectivity and remote monitoring options. Tasmania has a digital transformation strategy underway. There are versions of virtual emergency departments emerging across Australia…

              Buckle up. 2023 could be a wild ride.

              About MediRecords

              MediRecords is a FHIR-enabled, true cloud clinical platform with ePrescribing and telehealth integrations. MediRecords supports GPmultidisciplinary and specialist clinics across Australia and is working with Queensland Health, the Victorian Virtual Emergency Department and the Australian Defence Force on innovative models of care delivery. Please book a demo if you’d like to discuss solutions for your business.

              Want to dive deeper? Further reading below:

              2023 predictions: Health tech suppliers give their verdict (digitalhealth.net)

              What health tech trends CIOs are focused on in 2023 (beckershospitalreview.com)

              Virtual everything, asynchronous care, sustainability: Healthcare innovation predictions for ’23 (beckershospitalreview.com)

              CMIOs on what to project for 2023 (beckershospitalreview.com)

              Digital Health Review of the Year 2022

              MR.R4.CORE\Home – FHIR v4.0.1 (medirecords.com)

              Report: Telehealth accounts for about 10% of outpatient visits | MobiHealthNews

              The King’s Fund interoperability report highlights relationships and tech (digitalhealth.net)

              Russian hacking group ‘KillNet’ targets US healthcare (beckershospitalreview.com)

              2023 forecast: 7 big-picture goals for hospital leaders (fiercehealthcare.com)

              Top 10 hospital and payer trends to watch in 2023 | Healthcare Finance News

              National Digital Health Strategy and Framework for Action | Australian Digital Health Agency

              Digital Health Transformation – Improving Patient Outcomes 2022-2032 | Tasmanian Department of Health

              DOH-Strategic-Plan-Nov-2022-update.pdf (health.qld.gov.au)

              victorias-digital-health-roadmap.pdf

              Single digital patient record set to deliver vastly improved patient experience | eHealth NSW

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                MediRecords Unwrapped 2022
                 

                Let's unwrap 2022


                Matthew Galetto - Founder and CEO

                I can’t believe it is that time of year again although, judging by the weather in Sydney, you could be forgiven for thinking it is winter!

                2022 has been a stand-out year at MediRecords. I am very proud of what we achieved over the last twelve months.

                We continue to lay foundations for success, focusing on our people and company-making initiatives across all areas of the business. The company has grown to a team of 140 capable, dedicated, and energised staff, all focused on our common goal – building a world class health technology business.

                The year started off with a bang by signing the Australian Department of Defence JP2060 – Phase 4 contract, along with our partners and consortium leaders Leidos Australia.

                We accelerated from there, growing the team and developing an array of new products and features in response to contracted work and customer feedback. Recently released items and features due for release in 2023 include:

                We also set up two new offices, delivered four major releases to Leidos as part of JP2060 – Phase 4 and went live at Northern Health, where MediRecords is playing a vital role in the Victorian Virtual Emergency Department (VVED). Our implementation at Northern Health includes what is likely the first FHIR-based integration between a hospital PAS (Patient Administration System) and an outpatient primary care solution – well done to all involved.

                2023 is set to be another stand-out year

                Other new features planned for 2023 include integrated payments in quarter two, more virtual care functionality, and a rapidly growing list of FHIR resources. Our lightweight EMR, complete with admissions and charting functionality creating a longitudinal patient record, will be available in quarter four. 

                Care, Connect, Engage

                On that note, MediRecords is getting a makeover with the launch of MediRecords 2.0. We have taken all our learnings over the last few years, listened to our customers, and applied that feedback – along with a healthy dose of innovation. Register your details for early access to MediRecords 2.0 news & previews here

                Wishing you a Merry Christmas and a Happy New Year

                Finally, and most importantly, I would like to thank all MediRecords staff and our valued customers for your support in 2022. Have a wonderful Christmas and New Year’s holiday break. Stay safe, relax, and enjoy your time with friends and family. We look forward to seeing you again in 2023.

                Merry Christmas.

                Matthew

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                  The Clinician Interviews Matthew Galetto, CEO at MediRecords

                  The Clinician Interviews
                  Matthew Galetto, CEO at MediRecords

                  This article was originally created and shared via The Clinician. The original article can be found here.

