One of the biggest news stories in Australian digital health in a decade was the announcement by the Australian Digital Health Agency of a new, national Health Information Exchange, which was revealed at a very detailed industry briefing in July. That news would continue to dominate the rest of the year in digital health in Australia, along with AI scribes, NSW Health’s Single Digital Patient Record, and some very welcome news on eReferrals.
In early July, the Australian Digital Health Agency (ADHA) released a national healthcare identifiers roadmap to drive uptake of the Healthcare Identifiers (HI) Service, in association with the Department of Health and Aged Care and Services Australia. The service will undergo a restructure and upgrade under a new five-year plan that will see legislative and data quality changes as well as a review of its architecture and extensibility. The aim is to overcome problems such as inconsistency in HI use across healthcare programs, inconsistent understanding of the service, and the HI Services processes being difficult to engage with.
Global EMR giant Epic announced it will support the International Patient Summary FHIR specification when it is available in 2025 due to what it said was increasing demand for IPS implementations. The International Patient Summary is a minimal and non-exhaustive set of basic clinical data that is designed to make it simpler for healthcare organisations to exchange data securely across international borders. Epic also announced that FHIR will become a primary means of information exchange in the coming years, and that IPS is a first step in that journey.
But in mid-July, the biggest news of the year happened when ADHA gathered the digital health industry at a briefing in Canberra to discuss its plans to develop a health information exchange (HIE)-based approach to the national digital health infrastructure. The plans include going to market this year for products and services that will move the My Health Record system from a document-based repository to a modern, FHIR-enabled near-real time personal health record system, as well as a new national infrastructure operator (NIO) contract for MyHR.
The new infrastructure will include a national, harmonised view of all healthcare providers that participate in a person’s healthcare journey across jurisdictions and across care settings – a project known as The Directory – and will enable healthcare providers to search, identify and access individuals in the system securely using existing consent and access controls. ADHA said it will use a microservices approach and will include multiple, federated data sources, including the My Health Record, hospital electronic medical records, GP practice management systems and consumer-held data from apps and wearables.
ADHA subsequently put out an approach to market for FHIR server products and services for My Health Record and an industry offer for allied health clinical information system connections to My Health Record. ADHA made clear that the My Health Record will be one data repository within the HIE, and will be modernised through the switch from a CDA architecture to a FHIR-based repository, allowing for much more seamless exchange of data.
The rest of July was dominated by preparations for the annual HIC conference in Brisbane, which included a terrific presentation from Healthdirect medical directors Darran Foo and Todd Miller on an analysis of almost 50,000 callers to Healthdirect’s virtual nurse triage service that showed more than 50 per cent of those who planned to visit ED or call 000 were redirected to other services. Other presentations included whether AI can learn to analyse the meaning of children’s drawings, how to adapt large language models for automated summarisation of EMRs in clinical coding, how nurses and midwives are the not-so-secret ingredient in the layer cake of digital health across Australia and New Zealand, and a panel on transforming research with synthetic health data using “fake” patients.
The conference itself was highlighted by a great presentation by Microsoft’s Simon Kos exploring how Teams was the essential mobile clinical second screen and another filling in for Microsoft’s chief medical officer David Rhew on the topic of opportunities and challenges with AI in healthcare, accompanying UC San Diego Health’s chief medical officer and chief clinical and innovation officer (CCIO) Chris Longhurst on how his organisation is using AI in its emergency departments to analyse EMR data to gauge a patient’s risk of developing sepsis and how ambient AI documentation can reduce pyjama time. Dr Longhurst was undoubtedly the star of the whole show.
For us, though, our favourite story of the year was part of a presentation at HIC by Royal Melbourne Hospital physiotherapist Julie Louie on the hospital’s patient portal, which uses Epic’s MyChart Care Companion app and platform. Ms Louie’s Parkville Precinct colleague Kath Feely gave a super talk on the portal at the Digital Health Festival in May in what was one of the best presentations we have seen on a practical implementation that has gone right for all the right reasons.
Also at HIC, Telstra Health launched a new FHIR-based API called Smart API+, which it says will support seamless integrations with partner solutions and provide customers with access to data and data exchange across Telstra Health’s primary care software solutions. Dedalus announced it was bringing its Trials4Care (T4C) secure research environment to Australia, offering a clinical trial and research platform for healthcare organisations to drive medical research.
And Magentus revealed it had expanded its roll-out of interoperable electronic requesting capability in its Genie and Gentu practice management platforms through a partnership with pathology provider Healius. The eRequests solution is Australia’s first Open FHIR API standards solution and was first developed in a partnership with Sonic Healthcare, where it was trialled in Sullivan Nicolaides Pathology labs and went live last year. It is available across the Sonic Healthcare network nationwide, and is now live with Healius, which together make up about 65 per cent of the private pathology market.
