Topic: Digital health

The start of 2024 has been busy with the expiry of NASH (National Authentication Service for Health) certificates for many general practices, specialists, pharmacies and allied health providers.

Many of these organisations would have received an email from SWSPHN a month before their certificates expired, reminding them to renew and offering assistance with downloading and installing their certificates.

What is NASH?

NASH was introduced in 2012 and is a Public Key Infrastructure (PKI) solution used to access digital health services such as:

• Electronic prescribing
• My Health Record
• Secure messaging
• Healthcare Identifiers (HI) Service

Why is it used?

NASH is used by healthcare provider organisations and supporting organisations to:

• authenticate and securely access digital health services
• digitally sign documents and other transactions
• encrypt health information for secure exchange

Many practices in South Western Sydney have been reporting they are receiving duplicate electronic discharge summaries.

Normally, when a patient is discharged from hospital they are provided with a paper copy of their discharge summary for them to give to their GP and a digital copy is forwarded to the GP.

If the doctor at the hospital decides to make changes or add new information to the discharge summary, a new digital copy will be sent.

For example:

• discharging clinician at the hospital has created the discharge summary document for the patient and has sent the digital copy to the GP
• five to 10 minutes later, they make changes or add information to the discharge summary and a new copy with the changes is sent electronically to the GP
• for the receiving GP, this will appear as if the document has been duplicated as there may have been only minor changes
• if the GP reads the document in its entirety, it may become clearer the document contains updated information, however the wording does not inform the GP of what has been added or changed

Top tip: Take a look at the end of the discharge summary document for the document version number.

Electronic discharge summaries not being delivered?

Shortly, we’ll be in touch with practices and GPs in our catchment who have previously not consented to their information being shared with South Western Sydney Local Health District (SWSLHD) for the purposes of maintaining practice and practitioner records in SWSLHD’s systems.

SWSPHN has been working closely with SWSLHD to audit and finalise secure mechanisms for sharing practice records.

This will help ensure electronic discharge summaries have the best chance of being distributed to the correct practice and GP after a patient admission.

Top tip: You can also check My Health Record for any electronic discharge summary records for your patients.

Digital health questions? Contact our team

If you are having any issues with electronic discharge summaries (including delivery) or any other digital health issues, contact our friendly and knowledgeable team at SWSPHN at digitalhealth@swsphn.com.au.

Any healthcare organisation, whether a large, multi-clinic medical practice or a solo private provider, must have a My Health Record security and access policy in place if registered to participate in the My Health Record system.

Maintaining and promoting this policy is an important way of ensuring the system is used safely and responsibly by staff.

There are several useful resources to assist you with developing or maintaining your policy and meeting the ongoing participation obligations.

A key requirement of any healthcare organisation’s policy is to ensure that users of My Health Record receive training before being authorised to access the system.

The training should include:

• how to use the system accurately and responsibly
• legal obligations of the healthcare provider organisation and people who access the system on behalf of the organisation
• the consequences of breaching those obligations

Users need to understand when they can view or upload information to My Health Record as well as the appropriate and lawful use of the emergency access function.

Provider Connect Australia (PCA) is an efficient way to update the business details of GPs and other healthcare providers moving in and out of your practice.

The free PCA, an initiative of the Australian Digital Health Agency, provides a single place to update your business information and services, which can automatically update your National Health Service Directory listing and your local Primary Health Network.

This ensures your information is correct and saves you time by reducing the duplication required if you had to manually inform all your business partners when changes occur at your practice.

Your business partners not using Provider Connect Australia?

PCA is working to add business partners.

If your business partners are not using PCA, let them know they can contact pca@digitalhealth.gov.au to get signed up to start receiving updates about changes at your practice.

How to sign up

Follow the steps from this guide Provider Connect Australia – Register or contact SWSPHN’s Digital Health team at digitalhealth@swsphn.com.au for assistance.

After 24 March 2024, the HI Service, My Health Record and electronic prescribing will no longer support connections from NASH SHA-1 or Medicare PKI certificates.

To maintain connection to these services, transition to a NASH SHA-2 certificate before 24 March 2024.

If you are using a NASH SHA-1 certificate for purposes other than the HI Service, My Health Record or electronic prescribing, when the certificate expires you will only be able to request a NASH SHA-2 certificate. It is your responsibility to be aware of any impact this may have to the way you use NASH.

Visit digitalhealth.gov.au/nash for more information and resources.

Need help with NASH certificate renewals?  Find out how SWSPHN can assist your practice.

Secure messaging has become an indispensable tool for the reliable, secure and timely exchange of critical information between healthcare organisations and practitioners.