                   

                  The Clinician sat down with Matthew Galetto (founder and CEO, MediRecords) for a conversation on interoperability, adoption issues for regulatory standards, and our recent collaboration on a FHIR-based integration.

                   

                  Thanks for being here, Matt. Could you describe your background and maybe some current or upcoming initiatives you’re particularly excited for?

                  Matthew Galetto: I founded MediRecords in 2014, but my background in health technology spans over 20 years. I started my health tech journey working in primary care, working with a health technology company consolidating GP clinical systems through acquisition during the dotcom boom. In fact, my job was to integrate a dozen or so different applications into a single consolidated platform—I was a lead technical architect in that endeavour.

                  I worked there for a few years and then set up a company called AsteRx, which was a data analytics and clinical data business that collated information from multiple GP systems and provided insights and reports back to corporate practice groups and industry generally.

                  How do you define and approach interoperability, both within MediRecords and in the larger context?

                  Matthew Galetto: Interoperability is information exchanging freely across different systems. There’s the technical implementation of interoperability, which is the systems themselves enabling the transfer of information across technology boundaries and platforms and in different healthcare settings, and there are also the regulation and legal structures that support information exchanges.

                  In the context of MediRecords, the interoperability piece is making sure that the system that we’ve developed in the platform that underpins our products and services can connect to the broader Australian health ecosystem. To do that, it needs to connect to different players in the market that provide certain services, so it might be diagnostic services, My Health Record, Medicaid-claiming type services, payments and those sorts of things.

                  So, I would describe the interoperability piece as that free-flowing information across systems.

                  What do digital health systems and organizations need to be doing to ensure that’s possible: to ensure information can be easily shared and used by other systems? What are the key barriers, or where do you see some organizations falling short?

                  Matthew Galetto: In the Australian market we have a bunch of these legacy technology providers, both in the GP/specialist arena and even in the hospital market. Systems are not geared for supporting the latest standards of interoperability—things like FHIR and SNOMED terminology services to underpin the ontology mapping of information across systems.

                  There’s been insufficient adoption of those standards here in the Australian market, and no incentives provided by government or industry to adopt those technologies, partly because so many of the existing market players still operate on old technology platforms.

                  In our recent collaboration, a bidirectional FHIR-based integration was able to be established between MediRecords and ZEDOC within a matter of a few days. From your perspective, what was the process like and what would you identify as the key success factors?

                  Matthew Galetto: Sure, that was a particular problem case that we needed to solve. ZEDOC was providing a PREMs and PROMs solution patient engagement platform and MediRecords was the underpinning electronic health record and system of record; we don’t have the same level of patient engagement capability that ZEDOC offers.

                  This particular customer was looking at integrating a patient-engaging PREMs and PROMs platform as well as MediRecords capability. To achieve that, as part of a proof of concept delivered in that very short timeframe you described, we were able to connect MediRecords in a bidirectional way to ZEDOC, with MediRecords providing the source of truth for the patient record.

                  Very quickly, were able to put into the clinical workflow a feeder of the patient record through to the ZEDOC platform enrolling that patient in a particular program. ZEDCO would then handle the patient engagement capability.

                  Information that was captured as part of those PREMs and PROMs would then make its way back into MediRecords’ platform as long-form patient summaries and patient-centered observation data, using remote patient monitoring devices. This information would also be added to the longitudinal health report of the patient.

                  That was achieved through applying those FHIR open standards capability. And given that there was a common language and common understanding and protocols we were able to achieve them in pretty quick time.

                  What role do standards like HL7 or FHIR play in enabling PMS like MediRecords to tightly integrate with solutions like ZEDOC?

                  Matthew Galetto: They’re vitally important. I’ve just come back from the US, having attended the HIMSS conference in Orlando. In the US in 2016 the government initiated the 21st Century CURES Act, which essentially removed barriers to the flow of information across systems so the patient could access their clinical record, regardless of where they travelled or the health care facility that they attended.

