Any plans on Front Desk becoming conformant with Digital Health/My Health Record?

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Hi there,
Just wondering what SmartSoft's plans/potential timeframe for becoming My Health / Digital Health record-conformant software is? If any? With non-medical prescribing coming online, increasing adoption by pharmacies, and the complexity of care increasing (as well as increasing volumes of valuable information being included) it would be great to know when we might have access to integration with FrontDesk.

Many thanks!
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Elyssa Hamad Mkali

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Posted 2 years ago

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Timothy, Business Care Manager

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Hi Elyssa. Thank you for your post.

Your question should be considered in the context that there are currently no allied health specific practice management systems that are compliant with My Health Record. 
 
Smartsoft is no stranger to developing integrations with essential third party services – Front Desk was the first allied health practice management system to integrate with Medicare and DVA Online and the first to develop integrations with HICAPS (first non-dental) and Tyro. We are certainly responsive to the needs of our users and the allied industry as a whole, but our official response at this time is that we are watching this space while we evaluate the uptake of My Health Record within our industry. 
 
As a first step, last year we became members of the Medical Software Industry Association so that we can have better industry knowledge and representation in regards to Government related initiatives.

I believe you don't need a PMS integration to use My Health Record functionality. You mention several general concepts "...non-medical prescribing coming online, increasing adoption by pharmacies, and the complexity of care increasing..."  You could contact ADHA and ask for access to the My Health Record portal and then come back to us with the specifics on how you have used their functionality in relation to the matters you have raised to assist you in your practice. 
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Elyssa Hamad Mkali

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Hi Timothy.

Congratulations on SmartSoft’s achievements and their very nice products.
Sorry I didn’t want to get bogged down in small details, but here’s some clarification as to why I ask the question I did.

1. It’s my understanding that conformant software is required in order to add events into My Health Record (MHR, formerly known as PCEHR). The internet accessible platform is problematic insofar as a) at present it only allows viewing of information, and b) where practice management software is conformant, it often allows you to see at a glance when a patient actually has an MHR (as well as to actually contribute to the MHR). Given at the moment it’s an opt-in system, that saves time running around logging in and checking if a patient is in the system or not.

So why might a podiatrist want to add events into MHR? Here’s a few reasons I have thought of..
a) Giving patients and their providers an easily accessible record of when they were seen and by which practitioner. Given not all Podiatry or Allied Health consultations are bulk-billed, this is not going to be adequately reflected in MBS billing data. For patients who are interested, it may help them keep better track of their Enhanced Primary Care (EPC) visit utilisation.
b) Non-medical prescribing. In my practice we have one clinician very close to endorsement for scheduled medicines, and 3 other clinicians have the potential (if they so desire) to undergo endorsement over the next 18 months-2 years. Having access to up to date prescription and dispense information would be a valuable tool in terms of patient safety/Quality Use of Medicines as well as clinical audits. Being able to add a prescription as a clinical event would also be valuable. This is not necessarily reduplication of PBS data because at this stage many non-medical prescriber prescriptions are not covered by the PBS.
c) Continuity of care for patients – without going into every example, I’d be inclined to highlight 2 scenarios:
a. A patient with a wound accessing multiple providers for care – adding an event with basic wound assessment data and treatment/dressing regime might help reinforce any written or verbal correspondence
b. Diabetic or vascular assessments – being able to upload most recent diabetic foot assessments or vascular assessments or at least record they have been done could help reduce duplication, improve patient flow (e.g. no need to wait for the podiatrist to come to ED if they’ve had dopplers/TBI done the week before in private practice), and be of use for geographically mobile patients
In terms of viewing information only, not having to go through to online portal to double check if they actually have an MHR would help overcome situations such as:

Not having up to date health summaries and patients who know they are on “ a little blue tablet, and half a white one”, for any clinician, having another way of accessing medicines information aids in diagnosis and treatment. E.g. I like to know if someone is on anti-coagulants before I go near them with something sharp, I like to know if they are on medicines that can interact with commonly recommended over the counter agents (EVEN THOUGH I still double check), and like to know if they are already being treated for a cause of a symptom, or if they are on medicines that could cause that symptom.

Imaging reports: e.g. today I was fortunate to be able to access some records I needed to help assess a complex wound, but it was far from straightforward. And I am in private practice so this type of patient isn’t my bread and butter, but it could equally have been a nuclear medicine scan for a stress fracture that aided my clinical decision making, or pathology results – it’s an aspirational goal but definitely foreseeable that more of these type of clinical records will be accessible through the MHR system.