There was welcome movement in NSW eReferrals management with the expansion of the Engage Outpatients eReferral program, which involves the roll out of HealthLink’s SmartForms technology for eReferrals and NSW Health’s electronic referral management system (eRMS) across multiple Local Health Districts (LHDs). Six LHDs are now implementing eRMS, including Western Sydney LHD, which began piloting the system last year, and South East Sydney LHD, which began piloting the system at 23 outpatients clinics at Prince of Wales Hospital in early 2024.
Other NSW LHDs and specialty networks are using different eReferral solutions. Hunter New England Health has used BPAC’s SeNT eReferral software since trialling it in 2016, while Sydney Children’s Hospitals Network (SCHN) is using a system from Sydney-based start-up Consultmed. Consultmed would have some big news on another LHD later in the year.
And the $1 billion Single Digital Patient Record (SDPR) project for NSW is up and away, with eHealth NSW announcing in September it had completed the build of the SDPR hosting environment in the Amazon Web Services (AWS) Cloud, the first technical step in rolling out Epic’s electronic medical record across the state. eHealth NSW described the AWS landing zone as a secure, scalable and foundation for how the EMR will be managed and deployed for the SDPR project.
The project is currently in the preparation phase for go live, which will last until early 2026 and includes configuration, testing and training. The lead roll-out site is Hunter New England LHD, where it is planned to be implemented early in 2026, along with Justice Health & Forensic Mental Health Network and the first laboratory information management system (LIMS) – also using Epic technology – in the HNE region, known as LIMS North.
The clinical director for the SDPR program at Sydney LHD, Angus Ritchie, said that when fully rolled out in five years, it will be the largest – or maybe just the second largest – single instance of Epic in the world.
Primary care
The Australian Digital Health Agency’s Provider Connect Australia (PCA) service was upgraded to allow clinical and practice management software system to connect to the service through a SMART on FHIR interface. PCA allows healthcare providers and business partners to maintain accurate and up-to-date business information in a single place that can then be published to multiple partners. The upgrade means PCA can now use SMART on FHIR to connect to a practice management or clinical system to import details of the practitioners at the practice rather than having to manually enter them into PCA.
The Hunter New England and Central Coast PHN partnered with data insights specialist Cubiko to roll out a support platform to practices in the region taking part in its sustainability and viability initiative (SAVI). Cubiko’s Sustainability Support Platform has been developed in response to longstanding concerns about the fragile viability of general practices as businesses and aims to equip them with the ability to optimise operations, improve efficiency and elevate patient care outcomes. It is one of a number of data analytics tools being used to support general practices.
The RACGP released guidance on using AI scribes in practice, warning that GPs will be liable for errors within the patient health record even if they are generated by the AI scribe and they must obtain consent from a patient to use an AI scribe in the consultation. The guidance also recommends that GPs consult with their medical defence organisation before proceeding, with MDOs such as Avant releasing its own advice on the tools, saying errors in clinical notes may cause patient harm if they are not checked for accuracy.
The Hunter, New England and Central Coast PHN launched an AI-enabled general practice initiative, looking for 10 practices in the region with strong digital maturity to test AI-powered solutions in their practices. Examples of tools to be investigated include AI-powered documentation such as ambient listening for notes, pre-consultation questionnaires and intake forms, workflow optimisation and task management tools, patient record and appointment management software, predictive analytics for operational insights, and virtual assistants for administrative support. The program will run for the next year, with selected practices becoming flagship sites that will lead and communicate with other practices to share their experiences and demonstrate the value of AI.
Acute care
Global electronic medical record vendor MEDITECH has collaborated with Google Cloud to develop an AI-powered search and summarisation capability in MEDITECH’s Expanse EMR to enable care teams to find the information they need using Google’s familiar search function. Powered by Google Cloud’s foundational and generative AI capabilities, the Expanse search and summarisation tool uses natural language processing and a large language model to delve into the medical record and extract data that is presented in context to the user from within their workflow. It is due to be rolled out worldwide next year.
An independent study of the implementation of Alcidion’s Miya Precision FHIR events platform at Melbourne’s Alfred Health found that adopting electronic patient journey boards (ePJBs) with two-way integration with EMRs and PAS systems can improve patient flow. The study was conducted by Monash University and the Digital Health CRC and involved an evaluation that formally reviewed the impact and effectiveness of the Alcidion ePJBs across The Alfred, Caulfield, and Sandringham sites. The Monash DHCRC study found that prior to the deployment of Miya Precision, wards experienced a 25 to 40 per cent discrepancy between patient information in the EMR and the whiteboards used to manage patient care.
