1. Tasmanian HealthConnect Trial e-Government Seminar Carole McQueeney August 2003

2. This session … The health sector – why HealthConnect! The HealthConnect Project – where it has come from? The HealthConnect model – what is it? An overview of the Tasmanian HealthConnect Trial. Progress to date. Questions

3. Australian health sector … Is complex! 20 million users 640,000 employed in the sector $54 billion a year (or 8.5% of GDP) Split constitutional responsibilities Public, for profit % not for profit sectors all play a role 48% Commonwealth funding, 23% State, 28% non-govt 5.9m hospital admissions, 214m Medicare services a year Information is held in silos AIHW ‘Australia’s Health 2002’

4. A proposed system to enable the safe and secure electronic exchange and storage of personal health information on an Australian wide basis. ‘right information, right place, right time’ What is HealthConnect?

5. 2000: Australian Health Ministers agreed 2 yrs R & D work fundamental building blocks eg privacy legislation; & trialing the concept in ‘live’ health settings. 2001: A set of trials endorsed by the HealthConnect Board – with April 02 approval to fast track Tas and NT trials. 1999: National Electronic Health Records (EHR) Taskforce was created to explore the issue of EHRs in Australia. HealthConnect’s origins … 2002: Australian Health Ministers agreed further 2 yrs development, including 12 month Tas Trial extension

6. The research agenda … What is its value? Is it technically feasible? What is the preferred implementation model? How can we manage privacy? What is the best governance structure? What role should the private sector play? What will it cost and is this sustainable? First 2 yrs R & D aimed to answer 7 research questions Second 2 yrs R & D is aimed at furthering these but with a focus upon implementation perspectives.

7. Hospitals GPs Community Nurse Pharmacist Pathology Emergency Room Physio Consumers HealthConnect model

8. Hospitals GPs Community Nurse Pharmacist Pathology Emergency Room Physio Consumers Event summary Event Summary HealthConnect model HealthConnect Repository

9. Hospitals GPs Community Nurse Pharmacist Pathology Emergency Room Physio Consumers Event summary Event Summary Graphical summary of pathology results, Hospital or DEM discharge summary, Diabetes complications monitoring List of current medications Allergies & principal diagnosis Health Summary Diabetes complications monitoring Portable Electronic Health Record ‘Views’ HealthConnect model HealthConnect Repository Secondary uses – planning and research

10. Key HealthConnect components Registration Privacy/Security Consent Event Summaries and Views Unique identification Provider directories Messaging Interfaces Storage Information standards Coding/Classification/Controlled vocabularies Electronic health record architecture

11. Trial: Stage 1 Oct 02 – June 03 Adults with diabetes GPs Royal Hob Hosp Emergency Dept RHH diabetes clinics Priv Pathology

12. Trial: Stage 2 July 03 – June 04 Adults with diabetes GPs Royal Hob Hosp Emergency Dept RHH diabetes clinics Priv Pathology Priv Optometry Priv Endocrinologists Priv Opthalmologists Priv Podiatry Diab Aust Educators Priv hospitals Priv anaethetists Community Pharmacy

13. The HealthConnect record … … is essentially comprised of ALL key health information (NOT just diabetes specific) including … Presenting problem Diagnosis Procedures Medications Alerts/Allergies Key observations Pathology results Inpatient medical imaging reports General comments

14. The Trial arrangements include … Healthcare providers let people know about the Trial. Recruitment interview (generally in their home). Participants state who can access their record. Key background health information is collected. Provider and consumer user accounts are set up. Providers forward event summaries when care is given. Providers & consumers web based secure ‘viewing’ of records. Access audit log available to consumers at any point. Direct secure downloads from HealthConnect to GP records.

15. The Trial ‘system’ … Pathology Emergency Department Hobart Pathology HealthConnect Repository Medical Imaging Clinician completes electronic templates General Practitioners

16. The Trial ‘system’ … Pathology Emergency Department Hobart Pathology HealthConnect Repository Medical Imaging Clinician completes electronic templates General Practitioners All new participating providers

17. The Trial ‘system’ … Pathology Emergency Department Hobart Pathology HealthConnect Repository Medical Imaging Clinician completes electronic templates General Practitioners All new participating providers

18. Activity to date … … in the trial’s first 9 months … 1757 GP summaries 1801 community pathology results (GP ordered) 290 hospital summaries have been provided, of these 28 = Emergency 58 = Inpatient 113 = Outpatient Diabetes Specialist Clinics 91 = Diabetes Education Clinics 500 + user accounts have been established Records accessed 725 times (incl 70 times by consumers)

19. Key issues … Fast tracking … Consent arrangements – road rules that work for all … Standards, standards, standards … Terminology, classification, coding issues … Industry readiness eg. software data validation … Infrastructure and communications … Active stakeholder engagement … Walking before you can run in a time critical sector …

20. More information … Tasmanian Trial Team Phone: 6233 3608 Healthconnect@dhhs.tas.gov.au National HealthConnect Program Office www.healthconnect.gov.au healthconnect@health.gov.au Health Online www.health.gov.au/healthonline