To ensure the efficiency and effectiveness of these communications, it is essential healthcare practices keep their contact details up-to-date with secure messaging providers.

The vital role of secure messaging

Secure messaging is the backbone of various healthcare services which require the swift transmission of sensitive data.

This method of communication plays a pivotal role in the following key areas:

• Pathology and imaging results: The transmission of test results is crucial for diagnosis and patient care. Secure messaging ensures these results are delivered promptly and securely to the right healthcare providers.
• Hospital discharge summaries: Effective care coordination relies on the seamless transfer of patient information between hospitals and primary care providers. Secure messaging streamlines this process, enhancing patient safety and continuity of care.
• Referrals and correspondence: GPs often need to collaborate with medical specialists and allied health professionals. Secure messaging enables the exchange of referrals and essential medical information to deliver comprehensive patient care.

The importance of keeping information up-to-date

Maintaining up-to-date contact details for practitioners within your healthcare practice is vital. Failure to do so can result in significant challenges, including:

• Practitioners being unsearchable: When a practitioner leaves your practice or joins a new one, their ability to receive secure messages depends on the accuracy of their contact details. Outdated information can lead to them becoming unsearchable at their new location.
• Messages sent to the wrong place: Using old contact details may result in messages being sent to practitioners at their previous practice, creating delays, misunderstandings and compromising patient care.

Secure messaging providers in Australia

To effectively manage your secure messaging, it is crucial to be aware of some of the prominent secure messaging providers in Australia.

These providers facilitate secure and seamless communication within the healthcare sector:

• Argus (Telstra health)

Argus is a leading secure messaging provider, offering a range of services to support healthcare organisations for their communication needs.

• Medical Objects – medical software and secure messaging

This provider offers medical software and secure messaging solutions, designed to enhance the efficiency of healthcare communication.

• HealthLink

HealthLink is another trusted secure messaging provider in Australia, dedicated to improving communication within the healthcare community.

Ensuring accurate secure messaging

To maintain accurate secure messaging, follow these steps:

1. Update contact details: Ensure your practice regularly updates practitioner contact details with your secure messaging provider.
2. Notify the provider: When a practitioner joins or leaves your practice, promptly inform your secure messaging provider to update their information.
3. Seek assistance: If you encounter challenges or need guidance regarding secure messaging, don’t hesitate to contact the Digital Health Team at SWSPHN at Digitalhealth@swsphn.com.au

Our Digital Health and Data Manager, Nick McGhie, has been awarded the “Best Paper Submission” at the HIMSS APAC 2023 conference in Indonesia’s capital, Jakarta.

The conference in September was hosted by US-based HIMSS (Healthcare Information and Management Systems Society) and aimed to activate digital transformation and advance digital health capability in the Asia Pacific region.

The award embodies the hard work and dedication Mr McGhie (pictured left), and our entire Digital Health and Data team have put into their goal to improve healthcare coordination, with iRAD, powered by dbMotion, at the heart of their strategy.

The award-winning paper ‘Real-time health information exchange’ focuses on the Integrated Real-Time Active Data (iRAD) tool, designed to revolutionise the real-time exchange of patient information, especially between hospitals and GPs in South Western Sydney. 

Mr McGhie said the presentation was more than just a product pitch but aimed to shed light on the lessons learned, ongoing challenges and their mitigation strategies. 

“I wanted to frame it as an accessible presentation of iRAD. There’s a lot of talk at the moment in Australia but, of course, internationally around health information exchange and how to achieve that,” he said.

iRAD was launched by SWSPHN in 2016, with a vendor selected in 2017. The project was first delivered at five sites in 2019, with more general and specialist practices joining the iRAD program in 2020. iRAD has now seen a significant expansion in scope and impact, with 25 per cent of primary care locations in South Western Sydney using iRAD. 

“The scope of it now, it’s obviously increasing not just in the locations that are connected, but also the patients who are consented – over 20,000 now,” Mr McGhie said. 

SWSPHN’s iRAD project has transformed and improved the sharing of patient information within primary healthcare. 

“Why can’t you see that information?’ We hear it all the time,” Mr McGhie said.

“As patients, we get frustrated when our healthcare providers don’t have our complete health picture, and the frustration is mutual. Our region is diverse, with half the population speaking languages other than English at home, which adds to the challenge.

“Working with Altera, we’ve made a way to ‘share by default.’ Clinicians can now access patients’ information in real-time, even from outside their practice. Patient consent is crucial for this to work,” Mr McGhie said.

The Digital Health and Data team’s recognition at HIMSS APAC 2023 was a collective effort, with each member contributing their skills and showing their commitment to shaping a better future for healthcare data management within our region.