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.

Find out more

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.

Digital Health website

 

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

In an era driven by digital advancements and the increasing importance of data in healthcare, interoperability has emerged as a key priority for healthcare organisations and professionals.

Interoperability is the ability of different healthcare information systems to seamlessly exchange, interpret and use data.

It promises to improve patient care, enhance clinical decision-making and streamline administrative processes.

However, at the heart of this transformation lies a fundamental requirement – clean data. 

Clean data defined 

Clean data, in the context of healthcare, refers to data which is accurate, complete and consistent.

It is free from errors, redundancies and inconsistencies which could compromise its reliability and usability. Clean data is critical for enabling the efficient and effective exchange of information between healthcare systems, a prerequisite for successful interoperability. 

Challenges in achieving clean data

Clean data is not without its challenges.

Some common hurdles include data entry errors, inconsistencies in coding and terminology, varying data standards, and issues related to data integration and mapping between systems.

Addressing these challenges often requires a combination of technology, standardised processes, data governance and education. 

Coded data

Coded data refers to information which has been systematically converted into specific codes or symbols from a standardised terminology or classification system.

In healthcare, this is commonly used for various purposes, including recording medical diagnoses, procedures, medications and other clinical details.

These codes are structured to ensure consistency, accuracy and interoperability across different healthcare systems and providers.

They serve as a common language, allowing healthcare professionals to communicate and exchange information effectively. 

The challenge of using “free text” instead of choosing correctly coded terminology lies in the potential for variability and ambiguity in unstructured narratives.

When healthcare practitioners rely on free text to document patient information, it can lead to inconsistencies, misinterpretations, and hinder interoperability.

To overcome this challenge, healthcare systems and professionals should prioritise the following strategies: 

Data: the lifeblood of healthcare 

Data in healthcare encompasses a vast spectrum of information, including patient records, research findings, health measurements and more.

This data is the lifeblood of the health and care system, influencing every aspect of healthcare. 

When we think digital – we need to think data. Data will be the lifeblood of the health and care system as we move to digital. 

From data to insights 

Data and the information derived from it form the foundation of decision-making in healthcare.

This includes clinical decision-making, administration of healthcare services, research and patient empowerment.

Information aggregates relevant data from sources like patient records, research and medical inputs.

Interpreting this data provides insights which enable informed decisions. 

Quality data is the key to generating valuable insights.

It ensures accuracy, completeness, consistency, and reliability.

When data quality is upheld, trust and confidence in the insights generated are reinforced. 

Quality in data: creating value 

Maintaining data quality is a shared responsibility across the healthcare ecosystem.

Legislation, regulations and systems provide a framework for data management, but it is essential for individuals to embrace a culture of data quality. 

Quality data is data which is accurately captured, categorised, shared in a timely manner and free from duplication.

The healthcare system generates vast amounts of data, yet issues with data quality hinder its potential, leading to inefficiencies, errors and potential harm. 

Data quality and safer practice

Patient safety, care coordination and privacy rely on correctly linking patient data across healthcare organisations.

Duplicate records pose risks, including privacy breaches and reporting errors.

Safer practice, therefore, hinges on data quality. 

Importance of enabling and connecting care 

Digital health’s significant advantage is in connecting care across a patient’s journey.

This supports multi-disciplinary care and a seamless experience for patients, practitioners and caregivers. 

Connecting care involves linking information across health services, providers and consumers.

Digital systems such as the My Health Record, electronic prescribing and integrated medical imaging aim to enhance this connection, emphasising the need for high-quality data. 

Trusted data which follows the patient across health interactions with the many health providers and practitioners they encounter is the most important component to link and connect care. 

Managing personal data: patient expectations 

Patients expect healthcare organisations to responsibly manage their personal data, ensuring privacy and confidentiality.

This is vital for building trust and confidence in the healthcare system, leading to a more personalised and improved patient experience. 

Digital transformation: shaping the future of healthcare

Healthcare organisations must invest in data quality and governance, implementing best practices for data management to ensure the promise of interoperability can be fully realised.

Clean data is not just a technical requirement; it is the cornerstone of better healthcare outcomes and a more efficient, patient-centric healthcare ecosystem. 

Immediate actions 

• Training and education: Provide training and education to healthcare staff on the importance of using coded terminology. This helps them understand the benefits of structured data and encourages compliance.
• Use of EHRs: Electronic Health Records (EHRs) are designed to facilitate structured data entry. Encourage healthcare providers to use the structured fields within your clinical software for documenting patient information.
• Templates and decision support: Create templates and decision support tools within EHRs to guide clinicians in selecting appropriate codes. These tools can help reduce the reliance on free text.
• Quality assurance: Implement quality assurance processes to review and validate coded data to maintain accuracy and consistency.

Embracing a culture of data quality and understanding its importance is the cornerstone of creating a healthcare ecosystem which is safer, more efficient and more patient-centric. As healthcare professionals, it is our collective responsibility to uphold the standards of data quality for a healthier, connected future.