I can appreciate that the MHR system has not yet had huge uptake but given that ADHA is rolling out training for non-GP health practitioners, increasing volumes of useful information e.g. prescription/dispense records, discharge summaries, health summaries etc, are being added in. At present it’s obviously an opt-in system, but if it were to become an opt-out system it’d be even more useful. And the more practitioners engage with and add useful information to it, the more helpful an initiative it will be. I’m not saying I need a compatibility update today by any means but knowing where a PMS provider is at regarding if/when they hope to become conformant would be useful for:

Giving feedback to other staff once training has been attended – e.g. for myself, when I speak to my colleagues about the system, I’d be saying that MHR is a great system with loads of potential, having used something vaguely similar in the public sector, BUT it seems unlikely that FrontDesk is going to be conformant any time soon so for now it’s not likely to be an easy to use tool and we probably don’t have to rush into learning about it.

Looking into priorities and planning for the future, e.g. if we were to have easy access to MHR, having an idea whether in the 6, 12, or 18 month window we will need to have policies, procedures and training in place for this particular initiative

For any new practices or practices looking at adopting PMS, considering whether their potential new PMS is conformant and supports this useful tool or has a timeframe when they are likely to come on board in the near future is worthwhile in informing their decision as to which software to adopt.

Kind regards,
Elyssa
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Timothy, Business Care Manager

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Hi Elyssa. Thank you for your reply.

Our best information is that though there has been money made available to GPs and medical PMS software companies for MHR implementations, as well as marketing for the 'opt in' option to patients, the system is grossly underutilised by the Australian health industry. At this stage, most GPs and specialists simply don’t use MHR to share their clinical information and very few patients have opted in to share their information. Further, there has been no money made available by ADHA for implementation in the allied health industry. 

Though you may be getting more of an upbeat story when speaking with MHR representatives, the reality is that most of your patients will not have any clinical notes, electronic imaging or drug information available and very few health professionals will be looking at your shared notes for the few patients that have allowed you to upload their data.

At this time our official position is that we are watching this space.
(Edited)
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Elyssa Hamad Mkali

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Fair enough. Thanks for the response :)
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Tracey Meyer

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Have there been any more thoughts on integration with My Health Record? We are getting pressure from the Murray PHN one of our contracts to look into it.
Cheers,
Tracey
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Timothy, Business Care Manager

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Hi Tracey. Thank you for your post. Please see above for our current position on this matter.
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Nat O

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Hi,
Just wondering whether anything further has been done on your current position? I have been made aware that as of 2018 there will be a large push for 98% of the population to have a myHealth record either created by them or for them. Although to date this record has been a very slow burner, it will only be a matter of months before we will be requiring better access and integration. And I would be very keen to have it as part FrontDesk.
Cheers
Natalie
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Tony Taddeo, Managing Director

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Hi Nat 

Thank you for your interest in MHR functionality in Front Desk. We will certainly be implementing functionality in this area, if it becomes commonly used by health professionals. 

Due to the many missed deadlines and targets since its release in July 2012, we remain sceptical if this will be in the next few months.

regards

Tony
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Sarah

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Hi there,

The department has now released it will be changing to an opt-out method - this means that somewhere in 2018 (I've heard September) every Australian will automatically have a MyHealthRecord unless they specifically opt out. More and more GP's and hospitals seem to be using it and all are learning as it will become the standard. The more health professionals that use the system, the more useful it will become. Is there any update on whether front desk will upgrade for this?

Kind Regards, 

Sarah
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Steven, Business Care

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Hi Sarah

We will be happy to integrate with my health record when it becomes a main stream tool for health professionals in Australia. Due to the many missed deadlines regarding its use and take-up in the past, it will need to be reality rather than just another proposed milestone for the project.
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Linda

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Hi Steven ,
My understanding is that by the end of 2018 this will be an opt out system. Our PHN has funding to assist allied health register for this and is also facilitating this with our local GP’s . Most of our hospitals are using it for discharge summaries and pharmacies are also using it. There is one other PMS that is available for allied health that has integrated it into their system. Our PHN is actively encouraging allied health to request it from their PMS suppliers and recommending those systems that have it. Have you reconsidered implementing it by the end of this year?
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Timothy, Business Care Manager

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Hi Linda, though your PHN may be upbeat regarding the My Health Record landscape the reality is that since its first release on 1, July 2012 (as the Personal Controlled Electronic Health Record) the actual use by health professionals is disappointingly low. Every few months since 2012, milestones have been set and then grossly missed regarding real world implementation levels for the system to be usable. I guess the latest hope is that an opt-out method, rather than opt-in for patients will improve its use. 

An article that I have handy shows that in August 2017 “...while 21 per cent of the population has a My Health Record, only 263 specialists were connected to the system, less than 150 hospital discharge summaries are viewed each month by any healthcare organisation, and about 200 GP-generated shared health summaries were accessed by staff working in public and private hospitals ..”

The full article can be found here: http://www.healthcareit.com.au/article/gps-and-hospitals-claim-my-health-record-not-fit-purpose-alar...

Even with 21% of the population registered at the time of the article, it shows medical specialists and GP’s are unanimously not keen to use the system. Will increasing the numbers of the population registered actually change this? We are happy to wait and see.