Virtual care
Melbourne’s Northern Health rolled out two Victorian Virtual Emergency Department (VVED) pods in its physical emergency department to offer a virtual alternative to patients presenting with non-life-threatening emergencies. The pods are also being used in the ED waiting rooms at Austin Hospital and Sunshine Hospital, with the VVED service planning to expand these into more regional and metro areas. The pods allow patients to receive a full video consultation and assessment by VVED clinicians and advised of the appropriate next steps, which may include alternate care providers instead of in the physical ED.
The roll out of virtual care across all custodial facilities in NSW is improving access to health specialists and reducing transportation costs for off-site healthcare. NSW Justice Health and Forensic Mental Health Network chief digital health and information officer Neville Board said virtual care was now available at all 38 custodial facilities in the state, including youth justice. A major benefit of the virtual care roll out had been better access to health specialists for prisoners, such as the Tele Smiles program for oral health assessments.
Virtual care provider iAgeHealth signed an agreement with the Roper Gulf Regional Council in the Northern Territory to implement a 24/7 virtual allied healthcare platform for aged care clients to receive support in their own home. The program, which provides client aged care clients recovering from illness or injury and managing chronic health conditions to receive care not available in remote areas.
Aged care
In what has been a momentous year for aged care, there was a big breakthrough in digital support with the release of the national Aged Care Data and Digital Strategy and action plan. Virtual nursing in aged care, the integration of My Aged Care with My Health Record, clinical information system standards, and AI and virtual reality technology pilots in aged care were all on the menu. Of the 23 projects and initiatives outlined in the action plan, all are at least in the planning stage or are underway. Some of the larger projects include the enhancements to My Aged Care that is currently underway, the My Aged Care to My Health Record integration and the aged care transfer summary.
In August, DOHAC announced that client support plans developed for people accessing aged care services and available on the My Aged Care (MAC) system will soon be able to be shared with the person’s My Health Record (MyHR). The new arrangements, which became available in December, will see the PDF-based client support plans packaged as clinical document architecture (CDA) documents and uploaded to the person’s MyHR with their consent. They will then be able to be viewed by healthcare professionals involved in their care.
And later in August, DoHAC and ADHA released Australia’s first ever aged care clinical information system (ACCIS) standards, which outline the minimum software requirements for every residential aged care facility’s clinical information system (CIS) and electronic medication management (eMM) software. Developed in collaboration with the aged care sector and software developers. Chief technology advisor at the Aged Care and Community Care Providers Association (ACCPA) George Margelis said the ACCIS standards would support the much-needed adoption of digital technologies in the aged care sector.
Some of the more interesting software, apps and new players in the market that caught our eye this year included:
Telemedicine provider My Emergency Doctor (MED) has implemented InterSystems’ HealthShare Health Connect Cloud solution to provide systems interoperability for MED’s virtual board rounds service at a 60-bed emergency department.
South Australian clinical software provider Clintel Systems has added a new digital front door module to its flagship CareRight platform, including customisable smartforms for eRegistration, eAdmission, and enhanced online communication with clients.
Digital health firm Oexa released what is thought to be the first consumer-focused digital prescription app to integrate with the My Script List (MySL) national active script list system. The free app is aimed at helping consumers manage multiple eScript tokens sent via SMS by consolidating all prescriptions into a single and secure application.
Hobart’s HealthCare Software (HCS) worked with Ambulance Tasmania to roll out its controlled drug management (CDM) solution for pre-hospital and emergency services across the state. The CDM solution, which is also used by Ambulance Victoria and St John Ambulance in WA, is now being marketed to ambulance services in the UK and Ireland through a distribution agreement with Swedish-based pre-hospital specialist Ortivus.
Avant Practice Solutions launched its VoiceBox Intelligent Transcription solution on the general market, promising an end-to-end dictation-to-transcription solution designed by doctors that helps to streamline medical correspondence. VoiceBox IT is a fully secure and data-protected smartphone app which is designed to record, format and deliver transcripts at the touch of a button.
Secure messaging system vendor HealthLink integrated its SmartForms functionality into Telstra Health’s cloud-based practice management system Helix. The integration has seen HealthLink become Telstra Health’s first partner to integrate with a Telstra Health product using its Smart API+ solution, which offers technology partners a unified FHIR-based gateway to connect with Telstra Health’s primary care software.
Cloud-based electronic health record and practice management system vendor MediRecords is now offering users an integration with Heidi Health’s AI medical scribe. The AI note-taking technology aims to streamline clinical documentation for doctors, with the integration meaning users won’t need to log into separate software or cut and paste across browser tabs.
Telstra Health said it plans to integrate the electronic screening and risk prediction tool for deterioration in aged care residents that it has developed with RMIT University into its clinical and care management software. The tool is similar to those used in acute care settings to detect deterioration but RMIT says it marks the introduction of a predictive tool for frail residents in residential aged care.
