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NACCHO 2018 National Conference – My Health Record
- 1. Australian Digital Health Agency
- 3. Health information that is available whenever and wherever it is needed Health information that can be exchanged securely High-quality data with a commonly understood meaning that can be used with confidence Better availability and access to prescriptions and medicines information Digitally enabled models of care that drive improved accessibility, quality, safety and efficiency A workforce confidently using digital health technologies to deliver health and care A thriving digital health industry delivering world-class innovation Australia’s National Digital Health Strategy
- 4. Australia’s National Digital Health Strategy Framework For Action How Australia will deliver the benefits of digitally enabled health and care
- 5. Framework for Action • The Framework for Action promotes collaboration and information sharing • Developed by all Australian governments, industry, and providers • Acts as a guide for organisations recalibrating their work programs to deliver national priorities • Priorities for delivery by 2022 include: o health information that can be exchanged securely o made available when and where needed o standardised so that it can be shared in real time.
- 7. A secure, legislated, patient-controlled, electronic summary of an individual’s key health information, able to be accessed by authorised individuals and registered healthcare providers involved in a person’s care anywhere in Australia at any time. What is My Health Record
- 8. QUEENSLAND WESTERN AUSTRALIA Vickey Hill Brian Peacock NSW, VIC, ACT Aboriginal Community Liaison Officers Pania Tahu
- 9. 9 FOR OFFICIAL USE ONLY 9 FOR OFFICIAL USE ONLY Key My Health Record system benefits Avoid adverse drug events Improved systems through secondary use of data Improvements in patient outcomes Reduced time gathering information Avoided duplication services Enhanced patient self-management
- 10. 10 FOR OFFICIAL USE ONLY 10 Individuals control who has access to their My Health Record Restrict access to specific documents in their record by establishing a code (LDAC) Restrict access to their record by establishing a code (RAC). Only authorised organisations can access record Subscribe to SMS or email alerts that report in real time when a new health provider organisation accesses their record In an emergency, a clinician can exercise a ‘break glass’ facility – but instances are monitored and logged. View the access history – all instances of access to My Health Record are monitored and logged Individuals can:
- 11. My Health Record opt out • This year, every individual with a Medicare or Department of Veterans’ Affairs card will get a My Health Record, unless they tell the Agency they don’t want one. • A four month opt-out period is now open until 15 November. • During this period, individuals can opt out by: o Visiting www.MyHealthRecord.gov.au or o Calling the Help line on 1800 723 471
- 12. Partnerships NACCHO (fortnightly meetings) Affiliates (monthly meetings) Clinical Peaks (invited collaboration) • Indigenous Allied Health Australia • National Aboriginal and Torres Strait Islander Health Worker Association • Congress of Aboriginal and Torres Strait Islander Nurses and Midwives • Australian Indigenous Doctor’s Association
- 13. Available collateral for Aboriginal and Torres Strait Islander consumers Tailorable Collateral • Ask your PHN for tailorable collateral with local images Translations • Translation of 60 second My Health Record video into 13 Indigenous languages • Factsheet translated into Kriol and Yumplatok Videos • Videos featuring Aboriginal and Torres Strait Islander providers and consumers Other channels • Remote Engagement Plan • Social Media • Local radio & TV • Newspaper advertisements
- 14. Information in Aboriginal and Torres Strait Islander languages On this page, you’ll find My Health Record videos and downloadable resources translated into 13 Indigenous languages. Aboriginal and Torres Strait Islander opt out materials Resources suitable for Aboriginal and Torres Strait Islander consumers. Aboriginal and Torres Strait Islander opt out materials Resources suitable for Aboriginal and Torres Strait Islander consumers. My Health Record Youtube Channel Barbara’s My Health Record Story For transient Aboriginal communities in Bourke and the surrounding region, it can be difficult managing chronic conditions between different healthcare providers. CEO of the Bourke Aboriginal Health Service, Barbara Flick (also known as Ungi), says that having a My Health Record means they will no longer need to tell the same story to new doctors over and over again. Esther’s My Health Record Story Aboriginal LGBTI woman, Esther Montgomery, is living with a number of chronic health conditions including high blood pressure, high cholesterol, diabetes and stage 2 renal disease. Her initial concerns about confidentially were overcome when she learnt more about My Health Record's privacy and access controls. Esther is encouraging everyone to find out the facts about My Health Record to decide whether it's right for them. Rob and Sandra’s My Health Record Story Rob and his wife Sandra use My Health Record when they travel, to give their healthcare providers a convenient snapshot of their health. Links to collateral
