My Health Record replatforming talks begin

The Australian Digital Health Agency has begun talks to replatform the My Health Record system ahead of the 2020 expiry of its multi-million deal with national infrastructure provider Accenture.

Accenture has held the deal for the design, build and integration of the system since 2011, when it was known as the personally controlled electronic health record (PCEHR).

Leading a consortium of suppliers, including Oracle and Orion Health, it has built the system’s core IT infrastructure and operations centre from the ground up.

It has also been responsible for the portals used by healthcare suppliers and consumers to access the record.

The system has cost the government in excess of $387 million to get to a point where 5.8 million people are registered, according to iTnews analysis of AusTender contracts.

This excludes the day-to-day operation of the system, which is provided by the Department of Human Services, and is likely to grow significantly once the three-month opt-out period concludes.

However, with the contract expected to expire in 2020, ADHA is now starting to look at moving to a “new, more flexible platform” using a portion of the $374 million allocated to the My Health Record in last year's federal budget.

Replatforming the system to an “open source environment using cloud technology” has already been raised to help reduce costs, with further funding to follow once this is decided.

Chief operations officer Bettina McMahon told an AIIA industry briefing last Friday that the agency has held “an initial kick off meeting with the standards organisations” on the next steps for the record.

She said it was also being advised by Australian health informatician and Fast Healthcare Interoperability Resources (FHIR) project lead Grahame Grieve on the Argonaut Project in the US, which is focused on improving information sharing standards across health records.

The hope is that by talking to clinical and technology peak about what a platform means, the agency can “[revisit] what role a My Health Record should play in Australian healthcare” instead of going to market with the same requirements, she said.

The agency will be looking to capitalise on the technological changes that have occurred since the system requirements were developed for the original tender in 2009/10.

“We have new technologies available, new methods available that you’re all using today,” she said.

“We’ve also got a lot broader interoperability between systems and there’s a lot more understanding of what’s happening globally as well.”

The agency is expected to “come out [to industry] with a more open approach” shortly to help shape its thinking.

Secure messaging moves ahead

While My Health Record remains the major focus for the ADHA ahead of the start of the opt-out period next month, it is also making waves with secure messaging.

The agency just last week reached “threshold agreements” [pdf] with clinical and secure messaging systems organisations for national interoperability and secure messaging.

The agreement will see the adoption of compliant messaging standards, conformity of clinical systems and other tools and process to make communication more seamless.

“We’ve got complete consensus amongst all of those players for the standards that we’re going to be supporting, for the way that we’ll be authenticating, for the way that we are going to support moving forward in terms of compliance, and secure messaging,” McMahon told the briefing.

Secure messaging remains largely non-existent across Australia, with fax machines often the primary method of transferring clinical information between healthcare providers.

This is despite a 2013 review of the PCEHR recommending that a standardised secure messaging platform be introduced.

But the national digital health strategy is committed to changing this through the introduction of secure digital channels.

A number of proof of concept projects led by Telstra Health and Healthlink consortiums have been progressing over the last 18 months.

The Telstra-lead trial is testing the delivery of discharge summaries from Royal Melbourne Hospital to GPs, while Healthlink is testing the delivery of referrals from GPs to specialists.

Both consortia are also building a federated search capability for healthcare provider directors