Virtual care continue to be a highlight of the second quarter of the 2022 year in digital health, with the Australasian Institute of Digital Health (AIDH) calling for a fully funded, national virtual care strategy in its 2022 federal election statement. Melbourne’s Northern Health continued the expansion of its virtual ED service, the Aged Care Industry IT Council started to make some serious inroads into the digitisation of the aged care sector, and there were some serious moves from WA, Tasmania and Queensland in electronic medical records. There was also the massive news that Oracle would buy Cerner, the world’s largest EMR vendor – which also happens to have the overwhelmingly dominant market share in Australia – for $28 billion.

April dawned with a peculiar announcement by the Department of Health that it was going to market for providers of prescription delivery services (PDS) and a single active script list registry. Quite why this is so no one knows, with the two existing PDS vendors having provided perfectly good and affordable IT since 2012, as well as working together through a joint venture to facilitate the National Data Exchange that powers Australia’s real-time prescription monitoring systems. In May, it continued to refuse to release a report commissioned from consulting firm Boston Consulting Group that informed the tender.

Late in the year eRx, the market leader, applied to the Australian Consumer and Competition Commission to allow a third PDS – a new service from Symbion – to join the revenue sharing deal that eRx and Medisecure share in exchange of interoperability at no cost to the government. We had been expecting a resolution to this situation by year’s end, but no deal so far.

It was a huge year for digital patient pathways platform Personify Care, which kicked a number of goals in its home state of South Australia in rolling out pre- and post-operative technology to improve patient outcomes, as well as its re-admission prevention program and patient reported outcomes measures at a number of hospitals and healthcare services.

This included an implementation at Adelaide’s The Queen Elizabeth Hospital (TQEH) for elective surgery specialties, the PROpatient project at Monash Health to test whether improved care coordination and symptom monitoring using Personify Care’s digital patient pathways can improve quality of life for people with pancreatic or oesophagogastric cancers, the Healthcare to Home post-discharge service for St John of God Health Care, and a really interesting project with Chamonix to allow hospitals to integrate the Personify Care platform with their existing clinical systems and the My Health Record and upload data as an event summary.

RCH was also revalidated for stage 7, the highest level, on the outpatient electronic medical record adoption model (O-EMRAM).

In what was an epic year for Epic, all four hospitals in Melbourne’s Parkville Precinct that use its EMR received stage 6 validation in the HIMSS inpatient electronic medical record adoption model (EMRAM) assessment, with Royal Children’s Hospital also scoring stage 7 for its outpatients EMR implementation. RCH first implemented Epic in 2016 and received its EMRAM assessment in 2017. The other three hospitals followed suit in rolling the system out in 2020 at the height of the COVID-19 pandemic and received stage 6 on the EMRAM score this year. RCH was also revalidated for stage 7, the highest level, on the outpatient electronic medical record adoption model (O-EMRAM). The Healthcare Information and Management Systems Society (HIMSS) EMRAM measures clinical outcomes, patient engagement and clinician use of EMR technology and covers eight stages of maturity.

While Northern Health’s Virtual ED service took most of the headlines, fellow health services also stepped up to the mark, with Monash Health, Alfred Health and Peninsula Health getting together to develop a Virtual ED service that can be accessed by Ambulance Victoria paramedics. The service allows medications to be prescribed and forwarded to the patient’s pharmacy and discharge summaries sent to the patient’s regular GP, with a plan to expand the service to other healthcare professionals, which could potentially include GPs, over time.

Northern Health then announced that it too would add Ambulance Victoria to its triage service, allowing paramedics to use the Virtual ED service from a patient’s home and receive emergency medical advice and care. The Virtual ED and Ambulance Victoria partnership covers the north-eastern catchment area and follows the launch of the virtual service last year for patients and GPs. The service allows patients to talk virtually to a triage nurse on their phone or laptop, and includes an ED specialist medical telehealth option to help GPs and community healthcare providers to identify patients that traditionally would have been referred to ED. In June, it received funding from the state government to go statewide, with an expanded Victorian Virtual Emergency Department (VVED). It uses technology including Healthdirect’s Video Call system and a patient registration and intake platform from NZ firm The Clinician.