- 15. 15 FOR OFFICIAL USE ONLY 15 FOR OFFICIAL USE ONLY Feedback from the National Workshop – Accelerating Clinical Use How do we communicate to community? • Face to face • Host community events such as a BBQ or Movie Night • Videos with local champions explaining their stories • A leaflet with very simple English and lots of local photos • Audio recordings and Radio ads • Ensuring the materials are visual and colourful • Promotional merchandise (such as stickers, t-shirts etc) • Continued provider education so AMS staff can effectively communicate with patients
- 16. 16 FOR OFFICIAL USE ONLY
- 17. 17 FOR OFFICIAL USE ONLY
- 18. 18 FOR OFFICIAL USE ONLY 18 • Yumplatok • Kriol • Yolngu matha (NT – Arnhem Land) • Pitjanytjatjarra (NT, SA and WA – APY Lands) • Arrernte (NT – Central desert) • Warlpiri (NT – Central desert) • Gurindji Kriol (NT – North/central west region) • Roper River Kriol (NT – North/central east region) • Tiwi (NT – Tiwi Islands) • Murrinh Patha (NT – Port Keats region) • Kunwinjku (NT – Arnhem Land) • Alyawarr (NT – Central desert) • Anindilyakwa (NT – Groote Eylandt) • Pintupi Luritja (NT, WA – APY Lands) • Burarra (NT – Arnhem Land) The My Health Record video for ACCHOs is available in English and has been translated into 15 languages
- 19. 19 FOR OFFICIAL USE ONLY • Working with the communications team to distribute information to clinicians to raise awareness of the My Health Record and expansion program Education and support for clinicians in primary care, jurisdictions, ACCHOs and private hospitals to drive My Health Record clinical registration and use Clinical change leaders will be trained to support increased use across the organisations Phase 2: Enablement Strategy Phase 1 Awareness September 2017 – July 2018 Phase 2 Enablement August 2018 – February 2019 Phase 3 Participation March 2019 – June 2019
- 20. 20 FOR OFFICIAL USE ONLY 20 FOR OFFICIAL USE ONLY Registration Status TIER 1 NOT REGISTERED TIER 2 REGISTERED BUT NOT UPLOADING TIER 3 REGISTERED AND UPLOADING CLINICAL DOCUMENTS
- 21. 21 FOR OFFICIAL USE ONLY 21 FOR OFFICIAL USE ONLY Education for providers Enablement status scan Support NASH certificate and HPI-O registrations to increase My Health Record registration Tailorable resources, including guides (MMEX, Communicare) Education delivery (face to face, webinars, case studies) Increase upload of shared health summaries and meaningful use
- 22. 22 FOR OFFICIAL USE ONLY 22 FOR OFFICIAL USE ONLY How education will be delivered Work with delivery partners (including PHNs) Face to face Site visits Webinars National workshop 16 October Local & Regional workshops Videos Factsheets Education Toolkits Education and Training Request Form: https://conversation.digitalhealth.gov.au/training
- 23. High Value Clinical Content in My Health Record The map reflects high value clinical content contributions to My Health Record projected for December 2018. The overall RAG status for each state or territory is determined by a combination of availability of the indicators adjacent to each state/territory. AS AT 16.08.18 Path DI Pharm GPs Pvt Hosp Pub Hosp QLD Path DI Pharm GPs Pvt Hosp Pub Hosp NSW Path DI Pharm GPs Pvt Hosp Pub Hosp VIC Path DI Pharm GPs Pvt Hosp Pub Hosp ACT Path DI Pharm GPs Pvt Hosp Pub Hosp SA Path DI Pharm GPs Pvt Hosp Pub Hosp NT Path DI Pharm GPs Pvt Hosp Pub Hosp TAS Path DI Pharm GPs Pvt Hosp Pub Hosp WA
- 24. Top ten viewing organisations by view count, with ACCHOs highlighted Organisation Name Total MHR document views to Aug 2018 NSW Department of Health 45747 St Vincent's Hospital Sydney Ltd 29643 Townsville Hospital 19904 Danila Dilba Health Service 18144 Cairns Hospital 15361 Central Australian Aboriginal Congress 15059 Sana Medical Centre 11640 Wurli-Wurlinjang Health Service 10375 Mackay Base Hospital 9235 Huaco Pty Ltd 7334
- 25. Test Beds
- 26. What are test beds? Test beds are projects assessing new digitally enabled models of care that are instigated and delivered co-operatively through sustainable and viable partnerships between industry, government and other organisations. Their purpose is to promote innovation to address Australia’s highest priority health challenges, generating evidence of how the new approaches improve health outcomes, are worthy of securing ongoing investment, provide further business opportunities for partners and can be translated for usage more broadly across the health system.
