Interoperability: A marker of an optimal health system

Having accurate, up-to-the-minute information about the patient sitting in front of you is invaluable to you and your patients.
 
One marker of an optimal healthcare system is interoperability: the seamless flow of patient data between healthcare providers, underpinned by a common language, to ensure everyone is on the same page.
 
The RACGP has long advocated for improvements in the communication systems involving general practice and other branches of the Australian healthcare sector. That’s why we’re a proud partner in the work of Sparked, an initiative to standardise communication across the health sector.
 
For us, this means communication between our computer systems and others such as hospitals, non-GP specialists and allied health professionals.
 
Sparked is developing and facilitating the adoption of Fast Healthcare Interoperability Resources (FHIR) standards for healthcare information exchange in Australia.
 
FHIR is an Australian-developed standard that has been adopted around the world and is now coming back to its origins. When implemented, these FHIR standards will facilitate real-time data exchange between all health services, with obvious benefits to the provision of care.
 
This project is led by the CSIRO’s Australian eHealth Research Centre, in partnership with the Department of Health, Disability and Ageing, the Australian Digital Health Agency, and not-for-profit HL7 Australia.
 
It brings together diverse stakeholders from government, software vendors, healthcare practitioners, provider organisations, and peak bodies, of which the RACGP is one.
 
Our representatives participate in the Sparked project through various working groups, and we provide an organisational response to consultations.
 
Sparked is in its third year of operation and is making good progress.
 
A key project is the Australian Core Data for Interoperability (AUCDI), which is a published series of data elements that support standardised clinical information capture at the point of care, and the exchange of that information to other care providers.
 
Two iterations of AUCDI have already been released and the third is currently in train.
 
Related work includes the development of Australian eRequesting Data for Interoperability (AUeReqDI), which will support the exchange of data for electronic requesting and ordering of pathology and imaging.
 
Sparked is also developing a Patient Summary, which is a standardised collection of information on an individual’s health and healthcare – basically, a standardised version of the Shared Health Summary we currently upload to My Health Record.
 
This is considered the minimum sufficient data to facilitate safe, high-quality, and efficient care.
 
The Patient Summary will help ensure the patient and their healthcare providers have access to timely and relevant information, and to share this with others as needed.
 
While we can do this now with letters, this standard will allow coded data in the letters that can be imported into the relevant sections of a computerise patient record.
 
The Patient Summary will be supported by an Encounter Record (also coded), giving a more complete view of patient interactions with the healthcare system. Such a record will be particularly useful when our patients transition across care settings.
 
Some use-cases already reliant on the FHIR standards are the Australian Immunisation Register and the National Cancer Screening Registry. I’m sure most GPs value these tools and the way the information from these resources can be downloaded into our practices’ systems.
 
Other future examples in development include hospital discharge summaries that have FHIR protocols and standardised nomenclature that allows importing of medications, allergies and diagnoses/procedures into our software directly from the document, with no need to manually type them into the record.
 
Chronic Condition Care Plans with the same functionality are also in development. It would also be useful to have letters to and from non-GP specialists in this format. Once the FHIR standards are in place, this will be much easier for software developers to implement.
 
The RACGP is proud to be part of the important work happening through Sparked. Our input is sought and highly valued by the organisers and managers. I encourage you to discover more about the Sparked products and resources.
 
While you’re there, you might consider getting involved by joining a clinical design group to validate and define critical data elements and structures of the FHIR standards.
 
They are fun events and it is great to see what is happening. You don’t need to have any computer skills (beyond being a user and a GP).
 
There’s plenty of work still to be done, and the end result will benefit us all – so come and get involved.
 
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digital health interoperability Sparked