In May, a consortium led by technology solutions and services firm Leidos Australia was named as the winner of the long-standing Joint Project 2060 (JP2060) Phase 4 eHealth system replacement project for the Australian Defence Force (ADF). The $329.6 million, seven-year contract will see the existing Defence eHealth System (DeHS) that uses the UK’s EMIS practice management system replaced with a contemporary system using cloud PMS vendor MediRecords for the primary and allied healthcare requirements, telehealth specialist Coviu for the telemedicine capability and Alcidion to aggregate data from consortium partner solutions to provide a single, consolidated, longitudinal view of participant health status and history. It also involves pharmacy software and electronic prescription exchange service Fred IT, oral health management software vendor Titanium Solutions, instrument tracking solution vendor Precision Medical, and data, analytics and tactical planning specialist Ascention. Radiology solution giant Philips Electronics Australia is also on board, as is EMR giant Cerner for the deployed critical care capability.

Australia needs a co-designed, accessible, and fully funded national virtual care strategy, the Australasian Institute of Digital Health argued.

As Australia headed for a federal election, the Australasian Institute of Digital Health recommended the development of a fully funded, national virtual care strategy in its 2022 election statement, calling on parties and candidates to support continued investment in the digital enablement of healthcare. A national virtual care strategy is one of three themes it has outlined its ‘Shifting the dial on Australia’s transition to a digital health future’ statement. The other two cover a commitment to a digitally enabled health workforce, and investment in the infrastructure needed for a 21st century healthcare system. Australia needs a co-designed, accessible, and fully funded national virtual care strategy, the institute argued, along with investment in a digitally equipped and trained workforce and in the infrastructure that underpins the delivery of healthcare in the 21st century.

The Aged Care Industry IT Council (ACIITC) announced it was working with the Australian Digital Health Agency on developing guidelines for the use of the My Health Record in the aged care sector, with hopes they can improve on the ‘dismal’ uptake of the system. Official figures show that just 14 per cent of residential aged care facilities are registered for My Health Record and of those, only three per cent are actually using it. The ACIITC has been working with ADHA on a big project looking at a range of issues for digital health in aged care, including digital infrastructure, the adoption of clinical software and its interoperability with external systems, as well as new initiatives for the My Health Record such as a transfer of care document. The project looked at infrastructure, the external use of clinical software in residential care, and interface issues with other providers such as allied health and GPs.

Funds began to flow for aged care software specialist vendors who were named in the first round of ADHA’s aged care industry offer, which aims to help vendors to enhance their software to incorporate My Health Record functionality, aged care transfer summary documents and medication management system interoperability. The industry offer was released in November last year and aims to assist vendors to better integrate with My Health Record, including adding an aged care transfer summary to the system. While the transfer summary is still a work in progress, the industry offer is the first phase in ADHA’s new aged care program of work, which also involves improving secure messaging integration, educating the workforce and improving digital literacy. There is also a program of work led by the federal Department of Health on electronic national residential medication charts (eNRMC).

The long-term investment will see the procurement and implementation of a statewide electronic medical record (EMR).

While WA Health insists it is still committed to a statewide electronic medical record as part of its 10-year digital health strategy, just $4.4 million was allocated towards planning for the initiative in the state budget in mid-May. Instead, $38.1m was allocated to rolling out the existing Opal digital medical record system at a five new hospital sites. The funds for the DMR are part of WA’s digital capability fund (DCF), which will see $18m allocated over four years for real-time data sharing. There was also money for the continued roll-out of the HealthNext ICT infrastructure program, and $250m for an emergency department package as part of a long-term system-wide approach to streamline patient flow, address the root causes of ambulance ramping, and implement alternative models of care to support treatment of patients in the most appropriate setting.

The Tasmanian state budget, on the other hand, saw $150 million allocated over four years out of an expected $475 million, 10-year investment in digital health technologies. The long-term investment will see the procurement and implementation of a statewide electronic medical record (EMR), an Ambulance Tasmania integrated electronic patient care record (ePCR), and a statewide clinical viewer for hospitals, community care, GPs, specialists and allied health to better access clinical information across care settings. There will also be a digital front door for patients through a consumer portal that will include scheduling of appointments, personal details and accessing results and medical advice, and a big emphasis on virtual care, following the success of its COVID@home project. Tasmania proposes to become the first Australian state to deliver a fully integrated healthcare system.