                  That regulation mandated FHIR as the protocol for exchanging information, and also supporting HL7 (version 2). But essentially, it was saying OK, these systems need to talk to each other, we need to define some common protocols and terminology for that information to share, so we’re going to regulate this. And what we’re seeing in the US is that the innovation that’s come from that initiative has resulted in interoperability across different systems.

                  We actually saw live demonstrations of some examples of patient records being shared, across continuums of care and across competitors, using HL7 and FHIR combinations. It was shared from primary care or ambulatory care, through to secondary care, through to tertiary care, and then even to some patient engagement platforms as well.

                  Those standards are critical in order for information to exchange with the known set of terminology, and also for defining how those systems can communicate.

                  In fact, we’re currently undertaking an integration with a hospital group in Victoria using a combination of HL7 and FHIR protocols. Those protocols are well documented, supported by the international organizations like HL7 and the FHIR community, so we have a clear understanding of what those standards and protocols are. This means we’re able to build confidently, understanding the protocols in place and that they’re reliable and safe to implement.

                  And what is the other side of that coin—what are the key barriers to adoption of those standards by the industry?

                  Matthew Galetto: If we look at FHIR, there are a couple of barriers. One is actually accessing resources and skills that have that knowledge, particularly in Australia. That’s a problem because of poor adoption. And then the other barrier is really a technical barrier.

                  FHIR is a web-based protocol—it’s designed for systems that are built and implemented in the cloud. The Australian market isn’t really cloud-ready at the moment, with 95-plus odd percent of the vendors operating in the old legacy client technology.

                  But the main barrier would really be the regulation. There’s just no government regulation to say, these are the standards that we need to implement, we want the industry to shift and pivot and implement these particular standards, and give us a roadmap to doing so. The regulatory barriers are significant in maintaining the status quo and not encouraging the adoption of these new standards.

                  With an eye to the future, can you give us your thoughts about the ability to capture data from patients at home and then bring that data into the system, what could that make possible?

                  Matthew Galetto: Well, if all of the systems are talking the same language and adopting the same protocols, regardless of whether they’re patient-facing or clinical-facing, then you have a clear understanding of the context of the information shared across those systems.

                  In terms of the Australian market, one of the things I noticed in the US is the challenges identifying a patient across states and/or healthcare settings. They don’t have the concept of a master patient index as such.

                  In Australia, we’re blessed with some of the initiatives that the ADHA have implemented, like My Health Record. These unique identifiers are tagged not only to the patient, but to the clinician and also to the practice.

                  We already have some of the foundations in place in Australia to identify the various participants in the healthcare system: patient, provider, practice, and location. If we’re talking about information flows from the patient to the clinician right through to the tertiary system, we do have those identifiers.

                  If we can find a way to then implement some of these standards, FHIR in particular, and identify the resources that need to be supported and implemented across these different settings, including the patient engagement setting, then I’m very encouraged about where we can go, provided that regulation comes into play.

                  What’s coming next as far as interoperability? What ought industry be considering in order to stay ahead of the game?

                  Matthew Galetto: Essentially, build those connected platforms and open up the systems. Be less protective of your information because it’s not your information—understand I’m talking as a vendor at the moment. Vendors have a tendency to lock the data in and feel that’s good for business when, in fact, it’s not.

                  This is the journey that MediRecords is going on—we will open up our platform to expose APIs. MediRecords’ platform will open up to and encourage third parties. Of course, through a curated process verifying their use case, but we’re opening up that system. Allowing third parties to connect and exchange and share information from the platform is the way to go.

                  So I think it’s a question of breaking down the technical barriers, but also the business models that are out there.

                  If you actually look at some of the vendors that are operating in the Australian market, understanding that they want to protect not only the customer list, but also the information that sits in those systems and maintain those silos of information.

                  If we can break that down, and also the business models that support those old siloed systems, then I’m pretty confident. If multiple vendors, like MediRecords and The Clinician, are prepared to open up those systems and support the exchange of information across those platforms, then there’s going to be a net benefit to the healthcare sector generally, but particularly to the patient, as well as a pivot from a clinician-focused to a patient-focused or patient-centric model.

                  In the scenario you’ve just described, would that diminish the reliance on regulation, or is there a way that industry could make this happen—to a point—without waiting for regulation to come in?