An up-to-date list of those that have integration with My Health Record can be found in the link below:  

https://www.myhealthrecord.gov.au/sites/g/files/net5181/f/register_detail_23oct18.pdf?v=1540433386

We don’t see any recognisable allied health PMS systems in this list.  

To answer your question, we would be more than happy to do a My Health Record implementation when it actually becomes a mainstream tool for health professionals or when funding for allied health, like that provided to the GP and medical specialist PMS industry, becomes available by the government.
(Edited)
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Linda

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Thanks for your response Timothy. I have passed on your response to our local PHN and they are taking this up with the national Digital Health team. It would be great to see some funding available for allied health software providers to enable you to come on board.
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Keryn

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Hi Smart Soft Team,

Our practice is really excited about the introduction of My Health Record and we hope that Smart Soft will be looking to integrate this system in with Front Desk.

We were offered a demonstration of the functions of My Health Record within Best Practice software. Their setup, functionality and integration looks really user friendly. Some other software do not look very easy to use, and appears they has been too rushed to make the function available, and as a result, have only created a sub-par function. I hope when Smart Soft look to build My Health Record into Front Desk, the right time is invested to make the integration comparable to that of Best Practice.

I am optimistically looking forward to seeing this part of Front Desk in the next 6 - 9 months.

Warm regards,
Keryn
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Sarah

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Hi there, 

Any update on this?

We have now already started the opt out period for My Health Record - between yesterday, and October patients must opt OUT, or automatically receive a My Health Record. Everyone is getting really excited about this but without software integration it makes it very difficult for Allied Health to go along.  This is not something that is going away.. and to be honest is going to be pivotal in Health care catching up with the rest of the world in terms of technology!

Again, the more it is available and used the better it will be, but the benefits for patients will be huge. 

Coming from general practice myself, I can assure you that whilst these things take time GP's (particularly the younger ones) are extremely keen on using this system as it does simplify their own work and patient flow. It also involves the patient a lot more in their own healthcare which is what GP's are after these days. But apart from GP's, it will be what the patients want. 

Fingers and toes crossed it's not too far away! :)
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Guppy

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This must be looked at as a priority for better patient care
Allied Health is a big part of the My Health Record do not leave them hanging.
Hospitals are putting up Discharge Summaries GP are referring, Pharmacies are on board, Specialist are now using it, what more do you need for convincing?
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Guppy

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I have seen them moving to BP to have this function

You could be the first
I am currently employed as a Digital Health Facilitator and hear it all the time
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Timothy, Business Care Manager

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Thank you for revealing your position in this matter. We don’t actually see any Front Desk users moving to BP as it is a GP centric system. As so much has already been spent on My Health Record, perhaps you could organise some funding for the allied health industry. That would definitely take out some of the risk for software developers who have been chasing a moving target for the past 5 years.
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Sarah

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This is not entirely true, there are several softwares that Allied Health use that have integrated My Health Record, including the Best Practice Allied Health software and several of the newer, cloud based softwares. (I found a list here https://trainitmedical.com.au/allied-health-providers-free-resources).

Whilst I agree there should be some funding available for Allied Health, we as your consumers have no power to make this happen. The My Health Record is only as useful as we make it, and without having the ability to upload or access it we cannot be part of journey. 

It's very disappointing to hear that despite the many that have expressed interest (see above) - this is still being treated as some sort of political issue rather than just getting on with it, even if the government changed it's mind... I'd prefer software vendors to move with the times, and change as they go if necessary... it's what we all have to do!
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Timothy, Business Care Manager

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Hi Sarah. Our link provided above is a primary source from the ADHA and is current as of 17/9/2018. I don’t see any of the cloud providers on this list? The only reference is to BP, which I guess we accept may include BP allied health. We believe that BP would've funded their interface through incentives provided to the GP industry for MHR. No such incentives have been made available for allied health. We are more than happy to complete an implementation when MHR becomes ratified and is used as a day to day tool by allied health professionals. We did the very same thing by being the first allied health PMS to introduce Medicare/DVA Online, HICAPS (non-dental) and Tyro. Alternatively, to take a leap of faith for a system that has missed every milestone for the last 5 years, there needs to be some funding for allied health professionals and PMS vendors, as has been the case for GPs.
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Guppy

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If you have a product and want to be competitive why should you get funded
My Health Record has not been a moving target so i am not sure what paper you been reading.  After the opt out period there will be a lot of My Health records created and activated once events get created.
It has been around for a lot of years. The problem has been the media beat up and to many sheep following each other. What the Allied Health clinics need is a leader someone who is prepared to help them. Listen to the feedback from the users it makes good business sense.
Can i suggest you visit the My Health Records site and download the facts brochure. It seems you have not read it yet as the Agency is now pushing to get Allied Health and Specialist connected.