And in the Queensland state budget, funds were released to continue the statewide roll-out of the Cerner integrated electronic medical record (ieMR), with $240 million promised over the next four years in additional funding and an extra $60m contingency for year five. The ieMR roll-out was paused in 2019 in order to optimise the existing digital hospital stack just as it was set to be implemented at Queensland’s largest health service, Metro North Hospital and Health Service (HHS). However, it was implemented at Metro North’s Surgical, Treatment and Rehabilitation Service (STARS) facility when it opened as a completely digital hospital in April last year. Metro North, Darling Downs and Cairns and Hinterland HHSs were next in the queue when the roll-out was paused. Another $60 million has been earmarked for 2026-27.

Primary care

The SafeScript NSW real-time prescription monitoring system became available to prescribers and pharmacists across the state in May, following the first phase of its roll-out late last year in the Hunter New England and Central Coast regions. SafeScript NSW, built by Fred IT based on its SafeScript Victoria system, has been live at the Northern Sydney, Nepean Blue Mountains, South Western Sydney and Central and Eastern Sydney PHNs this year and is now available across the state. While similar systems have been made mandatory in other jurisdictions, it will remain voluntary in NSW for the time being.

Clinical and practice management software vendor Best Practice Software released a revision of its Bp Premier Saffron service pack three (SP3) containing the final changes users need to support the transition to Medicare web services. While most software moved over to the new system by the March 13 deadline, some BP users were given an extension. The new release is a requirement for practices that have not yet upgraded or made the move to Medicare web services to continue to transmit Medicare claims, additions to the Australian Immunisation Register (AIR) and to access other Services Australia functions after the June cut-off date.

A new digital and telephone service that provides ongoing mental health support for people with complex mental health issues was rolled out across five primary health networks (PHNs), allowing access to a digital participant portal through a health professional referral or self-referral. The guided service has been developed and delivered by national complex mental health organisation SANE and is will be initially available in the regions covered by the Capital Health Network in the ACT, the Central Queensland, Wide Bay and Sunshine Coast PHN, Central and Eastern Sydney PHN, and the Brisbane North and North Western Melbourne PHNs.

Acute care

Northern Territory Health announced plans to upgrade the Miya platform from Alcidion that it has used for over a decade and deploy the latest version of the Miya Precision solution to support patient flow and bed management between its major hospitals and satellite health services. The platform will also integrate with the Acacia electronic medical record that NT Health is rolling out across the territory, using InterSystems’ technology under the $259 million core clinical systems renewal program. The agreement will see NT Health deploy the latest Miya Precision solution utilising core modules Miya Flow and Access with the ability to add further modules over time across their entire network.

Royal Prince Alfred Hospital in Sydney extended its rpavirtual service first developed for palliative and chronic care patients and then ramped up to provide care for COVID-19 patients at home to a new virtual rehabilitation program and an intensive care service for critically ill patients at Broken Hill Base Hospital in western NSW. The vRehab is being used for adult patients requiring short-term intensive rehabilitation to allow them to be discharged from hospital earlier. The vICU program uses remote monitoring and video conferencing to connect clinicians, patients and carers in Broken Hill with intensive care staff at RPA and rpavirtual.

Monash Health announced it will no longer accept faxed referrals to its specialist consulting services following a two-year project to swap over to electronic referrals for GPs and other private specialists. Monash Health has made all of its specialist consulting services available by eReferral using HealthLink’s SmartForms technology, which allows users of Best Practice, MedicalDirector, Genie and Medtech Evolution to write and send a referral within their clinical information system using pre-populated forms. Those practices not using a HealthLink-enabled practice management system will be able to make an electronic referral through the online MyHealthLink portal. The system, which is free for GPs, provides them with notifications that the referral has been received, whether additional information is required and confirmation of an appointment booked with the patient.