                  Matthew Galetto: My personal view is that we need regulation. And my personal view is that we need the government setting the example on some of the infrastructure and rails that support the exchange.

                  I’ll give you an example: there’s a tender out now for the prescription exchange which is currently managed by two private operators. They’ve done a wonderful job in the last 10 years implementing a particular framework to support electronic prescribing.

                  The government have now issued a new tender, and they’re looking to undercut the commercial model of those existing vendors by maybe 20%. The original value of that contract will disappear, and all the business models out there supporting the electronic prescribing with money flowing through to the PMS vendors and to the dispensary systems.

                  That’s an example of some infrastructure that I think could be owned and operated by the government, which seems odd, but I think it’s something that might benefit the ecosystem just generally. One other area that’s a bit of a problem in Australia is around the exchange of information messaging between pathology companies, specialist to GPs and vice versa. These are private enterprises and I’ll give you an example of one of the challenges…

                  There are three particular brokers in the market that provide services supporting the exchange of information across systems. So that’s the pathology companies, radiology and diagnostic reports, and requests and specialist letters and referrals and those sorts of things.

                  The ADHA formed a common directory service a couple of years ago and all the brokers were encouraged to upload their contacts list to this new directory service implemented by ADHA. None of them uploaded because they were afraid of sharing their customer lists with their competitors.

                  In that example you have a bit of innovation around FHIR, implementing and documenting it, and then in the end the private sector didn’t conform and participate.

                  I think there’s an example where some regulation needs to come in and mandate a few things. I don’t think we’re going to get the change without the regulation.

                  Considering the digital health landscape through the lens of interoperability, is there an element of the current conversation that you think is not getting enough attention, or is given short shrift? In other words, what are you thinking about that we all should be thinking about?

                  Matthew Galetto: For any health technology company hosting information, security will be what keeps them up at night. That’s certainly the case for us: making sure our system is secure.

                  And as you open up your systems through the interoperability play, including these new standards, security has to be absolutely front of mind, because you are actually opening up your systems to the market generally.

                  Some context for the Australian market: we don’t actually have any security standards that are like a HIPAA compliance standard. So going back to one of your previous questions around some of the barriers and the regulation, we definitely need to see an uplift in the security protocols and accreditation services to support the interoperability piece, and the opening up these systems using FHIR and so forth.

                  Learn more about The Clinician and MediRecords’ recent FHIR-based collaboration in this case study here

                  This article was originally created and shared via The Clinician. The original article can be found here.

                   

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                    MediRecords Product Update: Consent Module
                     

                    Product update:
                    Consent Module

                    MediRecords is excited to announce another product update, the Consent Module.

                    The Consent Module addresses a critical need in healthcare – the need to capture and store electronic consent forms (and help make clipboards and paper-based questionnaires a thing of the past). 

                    MediRecords’ Consent Module has the flexibility to record consent for various procedure types or investigations. The Consent module is per-patient and used to capture and store the Consent type, scope, and associated documentation required (coming soon). 

                    It shows exactly what the patient has provided consent for or rejected. This includes concepts such as Advanced Care Directives, information disclosure to third parties, acceptance of privacy policies and more. 

                    You can open this new feature via a new tab at the top of the patient record, for quick viewing access. Potential ways to use the Consent Module include: 

                    1. New Patient Registration form – patients can sign consent for a practice to begin collecting their medical information 
                    2. Advanced Care Directive – patient provides consent for their care if they become unable to make these decisions themselves 
                    3. Procedural consent – Useful in pre-admission workflows – consent for upcoming procedures or treatment 
                    4. Do Not Resuscitate – orders given by the patient not to resuscitate if they fall unconscious

                    Future enhancements are imminent for this feature. In future releases you will be able to upload a Consent document directly to the Consent record, so that you can store paper consent forms along with electronic records.  

                    To learn more about the Consent Module and how you can implement it for your business, please follow the link to our Knowledge Base articles below or contact our friendly Support team. 

                    If you have feedback on our new feature, please reach out to your account manager. We would love to hear from you!  

                    Consent Module Support Knowledge Base article 

                     All new customers are welcome to book a demonstration to learn how MediRecords can support your organisation today

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