- 27. Priority Health Areas Priority health areas for Digital Health Test Beds Consumer self-management, enhanced participation and empowerment Priority health areas for Digital Health Test Beds (cont’d) National Digital Health Strategy – Enhanced Models of Care – Health Priority Areas End of Life Care Chronic Disease Management Children’s Health Record Emergency CareEmbedding Telehealth Aged Care Digital literacy Workflow efficiency Primary and secondary prevention Aboriginal and Torres Strait Islander health Patient experience Integrated care
- 28. Continuity of Care for Prisoners Returning to the Community DESCRIPTION oUse the My Health Record to develop a coordinated information transfer and patient journey from prison to primary care. oEnsure that continuity of health care assists in preventing relapse or deterioration of mental and physical health conditions. LEAD ORGANISATION PARTNERS REGION(S) Empowerment Patient experience Digital literacy Workflow efficiency Integrated care Prevention Indigenous health End of life care Chronic disease management Aged care HEALTH PRIORITY AREAS Darling Downs & West Moreton PHN DURATION FY18/19 FY19/20 FY20/21 FY21/22
- 29. Prescribing Personalised Health Information to Improve Self-management DESCRIPTION oThis test bed will roll out the Healthily GoShare digital patient education platform oIt will provide timely, accessible, best practice information using email or SMS, tailored to health literacy levels, and will link to My Health Record and the hospital eMR. LEAD ORGANISATION PARTNERS REGION(S) Empowerment Patient experience Digital literacy Workflow efficiency Integrated care Prevention Indigenous health End of life care Chronic disease management Aged care HEALTH PRIORITY AREAS Perth DURATION FY18/19 FY19/20 FY20/21 FY21/22
- 30. Thank you
Editor's Notes
- About the Australian Digital Health Agency The Agency is tasked with improving health outcomes for all Australians through the delivery of digital healthcare systems, and implementing Australia’s National Digital Health Strategy – Safe, Seamless, and Secure: evolving health and care to meet the needs of modern Australia in collaboration with partners across the community. The Agency is the System Operator of My Health Record, and provides leadership, coordination, and delivery of a collaborative and innovative approach to utilising technology to support and enhance a clinically safe and connected national health system. These improvements will give individuals more control of their health and their health information, and support healthcare providers to deliver informed healthcare through access to current clinical and treatment information.
- How is the Australian health system ranked globally? By global standards, Australia ranks highest on Administrative Efficiency and Health Care Outcomes, and is among the top-ranked countries on Care Process and Access (Commonwealth Fund 2017). However, we know there are problems in the system that need to be addressed. For example: One in three GPs will see a patient for whom they have little or no health information. Many patient records are created as paper files. They are regularly transmitted between healthcare providers using unsecure email and fax machines. The introduction of a digital health system will help reduce these issues because: Content shared digitally between clinicians and patients means reduced risk of lost information Medicines information available securely online reduces patient safety risk People and clinicians will be able to see results of previous tests. Digital health benefits (featured in PowerPoint slide) Pre-birth: Content shared with My Health Record means reduced risk of lost information Adult: Digital tools make it easier to access services remotely Older adult: Medicines information available via My Health Record reduces safety risk Senior: People and their clinicians will be able to see results of previous tests
- The Agency is tasked with improving health outcomes for all Australians through the delivery of digital healthcare systems, and implementing Australia’s National Digital Health Strategy – Safe, Seamless, and Secure: evolving health and care to meet the needs of modern Australia in collaboration with partners across the community. Australians are increasingly able to access new digital services that help them take more control of their health and wellbeing following the launch of the strategy. The strategy is helping deliver improved services including digital baby books for new parents, and coordinated real time care for patients with chronic illnesses. In addition, GPs and other health professionals will no longer need to use fax machines to communicate key clinical reports, as they will transition to safer digital health services. The strategy has a clear plan for collaboration and action to improve health outcomes for all Australians. All Australian governments, industry, and providers have developed the first Framework for Action under the strategy. The framework promotes collaboration and information sharing, and acts as a guide for organisations recalibrating their work programs to deliver national priorities.