Meanwhile, eHealth NSW officially went live with its Engage Outpatients electronic referral program, which involves HealthLink’s SmartForms technology and its referral management system (RMS) piloted throughout the state. Engage Outpatients was officially launched at Royal Prince Alfred Hospital but has been available in several primary health networks since last year, having been trialled by general practices in the NSW Northern Rivers region in association with Lismore Base Hospital. The plan is to change the management of referrals, triage and appointment scheduling in NSW hospitals through the capture of eReferrals, fax digitisation and transcription and scanning of paper-based referrals into an integrated referral management platform.

Aged care

West Australian aged care provider Bethanie announced it was running a trial of artificial intelligence technology to collect behavioural and health data in real time using sensors installed around its residential aged care facilities. The proof-of-concept trial will see the captured data processed using artificial intelligence and downloaded to a dashboard to give carers an insight into residents’ health and wellbeing. The trial is being run in association with Optus using InteliCare’s motion sensor, radar sensor and fall detector technology.

The University of Queensland’s Aged Care Data Compare (ACDC) project geared up a notch with the development of a data hub for aged care quality indicator benchmarking, the first step in establishing a minimum data set for the sector. The project aims to build tools to enable data to be exchanged between software solutions and across care settings using FHIR implementation guides for data exchange and to demonstrate that reliable and standardised data can be used to assist in monitoring the quality of care provided. ACDC has developed a suite of quality indicators that can be calculated from this data, and is also developing the data hub to allow provider organisations to confidentially share data and undertake benchmarking.

Regional, rural and remote aged care specialist integratedliving became the first provider to deploy a commercial application of the Smarter Safer Homes (SSH) technology to clients in their homes. Developed by the CSIRO, SSH is an in-home monitoring and data analytics program that works by unobtrusively monitoring activities of daily living and proactively alerting for anomalies that indicate an intervention is required. CSIRO signed a licensing agreement with ASX-listed aged care technology provider HSC Technology Group last year to integrate its the sensor-based in-home monitoring system with HSC’s platform. The technology has been developed over a decade by CSIRO’s Australian e-Health Research Centre (AeHRC) and tested in a number of pilots.

Pharmacy

Artificial intelligence analytics and facial recognition technology developer StrongRoom AI and pharmacotherapy software solution vendor EasyDose have joined forces, aiming to provide a consolidated platform for controlled drugs to pharmacies. StrongRoom AI provides an AI-driven controlled drug management platform aimed at reducing adverse drug events within pharmacy, hospital and aged care facility settings, while EasyDose provides a solution to streamline the daily dispensing of methadone and buprenorphine to opioid-dependent clients. EasyDose is mainly active in Western Australia, and the merger will help StrongRoom AI’s expansion plans.

Some of the more interesting software, apps and new players in the market that caught our eye this year included:

• Sydney Local Health District rolled out Vocera’s hands-free wearable communication devices to its emergency departments following a quick-fire trial in its ICUs. Royal Prince Alfred and Concord hospitals have adopted the new technology in their EDs as well as ICU. The badges are attached to the front of clinicians’ scrubs and can be worn under PPE. They are voice-activated and work off the hospital’s Wi-Fi, and are easy to clean.
• Pharmaceutical giant Pfizer made an ultimately successful bid of $100 million for AXS-listed respiratory health software developer ResApp Health in April. The company specialises in smartphone apps for respiratory health, with Therapeutic Goods Administration-approved products for asthma, pneumonia and COPD.
• Software solutions firm Harris Computer finalised the purchase of NASDAQ-listed Allscripts’ hospitals and large physician practice business, rebranding it as Altera Digital Health. Harris announced the purchase of Allscripts’ assets, which include the Sunrise EMR suite used by SA Health and some Victorian hospitals as well as the Australian-developed Opal digital medical record, formerly known as BOSSnet, in March this year for a price of $A950 million.
• The Royal Australian and New Zealand College of Radiologists (RANZCR) and the Australian Diagnostic Imaging Association (ADIA) released a SNOMED-based radiology referral set (RRS) aimed at enhancing interoperability and data accuracy between referrers and radiology providers. The RRS is described as a set of SNOMED CT-AU terminologies that can be used in the background of referrers’ software systems, providing greatly enhanced interoperability and data accuracy between referrers and radiology providers.

Want to know what happened next? We’ll have part three of our 2022 Australian eHealth year in review tomorrow. Click here for part one.