Dedalus ANZ’s National Identifiers and Healthcare Connector (NIHC) package has been granted access to the Healthcare Identifiers (HI) Service and My Health Record, in what the company called a “complex process” that ensured robust security measures.

The development would see benefits for health providers as well as patients, by facilitating timely access to medical records and offering added functionality for users.

Dedalus ANZ interoperability team lead Marcus Shirrefs said the company had stepped its NIHC package through conformance and production access four times as it progressively added functionality and support for additional use cases. 

Mr Shirrefs said NIHC was originally granted production access to the Healthcare Identifiers Service in December 2023 to support its i.Pharmacy package and integration with electronic script exchanges and active script list systems. 

“We then added the ability to view a patient’s My Health Record in August 2024, supporting our webPAS offering. Our latest conformance steps were adding the ability to upload Discharge Summaries from webPAS to a patient’s My Health Record, which was granted production access in November last year.”

COMPLEX PROCESS

“Gaining access to the Healthcare Identifiers Service and the My Health Record platform is a complex process which involves assessing the use cases you are seeking to support, determining which requirements and compliance steps you’ll need to address and then, once developed, stepping through detailed testing – self attested and observed, capturing the necessary evidence and submitting it for evaluation,” Mr Shirrefs said.

“Multiple product development teams at Dedalus have worked together to deliver these capabilities with a significant cross-functional testing effort involved to ensure we’ve interpreted and addressed the compliance requirements correctly.” 

Mr Shirrefs said Dedalus took its responsibility to help healthcare providers meet their legislative and accreditation obligations seriously. 

“From regular changes such as annual modifications to statutory reporting, to aspects such as the recent ‘Sharing by Default’ health legislation amendment, we’re seeing conformance requirements changing more frequently as bodies such as DOHAC and ADHA execute against the National Digital Health Strategy.” 

Mr Shirrefs said the Australian Commission on Safety and Quality in Healthcare had mandated health service organisations to work towards implementing systems that could provide clinical information into the My Health Record, and Dedalus’ development of NIHC had been undertaken to support those requirements.

“In developing NIHC as an integration component into those national services, we’re seeking to consolidate the development work and conformance requirements as more and more of the Dedalus offerings look to connect and support our customers’ needs to help meet and stay ahead of the accreditation check points.”

Mr Shirrefs said Dedalus’ NIHC roadmap included future integration of i.PM, MedChart and our Orbis EMR offering for varying aspects of those national systems. 

“Through NIHC, we’re seeking to have a single code base that can service all our regional products, consolidating the ongoing conformance testing efforts into one single platform, making it a more commercially viable option than healthcare providers all having to undertake their own conformance testing again and again.”

BENEFITS FOR PROVIDERS AND PUBLIC

Mr Shirrefs said that as Dedalus talked to customers about connecting with the national services, it found benefits that went beyond “just passing their next accreditation check.”

“For example, the My Health Record system delivers a raft of functionality that may mean that a health service provider can now support a range of functions empowering their patients. 

“My Health Record has covered patient identity, authentication and authorisation through their MyGov login process. They deliver a secure web portal to patients that want to view details of their encounters with our health systems as well as the My Health mobile app. 

“They manage record sharing by a patient to other people, be that a parent viewing a dependent child’s record, or an individual choosing to share their record with another person – such as an elderly patient that may wish to share their record with their own, adult children.”

Mr Shirrefs said the My Health Record system also covered access to that record by other health professionals, including security, identity, authentication and authorisation checks. 

“A healthcare provider that sought to build out an equivalent solution to share medical records securely with patients and other, third-party health care providers would be faced with solving all those functional aspects of such a solution.”

For patients, timely access to their record for their own purposes would give them transparency over their medical records that had been difficult to achieve in the past, Mr Shirrefs said.

“Trying to remember that long list of medications you were discharged from hospital with when you next visit your GP can be difficult. However, through a detailed discharge summary, a patient can just ask their GP to look up their My Health Record to view that discharge meds summary on their hospital discharge summary.”

TECHNICAL SPECS

Mr Shirrefs said NIHC was a .Net based application supported by Microsoft SQL server and was combined, where necessary, with Dedalus’ DC4H Integration Engine in order to facilitate the necessary integration with a customer’s software packages. 

“Integration with NIHC is achieved via REST based APIs while we can deploy our integration engine to manage the conversion of older integration approaches such as HL7 v2 messaging to the more modern APIs we’ve built NIHC around.

“We’ve stepped NIHC through the necessary conformance steps to be able to offer it as a Contracted Service Provider (CSP), where Dedalus host and manage the software on behalf of a healthcare provider organisation, and also under the Clinical Information System (CIS) model where clients choose to host and manage the solution themselves – effectively ‘on-prem’.”

Mr Shirrefs said the CSP model removed a customer’s need to support any of the underlying technologies, “as our managed service offering provides full support from infrastructure upwards.”

SECURITY MEASURES

Mr Shirrefs said the conformance measures required of any software package connecting to the Healthcare Identifiers Service and the My Health Record covered a wide range of security and privacy functionality.

“So by stepping NIHC through the conformance testing and being granted production access to those national platforms, we’ve proven the software meets those requirements. 

“When a client chooses to host NIHC themselves under the CIS model, a range of security aspects become their responsibility, while under our managed service offering (CSP model), Dedalus ensures that NIHC is operated in a fully secure manner.”

Mr Shirrefs said security measures undertaken by Dedalus included:

• Encryption at rest and encryption in flight.
• Commonwealth NASH certificates when connecting to the national services.
• Role-based authorisation control mechanism in NIHC, and building in support for oAuth2 flows to allow customers to enact their own security standards, such as multi-factor-authentication.
• Commissioning independent third-party penetration testing of Dedalus hosted CSP solution.
• Any major changes to the software require additional conformance testing and certification.

Mr Shirrefs said the pace of change in the national interoperability space, with the adoption of HL7 FHIR in the My Health Record and the recently announced national HIE meant that maintaining conformance and matching the capabilities of the federal platforms were “key to offering an integrated set of software products.”

“Something that Dedalus has committed itself to for our existing clients and healthcare providers seeking to adopt compliant solutions,” Mr Shirrefs said.