- Framework for Action notes available on next slide
- The Framework for Action is the implementation plan for the National Digital Health Strategy and details how all those in the digital health ecosystem are working together to help empower people, and those who care for them, with modern digital services and products. The Framework for Action outlines seven areas prioritised for delivery between 2018 and 2022 to realise the benefits of digitally enabled health and care. These priorities include health information that can be exchanged securely, made available when and where needed, and standardised so that it can be shared in real time. The seven priority areas include: 1. My Health Record - Health information that is available whenever and wherever it is needed 2. Secure Messaging - Health information that can be exchanged securely. 3. Interoperability and Data Quality - High-quality data with a commonly understood meaning that can be used with confidence. 4. Medicines Safety - Better availability and access to prescriptions and medicines information. 5. Digitally Enhanced Models of Care - Digitally-enabled models of care that drive improved accessibility, quality, safety and efficiency. 6. Workforce and Education - A workforce confidently using digital health technologies to deliver health and care. 7. Drive Innovation - A thriving digital health industry delivering world-class innovation.
- My Health Record notes available on next slide
- SYSTEM: Most of you would be aware that we have a very disconnected healthcare system. WASTED TIME: Many of you waste time chasing patient information. These statistics indicate how wasteful our current health system is and the dangers to patient safety that current practices pose.
- My Health Record benefits include reduced hospital admissions, reduced duplication of tests, better coordination of care for people with chronic and complex conditions, and better informed treatment decisions. A significant proportion of medication errors that lead to harmful Adverse Drug Events (ADE) may be preventable through increased accessibility to patient information, such as that provided by My Health Record: 2% to 3% of hospital admissions are caused by medication errors (230,000 per year at a cost of $1.2 billion annually) 2 of every 3 patients experience a medication error on admission Over 3% of people staying in hospital experienced an ADE as a cause of or during admission in an Australian study – over 10% of these were considered life threatening 12 to 13% of discharge summaries contain medication errors (2 per patient) Estimated 50% of ADEs could be avoidable by using My Health Record
- Currently the number of individuals opting to use these privacy settings is fewer than 2 out of every 1000 individuals registered, and where an individual has opted to use privacy settings, healthcare organisations do not have to be granted access to a My Health Record in order to upload to it. The following are some points to consider in relation to patient access and control: A patient can remove but not edit any document uploaded by a provider When attempting to remove a document, the patient will receive a system generated warning that this action may have an impact on their care Healthcare providers will not be notified that a document has been removed or that access to a document has been restricted by a patient. However, if you are the author of the removed document, when you access the patient’s My Health Record, this will be indicated to you in the document list Patients can view the access history of their My Health Record and see which organisations accessed and made changes to their record. Whatever is written in a uploaded document or summary will be fully visible to the patient and their authorised representative. All hospitals have policies on clinical documentation which reflects their interpretation of the My Health Records Act, Privacy Act and any local government nuances.
- By the end of 2018, a My Health Record will be created for every Australian, unless they choose not to have one. If people choose not to have a My Health Record, they will be able to opt out of having one created for them during a four-month period, starting on Monday 16 July and ending 15 November 2018. The Australian Government recently announced a one-month extension to the My Health Record opt out period. The opt out period will now end on 15 November 2018. This extension is to allow changes announced by the Minister to the My Health Records Act 2012 to be communicated with Australians. These legislative changes reflect evolving community expectations, and will ensure the operating practices of the Agency are enshrined in legislation to protect people’s privacy to this highest standard.
- The Provider Readiness stream’s main objective is to have healthcare providers aware of My Health Record; be able to discuss with a consumer what the benefits of My Health Record are; and know where to seek further information about My Health Record if required. This is achieved through a multi-layered, multi-channel, complex tailored change and adoption program based on the 3- tiered approach consisting of Awareness, Enablement and Participation that aims to achieve meaningful clinical use.
- State and territory breakdown of pathology, diagnostic imaging, pharmacy, GP, and hospital clinical content uploads to My Health Record as at 16 August 2018
- My Health Record notes available on next slide
- DESCRIPTION This test bed will use the My Health Record (MHR) to develop a coordinated information transfer and patient journey from prison to primary care. Information will be uploaded to the MHR from all health service providers who provided services to prisoners (including pathology, dental, sexual health, general practitioners) to ensure that former prisoners build on and maintain any health gains that they made in prison and to ensure that continuity of health care assists in preventing relapse or deterioration of mental and physical health conditions.
- This test bed will roll out the Healthily GoShare digital patient education platform Health professionals can send their patients customised bundles of credible health resources with the aim of improving integrated care and chronic disease self-management in Aboriginal and Torres Strait Islander communities at Midland Public Hospital. It will provide timely, accessible, best practice information using email or SMS, tailored to health literacy levels, and will link to My Health Record and the hospital eMR. The platform has already been deployed in West Syd and Vic