Ending the reign of the fax machine is one step closer

Doug Hendrie

19/06/2018 3:47:08 PM

The holy grail of healthcare messaging – secure, interoperable and searchable – is a step closer after professional stakeholders agree to adopt a national set of standards and processes.

Is the tyranny of the fax machine nearly over?
Is the tyranny of the fax machine nearly over?

The quest to replace the humble fax machine in one of its last redoubts, healthcare, has been going for 15 years.
The issue recently rose to the national spotlight in the wake of the death of Mettaloka Halwala, a cancer patient whose crucial medical test results were faxed to the wrong number.
Coroner Rosemary Carlin questioned why the ‘antiquated’ technology still existed in healthcare.
But the fax has been far more difficult to replace than many expected.
There are many different clinical information and secure messaging systems in healthcare, which makes interoperability a real challenge. In addition, there has been no equivalent of a standard phone directory for secure messaging, meaning looking up a recipient can be a challenge in itself.
By contrast, even though there is no guarantee a fax is read – or even goes to the right number – it is surprisingly secure, and it is easy to look up fax numbers.
But earlier this month more than 50 members of the clinical and secure messaging software suppliers and industry stakeholders finally agreed on a basic set of standards at a workshop hosted by the Australian Digital Health Agency (ADHA) and Medical Software Industry Association.
If adopted, this would mean a message containing sensitive healthcare data sent from one doctor to another will be able to be sent securely, rendered correctly, and read by the right recipient.
Workshop participants agreed to support the HL7v.2 message standard in the medium term, with immediate support for the two most commonly used standards: HL7v2, used by pathology labs and high-volume clinical software platforms; and CDA, used for interactions with My Health Record.
ADHA Chief Operating Officer Bettina McMahon said that Australia has struggled to implement a national scale solution.
‘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,’ she said. ‘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.’
Dr Nathan Pinskier, Chair of the RACGP Expert Committee – eHealth and Practice Systems (REC–eHPS) and also Chair of the Secure Messaging Program Steering Group for the ADHA, is very pleased that interoperable secure messaging may finally be within reach.
‘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,’ he said.
‘As a consequence of the significant work undertaken in the past 18 months, we are closer than ever to achieving this vision.’
According to Dr Pinskier, a major step has been getting buy-in from the secure messaging sector.
‘There’s a lot of good will – for the first time in many years, we’ve got software vendors talking to each other and collaborating,’ he told newsGP. ‘There may have been a degree of competitive IP [intellectual property] protection [before this]. But now everyone agrees if we get this right, we can grow the pie.
‘People just want to click a button and send a message. In the next year, well see it. But it’s critical to get this part right, to get agreement on which technical specifications to use.
‘By meeting, discussing the problem and thrashing it out, that’s how we’ve got to where we are today.’
The agreement comes after progress on two proof-of-concept projects undertaken by Telstra Health and Healthlink.
HealthLink Chief Executive Tom Bowden said 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 Telstra Health and Healthlink are working on a federated search capability; essentially, allowing a clinician to use a single search that scans multiple provider databases to get the correct electronic address of another healthcare provider.
‘[This is] so you aren’t going outside your clinical software to find a specialist. It’s like the Yellow Pages, integrated into your clinical software,’ Dr Pinskier said. 

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Juliet Gallagher   22/06/2018 6:51:21 AM

There is no solution yet for other health providers who we need to communicate quickly with eg Nursing home wards Physio Speech Pathology Pharmacy Community nurses etc

Peter McKenzie   14/12/2018 10:14:22 AM

NSW Health Privacy manual states confidential patient information can not be sent by email to emails outside NSW Health unless it is encrypted and password protected. Yet they do not provide any encryption tools for that purpose. The reality is fax is the only option.